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Less acid secretion

GI Drugs

Factors that protect gastric mucosa mucus, prostaglandins, bicarbonate, blood flow, restitution (repair)
Factors that damage gastric mucosa NSAIDS, acid secretion, Pepsin, H.Pylori, smoking, ischemia, alcohol, bile acids
What do Prostaglandins increase? increase bicarbonate, mucus, blood flow
Mucus is produced by what cells in the GI? chief cells
ASA is a NSAID that block what? prostaglandins
What 3 receptors enhance activity of acid secretion? H2, M3 (Ach), CCK
What 3 factors produce acid secretion? H2, Ach (M3), CCK
Histamine (H2) receptor, increase acid secretion and activity of proton pump
Ach (M3) increase acid secretion and activity of proton pump; muscuranic cholinergic, Ach receptor
CCK cholecystic kinase receptor, released by gastrin to increase acid secretion, gut hormone
What do villa do? increase surface area in the stomach
What do proton pump need to work or to be activated? needs ATP because it works against the gradient
How does the proton pump work? needs ATP, take protons (H+) from the blood into the stomach lining/contents to secrete acid
If you block one receptor will you still produce acid? YES
If you block proton pump will you still produce acid? NO
PUD is caused by what? H.Pylori
How does H.Pylori cause PUD? H.Pylori stimulate the production of acid secretion
Antacids Sodium Bicarbonate (Alka-Seltzer),Calcium Carbonate (Tums), Magnesium or Aluminum Hydroxide (Maalox) weak bases, used before H2 antagonists and PPI, affect absorption of other drugs by affecting solubility and pH (more basic/changing ionization-how much of drug gets absorbed)
Do not give what within 2 hours of tetracyclines, fluroquinolones, itraconzole, iron? antacids
H2 antagonists Cimetidine, Nizatadine, Ranitidine, Famotidine competitive inhibitors of parietal cell H2 receptors, blocks histamine, BID for GERD, PUD, stress ulcers (IV), not the best choice for PUD, structure looks like histamine to inhibit receptor, excreted via kidneys (GFR), first pass metabolism, minimal SE
Nizatadine H2 antagonists, do not undergo first pass metabolism (liver)
Cimetidine H2 antagonists, interfere w/CYP's (drug interactions)
Proton pump inhibitors Pantoprazole, Lansoprazole, Omeprazole, Esomeprazole, Rabeprazole irreversible inhibitors of parietal cell proton pump, inhibits ATPase, prodrugs activated at low pH (acidic), good choice for PUD, used for GERD, PUD (H.Pylori/NSAIDS), stress ulcers, safe, short half life, but 24 hrs inhibition, not excreted via kidneys
What are the drugs that block histamine? Cimetidine, Nizatadine, Ranitidine, Famotidine
Cimetidine, Nizatadine, Ranitidine, Famotidine H2 antagonists
What drugs block proton pump entirely? Pantoprazole, Lansoprazole, Omeprazole, Esomeprazole, Rabeprazole
Pantoprazole, Lansoprazole, Omeprazole, Esomeprazole, Rabeprazole Proton pump inhibitors
What group of drugs belong to this suffix - dine? H2 antagonists
What group of drugs belong to this suffix -prazole? proton pump inhibitors
What is triple therapy? treats ulcers from H.Pylori, used for 14 days, PPI, 2 ABX, Prostaglandin
What are the drugs for triple therapy? 1 PPI, 2 ABX, 1 prostaglandin: 1 PPI (BID) Clarithromycin (500mg BID) Amoxicillin (1g BID)/Metronidazole (500mg BID) Misoprostol (prostaglandin)
Once triple therapy regimen has ended, pt. continue taking what med? PPI daily for 4-6 wks to ensure healing
What may happen with chronic increases of gastric pH (basic)? increase gastric secretion increase bacterial colonization absorption of vitamins-B12,calcium, magnesium
Created by: cburrows



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