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38 Cards in this Set

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What are the protective effects of the stomach? What hormone produces it?
increase blood supply, increase mucus and bicarbonate-----Prostaglandins
Gastric acid increase is caused by
endogenously - histamine, gastrin, acetylcholine --------------- others - infection, NSAIDs, smoking
What antibiotics are used to treat ulcer disease
amoxicillin, clarithromycin, tetracycline, metronidiazole
What are the types of antiulcer drugs?
H2 receptor (histamine) inhibitor ------------- Proton pump inhibitor ------------- Mucosal protectants ------------- Prostaglandin replacement therapy
What is the mechanism of Cimetidine?
(H2 inhibitor) - H2 receptor stimulates acid production. Cimetidine blocks this receptor. Ranitidine also.
What is the action of Omeprazole?
(proton pump inhibitor) - irreversible inhibition of enzyme that secretes gastric acid. Also Esomeprazole, Lansomeprazole.
What is mechanism of Sucralfate?
(Mucosal protectant) - creates protective barrier around ulcer
What is Mechanism of Misoprostal?
(prostaglindin replacement) - analog for endogenous Prostaglandin E - stomach protective effects
Mechansims of antacids?
alkaline substances that neutralize stomach acid
Compare Cimetidine and Ranitidine adverse effects.
Ranitidine produces similar, but less adverse effects. ------- Cimetidine has anti-androgenic effects ( gynocomastia, reduced libido, impotence) ------ hallucinations in the elderly --------- hypotension and dysrhythmias from IV Bolus
What effect does concurrent food have with Cimetidine?
prolongs the effect of Cimetidine
What reduces absorption of Cimetidine?
antacids
How long does Omeprazole have an effect?
irreverible binding to proton pump enzymes. replaced after 2 hours.
Omeprazole reduces the absorption of what?
Ataznavir (HIV) and ketoconazole (antifungal)
What medications are contraindicated with sucralfate?
antacids, proton pump inhibitor, H2 receptor antagonist b/c sucralfates require and acid pH for proper activation
What is the most common adverse effect of sucralfate? What can be done to avoidit?
constipation. drink at least 1500 ml/day and high fiber diet
What antiulcer drugs are contraindicated for pregnancy?
misoprostal (prostaglandin replacement) and cemitidine (H2 antagonist)
What are adverse effects for Misoprostal?
abdominal pain, diarrhea, cramping and vaginal bleeding in women
What antacid may cause acid rebound?
Calcium carbonate
What antacid can cause hypertenntion and HF
sodium bicarb - not used often
What are different kinds of antacids?
Mg(OH)2, Al(OH)2 -------- Calc Carb, Sodium Bicarb
How does methylcellulose and psyllium work?
bulk formaing lax - retains water as it moves down tract
How does docusate sodium work?
surfactant lax - decrease surface tension on stool allowing water to be absorbed
How does Bisacodyl work?
Stimulant lax - stimulate intestinal motility
How does lactulose work?
osmotic lax - disaccharide not absorbed, water pulled into intestines
What does Mg(OH)2 do?
both antacid and laxative. as laxative, salts are not absorbed through GI wall. Water pulled in through osmotic effect.
What does sodium phosphate do?
osmotic laxative - as laxative, salts are not absorbed through GI wall. Water pulled in through osmotic effect.
How does a glycerin suppository work?
lubricant - like mineral oil, it softens stool
What is a precaution for osmotic laxatives?
since evacuates large amt of watery stool, keep hydrated
What laxative causes a burning sensation??
bisacodyl (due to intestinal motility?)
While on laxatives it is important to
take fluids
What are the kinds of antidiarrheal meds?
opiates (paregoric) and opiodios (lomotil, loperamide = immodium, bismuth subsalicylate = pepto bismol)
What is the action of odensatrion
serotonin receptor antagonist (seratonin associated with emesis)
Action of Metclopramide?
1. block dopamine and serotonin receptors 2. inc upper GI motility and tone
Action of scopolamide?
for motion sickness - muscarinic antagonist, suppressing neuarl activity in pathway to middle ear
Action of chlorpromazine?
block dopamine
Action of Dramamine?
blocks acetylcholine and histamine, blocking neuronal receptors in path from inner ear to vomit center
Action of antivert?
blocks acetylcholine and histamine, blocking neuronal receptors in path from inner ear to vomit center