Nu 578, Unit 4 - GI Drugs
Study online at https://quizlet.com/_c8dooq
1. Treatment Goal for PUD/ GERD: •Main treatment goal: neutralization of stomach acid
•Oxyntic glands in stomach secrete acid (parietal cells)
•To get maximum acid secretion, these cells need to be stimulated by gastrin + ACh + histamine
•If any one of these 3 is “, acid secretion will be markedly “
2. acid secretion: - ‘ACH ‘gastrin in gut
-Histamine is always available in gut
- when the 3 work together, They stimulate the parietal cells to ‘HCI secretion.
3. Cimetidine (Tagamet): H2 receptor antagonist
- PUD or GERD tx
- Inhibits P450 enzymes.
- Well tolerated, but watch for renal/hepatic tox in older patients.
4. Ranitidine (Zantac): H2 receptor antagonist
- PUD or GERD tx
-Less P450 inhibition—on recall due to contaminant that may cause cancer
5. Famotidine (Pepcid): H2 receptor antagonist
- PUD or GERD tx
- No P450 inhibition
6. Nizatidine (Axid): H2 receptor antagonist
- PUD or GERD tx
- No P450 inhibition—recalled drug
7. Aluminium salts(Remegel): - Antacid
- PUD or GERD tx
- Constipation, hypercalcemia
8. Ca carbonate(Tums): - Antacid
- PUD or GERD tx
- Constipation, hypercalcemia
9. Mg salts(Milk of Magnesia): - Antacid
- PUD or GERD tx
- diarrhea
10. Na citrate (Bicitra): Prep-op antacid
11. Sucralfate (Carafate): Forms protective coat over ulcer, causes constipation
1/6
, Nu 578, Unit 4 - GI Drugs
Study online at https://quizlet.com/_c8dooq
12. Metoclopramide (Reglan): - ‘rate of gastric emptying
- extrapyramidal effect, possible
- do NOT use w/MAOIs or antipsychotics
13. Cisapride (Propulsid): ‘GI motility by ‘ACh release. Used for GERD
14. Omeprazole (Prilosec)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Rabeprazole (Aciphex): - Inhibits H+ secretion by blocking H+/K+ ATPase.
- Also inhibits P450.
- PPIs—Proton Pump Inhibitors.
- Linked to chronic kidney disease with long term use; difficult to deprescribe without a lot of acid reflux
15. Misoprostol (Cytotec): - PG derivative.
- Protects stomach by ‘HCO3 + mucus secretion.
- Do NOT use in pregnancy!
16. Treatment of Ulcers: • Ulcers are usually colonized by H pylori which delay the healing process. Strategies
for PUD combine an H2 antagonist or PPI+ an antacid + an antibiotic
• Most H2 blockers have best efficacy if given 30-60 min before meal
• Watch coadministration of other drugs with antacids!
17. Combination treatment for Ulcers: • Helidac—Bismuth subsalicylate, metronidazole, tetracycline.
Tell patient to also take a PPI or H2 blocker
• Pylera—Bismuth subcitrate, metronidazole, tetracylcine. Tell patient to take a PPI or H2 blocker.
• Prevpac—Lansoprazole, amoxicillin, clarithromycin.
18. Diphenoxylate + Atropine (Lomotil): - Diarrhea tx
- Binds both opiate and ACh receptors in GI
- Do NOT use in parasitic/bacterial infections
- Do NOT use w/MAOIs
19. Loperamide (Imodium): -Opiates
-Tx for diarrhea
- do not use w/ MAOIs
2/6
Study online at https://quizlet.com/_c8dooq
1. Treatment Goal for PUD/ GERD: •Main treatment goal: neutralization of stomach acid
•Oxyntic glands in stomach secrete acid (parietal cells)
•To get maximum acid secretion, these cells need to be stimulated by gastrin + ACh + histamine
•If any one of these 3 is “, acid secretion will be markedly “
2. acid secretion: - ‘ACH ‘gastrin in gut
-Histamine is always available in gut
- when the 3 work together, They stimulate the parietal cells to ‘HCI secretion.
3. Cimetidine (Tagamet): H2 receptor antagonist
- PUD or GERD tx
- Inhibits P450 enzymes.
- Well tolerated, but watch for renal/hepatic tox in older patients.
4. Ranitidine (Zantac): H2 receptor antagonist
- PUD or GERD tx
-Less P450 inhibition—on recall due to contaminant that may cause cancer
5. Famotidine (Pepcid): H2 receptor antagonist
- PUD or GERD tx
- No P450 inhibition
6. Nizatidine (Axid): H2 receptor antagonist
- PUD or GERD tx
- No P450 inhibition—recalled drug
7. Aluminium salts(Remegel): - Antacid
- PUD or GERD tx
- Constipation, hypercalcemia
8. Ca carbonate(Tums): - Antacid
- PUD or GERD tx
- Constipation, hypercalcemia
9. Mg salts(Milk of Magnesia): - Antacid
- PUD or GERD tx
- diarrhea
10. Na citrate (Bicitra): Prep-op antacid
11. Sucralfate (Carafate): Forms protective coat over ulcer, causes constipation
1/6
, Nu 578, Unit 4 - GI Drugs
Study online at https://quizlet.com/_c8dooq
12. Metoclopramide (Reglan): - ‘rate of gastric emptying
- extrapyramidal effect, possible
- do NOT use w/MAOIs or antipsychotics
13. Cisapride (Propulsid): ‘GI motility by ‘ACh release. Used for GERD
14. Omeprazole (Prilosec)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Rabeprazole (Aciphex): - Inhibits H+ secretion by blocking H+/K+ ATPase.
- Also inhibits P450.
- PPIs—Proton Pump Inhibitors.
- Linked to chronic kidney disease with long term use; difficult to deprescribe without a lot of acid reflux
15. Misoprostol (Cytotec): - PG derivative.
- Protects stomach by ‘HCO3 + mucus secretion.
- Do NOT use in pregnancy!
16. Treatment of Ulcers: • Ulcers are usually colonized by H pylori which delay the healing process. Strategies
for PUD combine an H2 antagonist or PPI+ an antacid + an antibiotic
• Most H2 blockers have best efficacy if given 30-60 min before meal
• Watch coadministration of other drugs with antacids!
17. Combination treatment for Ulcers: • Helidac—Bismuth subsalicylate, metronidazole, tetracycline.
Tell patient to also take a PPI or H2 blocker
• Pylera—Bismuth subcitrate, metronidazole, tetracylcine. Tell patient to take a PPI or H2 blocker.
• Prevpac—Lansoprazole, amoxicillin, clarithromycin.
18. Diphenoxylate + Atropine (Lomotil): - Diarrhea tx
- Binds both opiate and ACh receptors in GI
- Do NOT use in parasitic/bacterial infections
- Do NOT use w/MAOIs
19. Loperamide (Imodium): -Opiates
-Tx for diarrhea
- do not use w/ MAOIs
2/6
