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30 Cards in this Set
- Front
- Back
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Increase gastric pH to above 4 so that pepsin is inactivated
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ANTACIDS
calcium-containing s/e - hypercalcemia w/ renal impairment Aluminum - constipation, hypophosphatemia Magnesium - hypermagnesemia, diarrhea Sodium - instigate CHF |
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Inhibit histamine at H2 Receptor --> reduced basal and food stimulated gastric acid secretion and volume
Associated w/ hypersensitivity, confusion in elderly, gynecomastia and infertility in males |
Cimetidine (tagamet)
also increases levels of drugs P450 system |
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Omeprazole
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Proton-pump inhibitor - irreversibly inhibits the H+/K+ ATPase pump of the parietal cell
Well tolerated |
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Effective for GUs and DUs, esophagitis, healing of ulcers assoc with NSAIDs, Zollinger-Ellison Syndrome, used in combination with antibiotics for H. pylori
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Proton Pump Inhibitors
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Sucralfate (carafate)
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Surface protective agent
forms ulcer adherent complex inhibits pepsin activity, absorbs bile salts, may stimulate PG secretion -short term treatement of DU - requires acidic envt |
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Bismuth Salts
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binding to ulcers, may stimulate PG synthesis, increase mucous production, inhibit pepsin
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Used in combination with antibiotics to decrease H pylori
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Bismuth salts
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analog of PGE1- used for NSAID induced ulceration
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Misprostol
CONTRAINDICATED IN PREGNANCY causes abdominal pain and diarrhea |
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Increases GI motility
Mimics cholinergic action but is a dopamine antagonist |
Metoclopramide
(can cause somnolence, nervousness, dystonia, parkinsonism, tardive dyskinesia) |
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Antiemetic with cholinergic and serotenergic activity
can cause fatal arrythmias |
Cisapride
(off the market) |
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Block Dopamine receptors in chemoreceptor trigger zone
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Phenothiazines
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Serotonin receptor antagonist used to treat nausea associated with cancer therapy
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Onsdansetron
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Dronabinon
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marijuana derivative
antiemetic |
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Opioid derivative used in treatment of diarrhea
usually used with atropine |
Diphenoxylate
(metabolized to active product) contraindicated in ulcerative colitis b/c of toxic megacolon |
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Loperamide
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inhibits Ach release through presynaptic opioid receptors in gut
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First line therapy for IBD
antiinflammatory agent - inhibits cyclooxygenase and lipoxygenase |
sulfasalazine
side effects:(20%)malaise, nausea, abdominal discomfort anorexia, folate malabsorption, hypersensitivity, many others |
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Tolerated by 80-90% of those who cant tolerate 5-ASA
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Olsalazine (dipentum)
contains 2 molecules of 5-ASA and is broken down in colon to release 5-ASA |
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Resin coated 5-ASA - released in a pH dependent manner in distal ileum and colon
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Mesalamine (Asacol)
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Ethycellulose coated 5-ASA - time dependent release from jejenum to colon
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Mesalamine (Pentasa)
best formulation for small bowel disease |
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immunomodulator that inhibits purine metabolism.
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6-MP (purinethol)
steroid sparing slow onset - 3 months bone marrow suppression, pancreatitis |
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Inhibits IL-2 - used as a temporary measure in severe colitis
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Cyclosporine
onset 1-2 weeks side effects: HTN, Seizures, Parasthesias, tremor, cholestasis, others |
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Folic acid antagonist most effective in crohn's disease.
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Methotrexate
steroid sparing |
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chimeric antibody against TNF-alpha. Used for moderate, severe or fistulizing crohn's disease
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Infliximab
s/e: increased risk of infection, infusion reaction, tachyphylaxis, nausea, serum sickness |
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Non-selective B-blocker
decreases renin, CO, and peripheral resistance |
proponolol
can cause bronchial constriction |
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Most popular selective B-blocker
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Metoprolol
(atenolol - similar but longer acting) |
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alpha1 and Beta blocker
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Labetalol
(carvedilol is another drug with combined a/B effects) |
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Peripheral A1 blocker - causes vasodilation without reflex cardiac stimulation
Used in HTN with benign prostatic hypertrophy |
Prasozin
Doxazosin S/E: Orthostasis - first dose effect - helped by taking at night |
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Central A2 agonist - decreases peripheral autonomic tone
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Clonidine
S/E - sedation, rebound HTN, dry mouth |
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Arterial vasodilator that works directly on smooth muscle
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Hydralazine
S/E: reflex tachycardia, Na retention and edema always use with B-blockers and furosemide |
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Potent arterial vasodilator that opens K channels- relaxation of smooth muscle cells but not used except for as a topical treatment for BALDNESS
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Minoxidil
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