Which H2RA increases transaminases (liver enzymes)?
Nizatidine (Axid)
What is the S enantiomer of omeprazole?
esomeprazole (Nexium)
Both men and women should take what in addition to a PPI?
calcium supplements
What is bad about PPIs?
decrease bone resorption of calcium by inhibiting the osteoclastic vacuolar H+K+ATPase
they make osteoporosis worse because they decrease stomach acid and you need stomach acid to absorb calcium salts: HYPOCHLORHYDRIA
What is the role of prostaglandins?
increase mucous and bicarbonate
What property of PPIs makes them have a longer duration of action (up to 3 days)?
highly protein bound 95-98%
What are the two most common side effects of a PPI?
headache
diarrhea
Protonix
Pantoprazole
Aciphex
Rabeprazole
Prevacid
Lansoprazole
Dexilant
Dexlansoprazole
Nexium
esomeprazole
What would you give to an asian friend who needed a PPI?
Nexium or Prilosec?
Nexium
Which H2RA has the most drug interactions and should not be recommended?
Tagamet (cimetidine)
Pepcid
Famotidine
Ranitidine
Zantac
Duexis
Ibuprofen/famotidine
H2RA MOA
reversible competitive antagonists at H2 receptors in gastric parietal cells
What is the only PPI that is not indicated for treating a duodenal ulcer?
Protonix
Which drugs are primarily used to decrease motility by decreasing smooth muscle tone in the GI, biliary and urinary tracts providing anti-secretory effects?
anticholinergics and antispasmodics (antimuscarinic)