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  1. Omeprazole- Prilosec
    Proton Pump Inhibitor, supressant of acid secretion, gastric and duodenal ulcers and GERD.
  2. Mechanism of action for Prilosec
    It blocks the final common pathway of gastric acid production, omeprazole can inhibit basal and stimulated acid release
  3. S/S for Prilosec
    • 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.
  4. What does Gastrin do?
    stimulates hyperplasia in gastric epi cells whose growth may ultimately result in gastric garcinoid tumor.
  5. Reglan: Metaclopramide
    -supressess emisis (vomiting) by blocking receptors for dopamine serotonin in the CTZ (Chemoreceptor zone)

    Increases upper GI motility by enhancing the actions of acetylcholine
  6. S/S of Reglan metaclopramide
    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.
  7. What do dopamine antagonists do?
    increases gastrointestinal tone and motility antispasmodics
  8. misoprstol (Cytotec)
    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.
  9. S/S of Cytotec
    diarrhea, constipation

    Dont take when pregnant!! Prostaglandins stimulate uterine contraction.

    Category X
  10. Pepcid famotidine
    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
  11. Difference in direct and indirect acting stimuli for ondansetron Zofran
    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
  12. Zofran ondansetron
    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)
  13. S/S of ondansetron - Zofran
    common: headache, diarrhea, dizziness
  14. Esoemeprazole Nexium
    achieves higher blood levels then omeprazole and somewhat lasts longer.

    can be used for prophylaxis if NSAID-induced ulcers
  15. most common adverse effects of Nexium esoemeprazole
    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.
  16. What is calcium carbonate and what are the S/S?
    • 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.
  17. bismuth Pepto Bismol
    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.
  18. Flagyl metronidazole
    antibiotic for protozoal infections. could be used for patients with crohns disease.
  19. S/S for Flagyl metronidazole
    • 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.
  20. Lomotil diphenoxylate (plus atrophine)
    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.
  21. Docusate surgactant


    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.
  22. Phenothiazine and EPS -prochlorperazine
    suppresses emesis by blocking dopamine receptors in the ctz

    side effects: extrayramidal rxn, antibholinergenic effects, hypotension and sedation
  23. Cathartics
    promote fluid evactuation of bowel

    effect is relatively fast and intense
  24. Protonix pantoprazole
    • 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.
  25. Pilocarpine
    • 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
  26. S/S of Pilocarpine
    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
  27. Azelastine
    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
  28. S/S of Azelastine
    mild sedation and should not be comined with alcohol

    headache, drowsiness, pharyngitis, dry mouth, nose and throat, nausea, vomiting, and bowel changes.
  29. Albuterol
    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
  30. Ipratropium bromide (anticholinergenic agent) (atrovent)
    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
  31. common effects from Ipratropium bromide
    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
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