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H2 blockers: names and MOA
- Cimetidine, ranitidine, etc
- Reversible block of histamine H2 receptors
- Decreases secretion by parietal cells
- Take before eating
-
H2 blockers: toxicity
- P450 inhibitor
- Antiandrogenic
- Cross BBB (confusion, HA) and placenta
- Decreased renal excretion of creatinine
-
-
PPIs: MOA
Irreversibly inhibit H/K-ATPase in parietal cells
-
Bismuth and sucralfate: MOA and use
- For ulcer healing and traveler's diarrhea
- Bind to ulcer base providing protection
- Allow bicarb secretion to reestablish pH gradient in the mucous layer
-
What is triple therapy of h. pylori ulcers?
- Metronidazole
- Amoxicillin (or tetracycline)
- Bismuth
-
Misoprostol: MOA
- PGE1 analog
- Increases gastric mucous barrier
- Decreases acid production
-
Misoprostol: uses
- Prevent NSAID ulcers
- Maintaine PDA
- Induce labor
-
-
Muscarinic antagonists: names
-
Muscarinic antagonists for PUD: MOA
- Block M1 receptors on ECL cells to decrease histamine secretion
- Block M3 receptors on parietal cells to decrease proton secretion
-
Muscarinic antagonists: toxicity
Tachy, dry mouth, difficulty focusing eyes
-
Antacids: problem
- They can affect concentrations of other drugs by altering gastric/urinary pH or delaying gastric emptying
- They can also cause hypokalemia
-
Antacids: names and problem with overuse
- Aluminum hydroxide: constipation and hypophosphatemia (--> muscle weakness, osteodystrophy, seizures)
- Magnesium hydroxide: diarrhea, hyporeflexia, hypotension, cardiac arrest
- Calcium carbonate: hypercalcemia, rebound acid
-
Infliximab: MOA
Monoclonal TNF antibody
-
Infliximab: uses
- Crohns
- Rheumatoid arthritis
-
Infliximab: toxicity
- Respiratory infection
- fever
- hypotension
-
Sulfasalazine: MOA
- Combination of sulfapyridine and 5-aminosalicylic acid
- Activated by colonic bacteria
-
Sulfasalazine: toxicity
- Malaise, nausea
- Sulfa allergen
- Reversible oligospermia
-
Ondansetron: MOA
- Serotonin antagonist
- Central-acting antiemetic
-
Ondansetron: toxicity
HA, constipation
-
Metoclopramide: MOA
- D2 receptor antagonist
- Increases resting tone, contractility, LES tone, motility
- Does not influence colon transport time
-
Metoclopramide: use
Diabetic and post-surgery gastroparesis
-
Metoclopramide: toxicity
- Parkinsonian
- Interacts with digoxin and diabetic agents
- Don't use in small bowel obstruction
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