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GASTROENTEROLOGY
| Question | Answer |
|---|---|
| (1) ANTACIDS | --ALUMINUM HYDROXIDE (MYLANTA) --MAGNESIUM HYDROXIDE (TUMS) --CALCIUM CARBONATE |
| (1) ANTACIDS MOA | -NEUTRALIZE GASTRIC ACID -INCREASE SECRETION OF MUCUS |
| (1) ANTACIDS INDICATED FOR: | --INDIGESTION --REFLUX ESOPHAGITIS --PEPTIC ULCERS --SYMPTOMATIC TX OF GERD |
| (1) ANTACID ADVERSE EFFECTS: | --ALUMINUM HYDROXIDE: hypophosphatemia; osteodystrophy --MAGNESIUM HYDROXIDE: hypermagnesemia; loss of deep tendon reflexes --CALCIUM CARBONATE: hypercalcemia |
| (1) ANTACIDS CONTAINING BOTH ALUMINUM AND MAGNESIUM | Used in order to balance the other's effect: Magnesium has laxative effects and Aluminum has constipating effects |
| (2) H2 ANTAGONISTS | -CIMETIDINE -FAMOTIDINE -RANITIDINE -NIZATIDINE |
| (2) H2 ANTAGONIST MOA: | -BLOCK HCL SECRETION -BLOCK SECRETORY RESPONSES TO FOOD STIMULATION |
| (2) HISTAMINE: | FOUND IN LUNGS, SKIN, GI RELEASED BY MAST CELLS IN TYPE 1 HYPERSENSITIVITY EXERTS ITS ACTIONS BY COMBINING WITH SPECIFIC CELLULAR HISTAMINE RECEPTORS ( H1-H4)-->H2 IS INVOLVED IN GASTRIC ACID SECRETION |
| (2) H2 ANTAGONIST INDICATED FOR: | -INDIGESTION -HEART BURN -DUODENAL ULCER -ZOLLINGER ELLISON SYNDROME |
| (2) H2 ANTAGONIST ADVERSE EFFECTS: CIMETIDINE | -CIMETIDINE: 1. INHIBITS CYTOCHROME P450-> DECREASES METABOLISM OF DRUGS AND INCREASE THEIR TOXICITY (theophylline, warferin, phenytoin, diazepam) 2. decreases androgens-->causes gynecomastia and decreased libido |
| (2) H2 ANTAGONIST ADVERSE EFFECTS 2: FAMOTIDINE | -FAMOTIDINE: blood dyscrasia (similar to thrombocytopenia, leukopenia, agranulocytosis) SMOKING DECREASES THE EFFECT OF H2 RECEPTOR ANTAGONISTS |
| (3) PROTON PUMP INHIBITORS: | --OMEPRAZOLE --LANSOPRAZOLE --ESOMEPRAZOLE |
| (3) PPI MOA: | -BLOCK GASTRIC ACID SECRETION BY INHIBITING THE H2/K+/ ATP-ase PUMP -DECREASE GASTRIC ACID SECRETION |
| (3) PPI INDICATED FOR: | -EROSIVE (ACUTE ) ESOPHAGITIS -GERD -DUODENAL ULCER -H. PYLORI |
| (3) PPI CONTRAINDICATED FOR: | -HYPERSENSITIVITY -PREGNANCY -BREAST FEEDING |
| (3) PPI ADVERSE EFFECTS: | -DECREASED BIOAVAILABILITY OF DRUGS THAT NEED ACIDITY LIKE CIPROFLOXACIN OR KETOCONAZOLE |
| H1 RECEPTOR ANTAGONISTS | --NO SEDATION-- LORATIDINE CETIRIZINE FAXOFENADINE --SEDATION-- DIPHENYHYDRAMINE PROMETHAZINE (slight alpha blockade) CHLORPHENIRAMINE MECLIZINE (Rx for Motion Sickness) HYDROXYZINE ( NO drowsiness or sedation bec doesn't cross BBB) |
