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Gastrointestinal - Pharmacology

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hezikry's version from 2015-08-06 20:27

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Question Answer
Cimetidine mechReversible block of histamine H2-receptors → ↓ H+ secretion by parietal cells
Ranitidine mechReversible block of histamine H2-receptors → ↓ H+ secretion by parietal cells
Famotidine mechReversible block of histamine H2-receptors → ↓ H+ secretion by parietal cells
Nizatidine mechReversible block of histamine H2-receptors → ↓ H+ secretion by parietal cells
Cimetidine usePeptic ulcer, gastritis, mild esophageal reflux
Ranitidine usePeptic ulcer, gastritis, mild esophageal reflux
Famotidine usePeptic ulcer, gastritis, mild esophageal reflux
Nizatidine usePeptic ulcer, gastritis, mild esophageal reflux
Cimetidine toxPotent inhibitor of P450 interferes with Phenytoin, theophylline and Warfarin
Antiandrogenic effects (prolactin release, gynecomastia, impotence, ↓ libido in males)
crosses BBB: confusion, dizziness, headaches
crosses placenta
↓ renal excretion of creatinine
Ranitidine tox↓ renal excretion of creatinine
H2 blocker A/E as a category.cause thrombocytopenia
Omeprazole (prazole) mechPPI. Another PPI is lansoprazole
Irreversibly inhibit H/K ATPase in stomach parietal cells
Omeprazole (prazole) usePeptic ulcer, gastritis, esophageal reflux, ZE syndrome, triple therapy
Omeprazole (prazole) tox↑ risk of C. diff infxn & pneumonia
↓ serum Mg with long-term use
Hypergastrinemia-increase in gastrin secretion by G cells
Quadruple therapy for H-Pyloribismuth, PPI, metro, tetracycline
Bismuth mechBinds to ulcer base providing physical protection and allowing HCO3 secretion to reestablish pH gradient in the mucous layer
Sucralfate mechBinds to ulcer base providing physical protection and allowing HCO3 secretion to reestablish pH gradient in the mucous layer
Bismuth use↑ ulcer healing, traveler's diarrhea, quadruple therapy for H. Pylori
Sucralfate use↑ ulcer healing, traveler's diarrhea, quadruple therapy for H. Pylori
Misoprostol mechPGE1 analog
↑ production and secretion of gastric mucous barrier
↓ acid production
Don't confuse w/mifepristone, progesterone inhibitor used for abortion
Misoprostol usePrevention of NSAID-induced peptic ulcers
Keeps patent ductus arteriosus open
Induce labor (ripens cervix)
Misoprostol toxDiarrhea
Contraindicated in women of childbearing potential (abortifacient)
Octreotide mechLong-acting somatostatin analog
Octreotide useAcute variceal bleeds
acromegaly
VIPoma
Carcinoid tumors
Secretory diarrhea
Octreotide toxNausea, cramps, steatorrhea
Antacid (general) toxCan affect metabolism/excretion of other drugs by altering gastric/urinary pH or by delaying gastric emptying
Can cause hypokalemia
A/E Aluminum hydroxide (antacid) overuseConstipation
proximal muscle weakness
hypophosphatemia & osteodystrophy
seizures
minimum amount of feces
A/E Magnesium hydroxide (antacid) overuseDiarrhea, hyporeflexia, hypotension, cardiac arrest
Must Go to the bathroom
A/E Calcium carbonate (antacid) overuseHypercalcemia, rebound acid remember that calcium stimulates G cells to produce gastrin, increases acid
Magnesium hydroxide mechosmotic laxative - osmotic load draws water out
Magnesium citrate mechosmotic laxative - osmotic load draws water out
Polyethylene glycol mechosmotic laxative - osmotic load draws water out
Lactulose mechosmotic laxative - osmotic load draws water out
Also treats hepatic encephalopathy since gut flora degrades it into lactic acid & acetic acid → promotes nitrogen excretion as NH4+
Magnesium hydroxide toxDiarrhea, dehydration
May be abused by bulimics
Magnesium citrate toxDiarrhea, dehydration
May be abused by bulimics
Polyethylene glycol toxDiarrhea, dehydration
May be abused by bulimics
Lactulose toxDiarrhea, dehydration
May be abused by bulimics
Infliximab mechMAB to TNF-α
Infliximab useCrohn's disease, UC, RA
Infliximab toxInfection (including reactivation of latent TB), fever, hypotension
Sulfasalazine mechSulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory)
activated by colonic bacteria
Sulfasalazine useUC, Crohn's
Sulfasalazine toxMalaise, nausea, sulfonamide tox, reversible oligospermia
Ondansetron mech5-HT3 antagonist
Powerful central-acting antiemetic
Ondansetron useControl vomiting postop or in cancer chemo pts or in pregnancy
Ondansetron toxheadache, constipation, QT prolongation
Metoclopramide mechD2 receptor antagonist
↑ resting tone, contractility, LES tone, motility
Does not influence colon transport time
Metoclopramide useDiabetics and post-surgery gastroparesis
antiemetic
Metoclopramide tox↑ parkinsonian effects
Restlessness, drowsiness, fatigue, depression, nausea, diarrhea
Interactions with Digoxin and diabetic agents
Contraindicated in pts w small bowel obstruction or Parkinson's
Orliostatinhibits gastric and pancreatic lipase decreases breakdown and absorption of dietary fays
Use of orliostatweight loss
motilin mechanismincrease phase III contraction of MAC
motilin usegastrophoresis that have not responded to metoclopramide or domperiodne
toxicity of motilinnausea, vomiting, QT prolongation
What disease do PPIs cover that H2 blockers do notZollinger-Ellison syndrome (increased gastrin)
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