Pharmacology

Proton Pump Inhibitor, supressant of acid secretion, gastric and duodenal ulcers and GERD.

It blocks the final common pathway of gastric acid production, omeprazole can inhibit basal and stimulated acid release

• Headache, diarrhea, N/V (minor effects)
• Gastric cancer- hyper gastric secretion of gastrin.
• Hip fracture- high dose increases the risk of osteoporosis and fractures, reducing acid secretion may decrease absoprtion of calcium.

stimulates hyperplasia in gastric epi cells whose growth may ultimately result in gastric garcinoid tumor.

-supressess emisis (vomiting) by blocking receptors for dopamine serotonin in the CTZ (Chemoreceptor zone)

Increases upper GI motility by enhancing the actions of acetylcholine

can suppress post op nausea and vomiting as well as emesis caused by anti cancer drugs, opioid toxins and radiation therapy.

High dose therapy sedation and diarrhea are common.

increases gastrointestinal tone and motility antispasmodics

analog of prostaglandin E, protects against NSAID induced ulcers by stimulating secretion of mucous and bicarbonate, maintaining submucosal bloodflow and suppressing secretion of gastric acid- treats peptic ulcers. PUD is the most common.

diarrhea, constipation

Dont take when pregnant!! Prostaglandins stimulate uterine contraction.

Category X

antisecretory agent, H2 antagonists

this drug is approved for treatment and prevention of duodenal ulcers, gastric ulcers, GERD and hypersecretory states (Zollinger-Ellison Syndrome)

take 1 hour ac with glass of water

does not suppress metabolism of other drugs

direct acting stimuly include signals from the cerebral cortex (anticipation or fear), signals from sensory organs (upsetting sights, noxious odors, or pain) and signals from the vastibular apparatus of the inner ear)

• indirect actin stimuli first activate the chemoreceptor trigger zone which in turn activates the vomiting center. Activation occus in 2 ways:
• -signals from the stomach and small intestine (along vagal afferents)
• -by direct action of emetogenic compounds- anticancer drugs, opioids, ipecac

used to prevent nausea and vomiting associated with radiotherapy and anesthesia; more effective when combines with dexamethasone

Benefits derive from blocking type 3 serotonin receptors (5-HT3 receptors)

common: headache, diarrhea, dizziness

achieves higher blood levels then omeprazole and somewhat lasts longer.

can be used for prophylaxis if NSAID-induced ulcers

headache and diarrhea may cause: nausea, flatulence, abdominal pain and dry mouth/ pose a risk of osteoporosis and fractures, may increase a risk for pneumonia if gastric pH is elevated.

• antacid
• alkaline compounds neutralize stomach acid: PUD and GERD; rapid acting, effects are of long duration.

adverse effects: constipation

calcium carbonate releases carbon dioxide in the stomach which can cause flatulence and belching.

act topically to disrupt the cell wall of H. Pylori causing lysis and death, cn cause black color on tongue and black stools, patient should be forewarned, black stool may interpretate gastric bleedinng, long term use for neurologic injury.

antibiotic for protozoal infections. could be used for patients with crohns disease.

• common: nausea, vomiting
• RXN can occur: Disufiram can occus if taken with alcohol; should not be taken when pregnant. long term use can cause peripheral neuropathy.

opioids, antidiarrheal agents

Lonox, Logen, Lomanate

used only for diarrhea, no effect of CNS, but can have typical morphine like rxn's when taken by high doses, taken orally, insoluble to water, cannot be abused by parental routes.

laxative

Colase

docusate sodium, penetrates small intestine and colon, all doses taken with full glass of water

inhibits fluid absorption

stimulate secretion of water and electrolytes into the intestinal lumen

docusate calcium

BOTH surgactant action softens stool by facilitating penetration of water, also causes secreation of water and electrolytes into intestine.

suppresses emesis by blocking dopamine receptors in the ctz

side effects: extrayramidal rxn, antibholinergenic effects, hypotension and sedation

promote fluid evactuation of bowel

effect is relatively fast and intense

• proton pump inhibitor
• like omeprazole

indications are duodenal ulcers, gastric ulcers, GERD and hypersecretory states

• PO or IV, most common effect:
• orally: diarrhea, headache and dizziness
• IV: diarrhea, headache, nausea, dyspepsia
• Inj site: thrombophlebitis and abscess may increase risk for pneumonia.

• By stimulating choinergenic receptors in the eye, it produces two direct effects:
• -Miosis- constriction of the pupil secondary to contraction of the iris sphincter
• -contraction of the ciliary muscle- an action that focuses the lens for near vision

IOP reduced indirectly

Contraction of the ciliary muscle focuses the lens for near vision

sustaines contraction of the ciliary muscle causes retinal detachment

constriction of the pupil

visual acuity caused by contraction of the iris sphincter

local irritation, eye pain and brow ache

antihistamines (nonsedating) intranasal and nasal spray

blocks the release of histamine and other mediators from mast cells

complain of a bitter taste. both drugs are indicated for allergic rhinitis in adults and children over 12 years. 2 sprays in each nostril, twice dails, somnolence develops in an increased amount of users

mild sedation and should not be comined with alcohol

headache, drowsiness, pharyngitis, dry mouth, nose and throat, nausea, vomiting, and bowel changes.

Beta 2 androgenic agonists, used in asthma patients, MDI (90 mcg/puff), solution for nebulizer, 2 puffs every 4-6 hours, dosing is 3-4 times a day, long term control

muscarinic antagonist, indications, allergic rhinitis, asthma and common cold.

does not decrease sneezing, nasal congestion or postnasal drip

nasal spray, 12 yr and older, 2-3 times a day

nasal dying and irritation, relieves bronchospasm, COPD, promotes bronchodilation, drug may raise IOP in glaucoma patients, patients with peanut allergy and soya protein should avoid, available in: MDI (combivent and solution for nebulation) Duoneb