| H1 RECEPTORS ANTAGONISTS INDICATED FOR | ALLERGIC REACTIONS NAUSEA AND VOMITING SLEEP AIDS AND COLD MEDS |
| H1 ANTAGONISTS ADVERSE EFFECTS | ANTICHOLINERGICS (DRY MOUTH, DRY EYES, URINE RETENTION AND CONSTIPATION) SEDATION IN SOME |
| (4) OTHER DRUGS USED IN GASTRIC INJURY | SUCRALFATE MISOPROSTOL |
| (4) SUCRALFATE | FORMS PROTECTIVE RESISTANT SHIELD IN THE ULCER SIDE EFFECT: CONSTIPATION |
| (4) MISOPROSTOL | PROSTAGLANDIN ANALOGUE PROSTAGLANDIN SUPPRESS GASTRIC SECRETION INDICATED FOR WHEN NSAIDS CAUSE ULCERS |
| WHY DO NSAIDS AND ASPIRIN CAUSE ULCERS? | THEY INHIBIT PROSTAGLANDIN COX-->PG-->INCR GASTRIC SECRETION NSAIDS DECR PG THEREFORE INCR GASTRIN SECRETION |
| BEST APPROACH IN TREATING H. PYLORI: | TRIPLE THERAPY: 2 ANTIBIOTICS + 1 PPI AMOXICILLIN + CLARITHROMYCIN + OMEPRAZOLE |
| ANTIEMETICS: | METOCLOPRAMIDE CHLORPROMAZINE PROMETHAZINE HALOPERIDOL SCOPOLAMINE ONDANSETRON DOLASETRON DRONABINOL APREPITANT |
| ANTIEMETIC 1. METOCLOPRAMIDE: MOA | CENTRALLY: INHIBIT DOPAMINE IN CTZ PERIPHERALLY: REVERSE THE MOTILITY OF VOMITING REFLEX--> INHIBITS D2 REC IN GIT * sphincter tone increases leads to downward peristalsis |
| ANTIEMETIC 1. METOCLOPRAMIDE: INDICATED FOR: | -NAUSEA AND VOMITING WITH CANCER CHEMOTHERAPY -TREATMENT OF POST-OP NAUSEA AND VOMITING -USED AS PROKINETIC-->IMPROVES PERISTALSIS-->PREVENTS REFLUX--GERD |
| ANTIEMETIC 1. METOCLOPRAMIDE: SIDE EFFECTS | DIARRHEA; HYPOTENSION; PARKINSON LIKE EFFECTS--dopamine receptors are blocked; HYPERPROLACTINEMIA: Galactorrhea; Gynecomastia; Impotence, and menstrual disorders -EPS AS WELL: Dystonia, Akathisia; Pseudoparkinsonism; Tardive Dyskinesia |
| ANTIEMETIC 2. CHLORPROMAZINE; PROMETHAZINE; HALOPERIDOL | --PROMETHAZINE IS AN H1 REC ANTAGONIST --CHLOPROMAZINE AND HALOPERIDOL ARE ANTIPSYCHOTICS -HOW TO DECREASE NAUSEA AND VOMITING? BLOCK DOPAMINE REC IN CTZ |
| ANTIEMETIC 2. CHLORPROMAZINE; PROMETHAZINE; HALOPERIDOL: ADVERSE REACTIONS: | EPS SIDE EFFECTS |
| ANTIEMETICS 3. SCOPOLAMINE AKA HYOSCINE | --ANTICHOLINERGIC INDICATED TO PREVENT NAUSEA AND VOMITING BY BLOCKING THE LABYRINTHE VESTIBULAR SYSTEM (RICH IN ACH) --MOTION SICKNESS-- |
| ANTIEMETICS 3. SCOPOLAMINE SIDE EFFECTS: | ANTICHOLINERGICS: DRY MOUTH; URINARY RETENTION; CONSTIPATION; TACHYCARDIA; MIDRIASIS -WHEN ORALLY TAKEN IT IS BETTER TO USE TRANSDERMAL PATCH APPLIED BEHIND EAR |
