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44 Cards in this Set
- Front
- Back
What med is used for improvement of mucosal defense?
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sucralfate 1 gm QID
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What drug is used to increase prostaglandin defense for prophylaxis of PUD?
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Misoprostol 200 mcg QID
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What is the pharmacologic approach to HP-induced ulcers?
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multi-drug regimen
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Dual drug therapy approach to HP-induced ulcer - which drugs and how is the eradication rate?
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clarithromycin + PPI
Amoxicillin + PPI Poor eradication |
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Triple drug therapy aproach to HP-induced ulcer - which drugs?
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PPI + 2 abx (amoxil, metronidazole, clarithro)
or 2 abx + ranitidine |
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Quad. drug therapy approach to HP-induced ulcer -
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Bismuth subsalicylate based (BSS)
2 abx + BSS +(H2 or PPI) Poor compliance |
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What do anticholinergics, ca channel blockers, benzos, estrogens/progesterones, narcotics, NSAIDS, nicotine, nitrates, xanthines predispose you for?
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GERD
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3 complications of untreated GERD?
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Erosive espohagitis and strictures
Barrett's esophagus GI bleeding |
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Typical symptoms of GERD
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heartburn
regurg belching hypersalivation |
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Atypical symptoms of GERD
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chronic hoarseness
cough dysphagia wt loss wheezing non-cardiac CP Bleeding |
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Name 2 GERD meds that increases gut motility and increase LES resting tone.
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metoclopramide (DA antagonist)
erythromycin (stim motilin receptors) |
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What are adverse effects of prokinetic agents used for GERD?
(metoclopramide and erythromycin) |
diarrhea, CNS effects, cardiac arrythmias
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What are CI to prokinetic agents for GERD?
(metoclopramide and erythromycin) |
bowel obstruction/perf
phemochromocytoma seizure history |
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Which drug class neutralizes pH of stomach acid within the lumen?
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Antacids
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Which drug class decreases acid secretion by competitive inhibition of histamine receptors in gastric parietal cells?
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H2 receptor antagonists
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Name 4 H2 RA's
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famotidine
ranitidine cimetidine nizatidine |
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SE of H2 RA's
(7) |
H/A
diarrhea constipation CNS excitation (cimetidine) thrombocytopenia -rare cardiac arrhyth. - rare |
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Do H2 RA's have Drug interations?
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yes
(warfarin, theophylline, diazepam, phenytoin, metronidazole, propranolol) |
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Which drug class decreases gastric acid secretion by irreversible inhibition of the parietal cell H+/K+ ATP pump?
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PPI
(lansoprazole, omprazole, rabeprazole, pantoprazole, esomeprazole) |
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Do PPI's have drug interactions?
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yes
keto/itroconizole digoxin diazepam theophylline carbamezepine |
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What is the treatment for stage I GERD?
(intermittent, mild heartburn) |
lifestyle changes
antacids and/or H2RA's 2-4 wk oromeprazole x 2 wks. |
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What is the treatment for stage II GERD?
(symptomatic relief of GERD) |
lifestyle changes
H2RA's 4-12 weeks or PPI's4-12 weeks QD |
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what is the treatment for stage III GERD?
(tx of complications) |
lifestyle changes
H2RA's high dose 8 - 12weeks PPI's 12 weeks BID |
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What are drug interactions from when using sucrulfate?
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it binds to other drugs.
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What is a SE of Misoprostol?
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uterine contractions
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What is the MOA of Loperamide?
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Inhibit cholinergic nerves
increased colonic transit time and fecal water absorption class - opiod agonist |
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What drug is a naturally occuring peptide in GI tract?
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Somatostatin (octreotide)
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Which drug inhibits secretion of hormones, reduces intest and panc secretion, slows GI motility, inhibits gallbladder contract, and inhibits GH?
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Somatostatin (octreotide)
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What are SE of octreotide?
(9) |
Fat-soluable vitamin defic.
nausea abd pain flatulence diarrhea gallstones glucose hypothyroid bradycardia |
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What is the MOA of aminosalicylates?
(sulfasalazine, mesalamine, olsalazine, blasalazide) |
anti-inflammatory
for crohn and UC |
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What are SE of aminosalicylates?
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N/V
anorexia HA rash anemia hepatitis pancreatitis |
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What drug is an immunosuppressant used for UC and crohn dz which decreased mets of purines?
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Azathioprine (imuran)
(response may take months) |
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What are SE of azathioprine?
(Imuran) |
rash
nausea diarrhea neutropenia |
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What is 6-MP?
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6-Mercaptopurine
cell cycle specific antineoplastic may take months for crohn and UC |
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What drug is a selective serotonin agonist for women only?
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Tegaserod (zelnorm)
IBS |
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What is Tegaserod (zelnorm) CI in?
(4) |
severe renal or hepatic dz
gallbladder d/o bowel obstr. |
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What are SE of Tegaserod?
(zelnorm) |
diarrhea, HA, abd pain, inc risk of cholecystect.
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What drug is a selective serotonin antagonist which improves diarrhea, and abd pain in females and is avail only with restricted use?
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Alosetron (Lotronex)
reports of severe constipation w/ bowel obstr. |
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What drug class is effective for vagal stimulation and antiemetic during chemo?
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serotonin antagonist
(ondansetron, granisetron, dolasetron, palonosetron) can be assoc with QT prolongation |
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Are corticosteroids used in conjunction with other antiemetics?
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yes
dexaethasone methylpredisolone |
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Name a neurokinin receptor antagonist used for an antiemetic?
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Aprepitant
- crosses the BBB - inhib CYP450 - $$$ |
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Which antipsychotics are used for antiemetics
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phenothiazines and butyrophenones
SE EPS droperidol - prolongs QT |
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What drug is excreted in bile, decreased hepatic chol secretion and used for symptomatc gallstones when surgery isn't possible?
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Ursodiol
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What drugs are given for GI bleed (varices)?
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Somatostatin (octreotide)
vasopressin |