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  1. What are 3 gastric cells that are involved in gastric acid production?
    parietal, chief, and mucous cells
  2. what do parietal cells do?
    produces and secretes HCL acid
  3. What do chief cells do?
    • Secretes pepsinogen
    • converts pepsinogen into pepsin in the acidic gastric environment
  4. What do mucous cells do?
    • Secretes mucous
    • Vital in maintaining the protective gastric mucosa lining
  5. What is the mechanism of the action of antacids?
    • Antacids:
    • used to neutralize gastric acid
    • promotes gastric mucosal defenses
  6. What are antacids made up of?
    • Aluminum
    • Magnesium
    • Calcium
    • Sodium
  7. What are the reasons for Antacids?
    • Treat symptoms of:
    • PUD
    • Gastritis
    • Gastric Hyperacidity
    • Heartburn
  8. What type of people should not take antacids?
    Patients with renal insufficiency
  9. What are the overall side effects of antacids?
    • Alkalosis
    • Mask symptoms of other disease
  10. What is the side effect of antacids with magnesium?
    Diarrhea
  11. What is the side effect of antacids with aluminum?
    • Constipation
    • Hypercalcemia
    • Hypophosphatemia
  12. What is the side effect of antacids with Calcium?
    • Constipation
    • kidney stones
    • rebound hyperacidity
  13. What does antacids do when interacted with benzodiazepines, sulfonylureas, valproic acis?
    Enhancment of these drugs
  14. When should you take any other medications in regards to taking an antacid?
    1-2 hours before or after an antacid
  15. What are the types of Alumunium and magnesium antacids that are available?
    • Maalox
    • Mylanta
  16. What are the types of calcium antacids that are available?
    • Tums
    • Rolaids (with Mg)
  17. What are the types of magnesuim antacids that are available?
    Milk of Magnesia
  18. What are they types of sodium bicarbonate antacids that are available?
    Alka-Seltzer
  19. What is the rule of thumb about mixing antacids with other drugs?
    do not mix
  20. What is the mechanism of action for H2R blockers?
    Decreases HCL acid secretion by blocking the H2 receptor sites of the parietal cells
  21. What are the indications of H2R blockers?
    • GERD
    • PUD
    • Esophagitis
    • Gastric Hypersecretory
    • Upper GI bleeding
    • Prophylactic to prevent stress ulcers in critically ill patients
  22. What type of patients should not take H2R blockers?
    Patients with liver and renal insuffiency
  23. What are the side effects of H2R blockers?
    • Hypotension (IV)
    • Headache
    • Lethargy, Confusion/Disorientation
    • Nausea, Diarrhea, Abdominal cramps
    • Impotence
    • Increased liver function tests, BUN, CREAT
  24. What type of H2R blockers are available?
    • Cimetidine (Tagament)
    • Famotidine (Pepcid)
    • Ranitidine (Zantac)
    • Nizatidine (Axid)
  25. What type of interaction does cimetidine (Tagament) have on theophylline, warfarin, lidocaine, phenytoin?
    Increase there therapeutic effect.
  26. What is the mechanism of action of proton pump inhibitors?
    • Prevents H ion movement out of parietal cells
    • Produces a temporary achlorhydric state
  27. What is the indication for proton pump inhibitors?
    • 1st line drug treatment for:
    • GERD
    • Esophagitis
    • Active gastric & duodenal ulcers
    • Gastric hypersecretory
    • NSAID induced ulcers
    • Preventative for stress ulcers
    • H. Pylori infections
  28. What type of proton pump inhibitors blockers are available?
    • Omeprazole (Prilosec)
    • Pantoprazole (Protonix)
    • Lansoprazole (Prevacid)
    • Rabeprazole (Aciphex)
    • Esomeprazole (Nexium)
