Med Chem 2

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What are some direct irritants to the GI tract?
- Potassium supps
- bisphosphonates
- NSAIDs
What are some drugs that lower esophageal sphincter tone and cause GERD?
- calcium channel blockers
- theophylline
- anti-cholinergics
- codeine
- narcotics
- beta agonists
- estrogen
- progesterone
What type of bacteria is H. pylori?

gram (-) rod
What is the hallmark test to see if you have an H. pylori infection?
- Urea test
- 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)?

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)
antispasmodics/anticholinergics/antimuscarinic MOA?

inhibits the action of acetylcholine at the postganglionic parasympathetic neuroeffector sites
What will a normal dose of an anticholinergics and a large dose do?
- normal: muscarinic receptor antagonists
- high: blocks nicotinic sites
Name the belladonna alkaloids.
- L-Hyoscyamine
- Atropine sulfate
- scopolamine hydrobromide
Name the quaternary anticholinergics.
- methscopolamine bromide
- clininium bromide
- mepenzolate
- glycopyrrolate
- methantheline
- propantheline
- tridihexyl Cl
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

Author

leo25

168776

Card Set

Med Chem 2

Description

Quiz 1

Updated

2012-09-04T01:18:15Z

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