| ANTIEMETICS 4. ONDANSETRON AND DOLASETRON | --5HT3 (SEROTONIN) RECEPTOR ANTAGONIST-- CENTRALLY: AT CTZ PERIPHERALLY: GI TRACT -1ST LINE DRUG IN PREVENTION OF NAUSEA AND VOMITING DUE TO CANCER DRUGS (given 30 mins before chemo |
| ANTIEMETICS 5. DRONABINOL + CANNABINOIDS (MARIJUANA) | FOR NAUSEA AND VOMITING DUE TO CHEMO MOA: DECREASE EMESIS BY ACTIVATING |
| ANTIEMETICS 6. APREPITANT | SUBSTANCE P/INK1 RECEPTOR ANTAGONISTS INDICATED FOR: PREVENTION OF NAUSEA AND VOMITING OF CHEMOTHERAPY--2ND LINE DRUG |
| EMETICS: 1 ACTIVATED CHARCOAL: MOA AND INDICATION: | FILTER THE POISON FROM THE GIT--DOESN'T BIND LITHIUM OR IRON USED FOR POISONING AND OVERDOES AFTER ORAL INGESTION |
| EMETICS: ACTIVATED CHARCOAL SIDE EFFECTS AND CONTRAINDICATIONS | PULMONARY ASPIRATION--ASPIRATION PNEUOMO CONTRAINDICATED FOR ACID, ALKALI AND PETROLEUM INGESTION |
| ANTIDIARRHEALS: LOPERAMIDE + BISMUTH SUBSALICYLATE | OPIOID RECEPTOR AGONIST -MOA: DECREASE THE ACTIVITY OF THE MYENTERIC PLEXUS--DOESN'T CROSS BBB SO NOT ADDICTIVE AND DOESN'T CAUSE EUPHORIA INCREASES TONE OF SMOOTH MUSCLE AND DECREASE PERISTALSIS |
| ANTIDIARRHEAL: [DIPHENOXYLATE AND ATROPINE] | CAN CAUSE ADDICTION AND EUPHORIA--CROSSES BBB--THEREFORE PAIRED WITH ATROPINE WHICH BALANCES THE DIPHENOXYLATE AS IT CAUSES UNPLEASANTNESS |
| ANTIDIARRHEALS: CONTRAINDICATIONS: | ABDOMINAL PAIN OF UNKNOWN CAUSE WITH FEVER---SHOULD BE FIRST TREATED WITH ANTIBIOTICS |
| LAXATIVES: BULK FORMING | PSYLLIUM: SWELLS IN GIT AND FORMS GEL WHICH DISTENDS COLON |
| LAXATIVES: HYPEROSMOTIC | LACTULOSE: INCREASES FLUID MOVEMENT: USED TO DECREASE AMMONIA IN PATIENTS WITH HEPATIC ENCEPHALOPATHY POLYETHYLENE GLYCOL AND ELECTROLYTE: GoLYTELY: USED FOR BOWEL CLEANSING BEFORE COLONOSCOPY--V. SAFE |
| LAXATIVES: STIMULANT | BISACODYL |
| LAXATIVES: STOOL | DOCUSATE CALCIUM |
| LAXATIVES: INCREASING LUMINAL PRESSURE | INCREASE LIQUID CONTENT |
| LAXATIVES: CONTRAINDICATIONS: | ABDOMINAL PAIN OF UNKNOWN CAUSE WITH FEVER--COULD BE A SIGN OF OBSTRUCTION |
| RX FOR INFLAMMATORY BOWEL DISEASES: ULCERATIVE COLITIS AND CROHN'S DISEASE | SULFASALAZINE -- [5-ASA + SULFAPYRIDINE] 1ST LINE MESALAMINE: SALICYLIC ACID INFLIXIMAB (MONOCLONAL AB)--BLOCKS TNF ALPHA |
| RX FOR INFLAMMATORY BOWEL DISEASES: ULCERATIVE COLITIS AND CROHN'S DISEASE: NEW DRUG | TEGASEROD: 5-H4 AGONTIST--MOA: ACTIVATION OF REC IN GIT-->STIMULATES PERISTALTIC EFFECT THIS IS A NEWLY APPROVED DRUG FOR THE RELIEF OF IRRITABLE BOWEL SYNDROME OF CONSTIPATION IN WOMEN DIAGNOSED WITH IBS |
Created by:
quinze
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