  29. When should you take proton pump inhibitors?
    • Orally 30-60 mins before a meal
    • Not with anyother meds
  30. What type of interaction does proton pump inhibitors have on diazepam & phenytoin?
    Increases
  31. What type of interaction does proton pump inhibitors have on Warfarin?
    Increases bleeding risk
  32. What type of interaction does proton pump inhibitors have on Digoxin, Ampicillin, & Iron?
    Decreases absorption
  33. What type of medication is Sucralfate (Carafate)?
    Anti-ulcer/Mucosal Protectant
  34. What are the indications for Sucralfate (Carafate)?
    Used to treat stress ulcers & PUD
  35. What are side effects to Sucralfate (Carafate)?
    Constipation, nausea, and dry mouth
  36. When should you give Sucralfate (Carafate)?
    1 hour before a meal and at bedtime
  37. What type of drug is Misoprostol (Cytotec) and what is it used for?
    • Cytoprotective
    • Prevents induced ulcers caused by NSAIDS
  38. What is side effects of Misoprostol (Cytotec)?
    • Headache
    • GI upset
    • vaginal bleeding
  39. What type of patients should not get Misoprostol (Cytotec)?
    Patients that are pregnant.
  40. Which neurotransmitters stimulate nausea & vomiting?
    • Acetylcholine (ACh)
    • Dopamine (D2)
    • Histamine (H1)
    • Prostaglandins (PG)
    • Serotonin (5-HT3)
  41. What are the mechanism of action for anitemetics?
    • Work at various points in the vomiting pathway to prevent the neurologic stimulus to vomit
    • Relief of nausea & vomiting
  42. What are the 6 types of antiemetics?
    • 1.Anticholinergics
    • 2.Antihistamines
    • 3.Neuroleptics (Phenothiazines)
    • 4.Prokinetics
    • 5.Serotonin Blockers
    • 6.Tetrahydrocannabinol
  43. What are the mechanism of action of anticholinergics?
    • Bind to & block ACh receptors in the vestibular nuclei
    • Blocks ACh receptors in the reticular formation
  44. How do anticholinergics work to prevent nausea?
    • Prevents nausea signals going to the CTZ & VC
    • Dry GI secretions & decrease smooth muscle spasms
  45. What type of anticholinergics drugs are avaliable?
    • Scopolamine
    • Atropine
  46. What are side effects of anticholinergics?
    • antisecretory
    • antispasmodic
  47. What type of antihistamine (h1blockers) are avaliable?
    • Meclizine (antivert) PO
    • Dimenhydrinate (Dramamine)
    • Diphenhydramine (Benadryl)
  48. What are the indications for neuroleptics aka Phenothiazines?
    Prevents nausea & vomiting by blocking dopamine receptors in the CTZ
  49. What type of neuroleptics drugs are available?
    • Prochlorperazine (Compazine)
    • Promethazine (Phenergan)
  50. What is the most common side effect of neuroleptics?
    • Extrapyramidal Reaction-involuntary motor symptoms
    • EKG changes-prolongs the QT interval (affects heart rate)
  51. What type of extrapyramidal reation is motor restlessness?
    Akathisia
  52. What type of extrapyramidal reation is painful or forecful muscle contraction?
    Dystonia
  53. What type of extrapyramidal reation is involuntary contractions of the oral & facial muscles?
    Tardive Dyskinesia
  54. What is the mechanism of action of prokinetics?
    Blocks dopamine receptors in the CTZ
  55. How does prokinetics drugs work?
    • Stimulates GI peristalsis
    • Enhances gastric emptying
  56. Metoclopramide (Reglan) is what type of drug?
    prokinetics
  57. How does Metoclopramide (Reglan) work?
    • Increases GI mobility
    • Decreases N&V
  58. What type of patients should not get Metoclopramide (Reglan)?
    • Patients with seizure precautions
    • Patients with GI obstruction
    • Patients with allergies to procaine & procainamide
  59. What is the mechanism of action of serotonin blockers?
    Blocks serotonin receptors in the GI tract, CTZ, and vomiting center
  60. Ondansetron (Zofran) is what type of drug?
    Serotonin Blocker

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Author:
 bpayton
ID:
 210315
Filename:
 gi drugs
Updated:
2013-03-30 08:53:16
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pharm
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Description:
GI drugs
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