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Peptic Ulcers

USMLE Step 1

DrugMOA & ADRs
Cimetidine MOA: competitively - H2 receptors on parietal cells, 45 mins to work (taken 4 long term relief), also used 2 promote healing of ulcers & prevent future ulcers, used 2 tx GERD; ADRs: anti-androgenic -> gynecomastia, galactorrhea & decreased sperm count
Ranitidine MOA: competitively - H2 receptors on parietal cells, 45 mins to work (taken 4 long term relief), also used 2 promote healing of ulcers & prevent future ulcers, used 2 tx GERD
Nizatidine MOA: competitively - H2 receptors on parietal cells, 45 mins to work (taken 4 long term relief), also used 2 promote healing of ulcers & prevent future ulcers, used 2 tx GERD
Famotidine MOA: competitively - H2 receptors on parietal cells, 45 mins to work (taken 4 long term relief), also used 2 promote healing of ulcers & prevent future ulcers, used 2 tx GERD, most potent
Misoprostol MOA: analog of PGE2 works to decrease HCl secretion, often used to tx elderly pts who have been on long-term NSAID tx; ADRs: contraindicated in pregnancy due to cause uterine contractions, diarrhea, nausea
Omeprazole MOA: directly - the H+ pump, drug of choice for peptic ulcer; ADRs: increased gastric carcinoids from decreased HCl state & increased gastrin state, also indirectly increase gastric bacterial load
Lansoprazole MOA: directly - the H+ pump, drug of choice for peptic ulcer; ADRs: increased gastric carcinoids from decreased HCl state & increased gastrin state, also indirectly increase gastric bacterial load
Pirenzepine MOA: antimuscarinic act to - ACh effect H+ secretion, reserved for pts w/ Zollinger-Ellison or in pts 4 whom other txs failed, specific to M1 receptors (so affects stomach w/o affecting the heart, eye & salivary glands)
Antacids MOA: weak bases that form H2O and a salt when combined w/ HCl; ADRs: also affect other drugs that require a certain pH in order to be absorbed, pepsin is inactivated at pH > or = 7.4
CaCO3 MOA: similar to antacid, but counter-protective b/c works through the Ca it provides to increase gastrin production; ADRs: Al & Mg containing prods cause constipation or diarrhea respectively
NaHCO3 MOA: antacid; ADRs: systemic alkalosis, increased CO2 prod yielding flatulence, belching & increased serum Na, thus contraindicated in pts w/ HPTN or CHF
Sucralfate MOA: mucosal protection, binds + charged grps in proteins of nml & necrotic mucosa, decrease inflammation & heal existing ulcers
Bismuth MOA: works to - pepsin, increasing mucus interaction w/ necrotic tissues (it coats and protects the crater), decrease inflammation, heal existing ulcers, also toxic to H. pylori, as well as many other types of bacteria
Created by: jerrica_08
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