Med Chem 2
What are some direct irritants to the GI tract?
What are some drugs that lower esophageal sphincter tone and cause GERD?
calcium channel blockers
What type of bacteria is H. pylori?
gram (-) rod
What is the hallmark test to see if you have an H. pylori infection?
labeled carbon 13 or 14
Explain the urea test.
H. pylori produces a urease enzyme that cleaves urea into CO2 and ammonia
the ammonia allows the bacteria to penetrate the protective mucous layer
patients eats carbon 13/14 radioactive labeled urea
plasma or breath is indication of (+) infection
What is the ultimate mediator of acid secretion?
H+ K+ ATPase proton pump
Which H2RA increases transaminases (liver enzymes)?
What is the S enantiomer of omeprazole?
Both men and women should take what in addition to a PPI?
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
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?
What would you give to an asian friend who needed a PPI?
Nexium or Prilosec?
Which H2RA has the most drug interactions and should not be recommended?
reversible competitive antagonists at H2 receptors in gastric parietal cells
What is the only PPI that is not indicated for treating a duodenal ulcer?
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)
inhibits the action of acetylcholine at the postganglionic parasympathetic neuroeffector sites
What will a normal dose of an anticholinergics and a large dose do?
: muscarinic receptor antagonists
: blocks nicotinic sites
Name the belladonna alkaloids.
Name the quaternary anticholinergics.
antispasmodic used to treat functional bowel/IBS?
Dicyclomine HCl (Bentyl)
MOA saline laxatives?
osmosis caused by the salt anions and cations draws water into the gut lumen resulting in increased intraluminal pressure
leads to increased peristalsis
Med Chem 2