Term
| agrerssive factors ofpepdtid disease |
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Definition
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Term
| defensive factors of bile |
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Definition
| mucous and bicarb secretion, prostaglandins, blood flow ,restitutionafter cellular injury |
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Term
| peptic ulcer drugs subdiciosn |
|
Definition
| reduce acidity, and increse mucousal defense |
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Term
| thre agonists of acid secertion |
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Definition
| histamine, acetylcholaine, and gastrin. |
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Term
| final common pathway of acid secretion |
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Definition
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Term
| h2 receptor antagonist naming |
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Definition
| cimetidine, ranitidine, famotidien ,nizaditine |
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Term
| h2 receptor agonists pharmacokinetics |
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Definition
| nizatididne has greatest oral bioavailbilty, with short half lives, all have alot of first pass metabolism, Dose dependant DOA. |
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Term
| 2 receptor agonist clerance |
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Definition
| combiantion fo hepatic metabolism and kidney. |
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Term
| h2 receptor agonist dose reduciton onsiderations |
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Definition
| in patients with renal sufficiency and in the elderly |
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Term
| h2 receptor agonists pharmacodynamics |
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Definition
| compettivie inbhitiors of histamine- suppress basaland meal stimualted acid secretion. |
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Term
|
Definition
| highly selective for h2 reeceptors. |
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Term
| h2 agonists clincial utility |
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Definition
no logner front line, PPI are stronger.
OTC preps are available. |
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|
Term
| h2 agonists clincial utility |
|
Definition
no logner front line, PPI are stronger.
OTC preps are available. |
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Term
| h2 receptor antagonists GERD |
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Definition
| h2 antagonists is useful for infrequent ( <3 times a week) heartburn of dyspepsia. frequent heartubrn better treated wit PPIs |
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Term
| h2 receptor antagonists GERD |
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Definition
| h2 antagonists is useful for infrequent ( <3 times a week) heartburn of dyspepsia. frequent heartubrn better treated wit PPIs |
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Term
| h2 antagonists in peptic ulcer disease |
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Definition
| ppis largely replace it. however efective for nocturanal acid suppresion. with signiciant ulcer healing. |
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Term
| h2 antagonists adverse effects |
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Definition
| safe drugs. Cimetidie has most side effects- poor clearance in elderly- toxic properties of cimetidine ; glaactorhea in women, gynecomastia in men., also confusion states. h2 antagonists cross placenta, dontgive to pregnant women, also in breast milk. |
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Term
| h2 antagonist drugi nteractions |
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Definition
| cimetidine only one that is problematic, inhibits manyp cyp enzymes in cluding cyp3a4 |
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Term
|
Definition
| omeprazole, esomeprzole Iansoprazole, pantoprazole, rabeprazole. |
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Term
|
Definition
| lipohillic weak base prodrug. Diffuses readily acorssl iid emmbrane, and goes into acidic comparments of secretory canalliculus of parietal cels. There it is converted to active form via protenaation, and forms covalvent Disulfide bonds with H/k atpase- irreversibly inactving enzyme |
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|
Term
| differneces between different PPIs |
|
Definition
| minimal, different drugs are basically same use. |
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|
Term
|
Definition
| is decreased severely by food, admiister on empty stomach (1 hr before meal) |
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Term
|
Definition
24 hours , despite halflife of 2-3 hours.
takes 3-4 days to full acid inhibiting potential, also 3-4 days of nto taking drug for full acid secretion to return. |
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|
Term
|
Definition
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|
Term
|
Definition
| hepatically metabolzied , no renal clearance, onlyworry about patients with very severe liver disease. |
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|
Term
|
Definition
pPIs supress both fasting and meal stimualted acid secretion, much betetr htan h2 antagoninsts. inhibit 90-98 percent of 24 hr acid secretion.
Little difference between different PPis for lcincial utility |
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Term
| GERD clincial utility PPI |
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Definition
| most effective agents for treatmetn of nonerosive/erosive GeRD. Once dialy dosing for relief and tissue healingi n most patients. First line therapyfor GERD. |
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Term
| PPI clinical utility peptic ulcer disease |
|
Definition
| more rapid symtpom relief adn faster ulcer healing than h2 antagonists |
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|
Term
|
Definition
| tripletherapy: PPI, clarithromycin, and amoxicillin or metronidzole. |
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Term
| PPI inhibitors clinical utility for NSAID associated ulcers |
|
Definition
if can discontinue NSAIDS h2 antagonists and PPI are equally effectivei n ulcer ealing.
However with conitnued NSAID use PPIs only are used |
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|
Term
|
Definition
PPIs are safe. GI effects.
total acid block is problematic- increased susceptiblity - particularly enterigus bug int ravle to udnerdeveloped countried, and C. Dif infections in hospitals |
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Term
|
Definition
| magnesium hydroxide and aluminum hydroxide (basicall weak bases). |
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Term
| antacids clinical utility |
|
Definition
too short acting, may promote healing in duodenal ulcersl
weak nuetralizing capacity,
For treatmetnof GERD- may beaffective in symptoamtic treatmetn but wont efefct natural progresison of disease |
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|
Term
| antacids clinical utility |
|
Definition
too short acting, may promote healing in duodenal ulcersl
weak nuetralizing capacity,
For treatmetnof GERD- may beaffective in symptoamtic treatmetn but wont efefct natural progresison of disease |
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|
Term
|
Definition
magnesium can cause diarrhea, aluminum can be cosntipation.
renal impairtment- may result in catioanbsorption adn systemic alkalosis |
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|
Term
|
Definition
viscosu substance insoluble inwater.
Binds to nectoric ulcer tissue creating barreier to acids,pepsin , bile
Possible binding to bile salts (which implicatedi n gastric ulcer formaiton).
Simtaulets protsaglandin syntehiss, which sitmaultes secreiton of bicarb and mucus. |
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Term
|
Definition
| Effective in the healing of duodenal ulcers. |
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|
Term
| sucrafalte concorruent use |
|
Definition
| requreis acidic ocnditiosn so cant bet ken with antacids, h2 recpetor antagoinists , or ppis. |
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Term
| collidal bismuth compounds nams |
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Definition
| bismuth subsalicylate and bismuth subcitrate potassium |
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Term
| colloidal bismuth compounds moa |
|
Definition
sleelctive bindign ot ulcer, coating nit and protecting form acid and pepsin.
May also inhbiit pepsin activity, stimatle mucus produciotna nd increase PGsyntehsis.
May have direct antimicrobial activity to H pylori |
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|
Term
|
Definition
whe ncombined with antibiotics , h pylori healing rates are increased.
minimal adverse effects |
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|
Term
| prostaglandin analog name |
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Definition
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|
Term
| prostaglandin analog usage |
|
Definition
| prevnetion of nsadi induced ulcers |
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Term
|
Definition
| stimaulted mucus and bicarb, with a little bit of acid inhibition. |
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|
Term
| misprostol adverse effects |
|
Definition
| diarrhea, and contriandicated in childbearing wome ndue to stimaulti ono hte uterus. |
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|
Term
|
Definition
increase LES Presusre to be us efu lfor GERD.
increases gastric emptying for usrei n gastroparesis or post surgical gastri cemptying |
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|
Term
|
Definition
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|
Term
|
Definition
| raises LES presusre and accelerate gastric emptying |
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|
Term
| metocoloparmiade receptor acitons |
|
Definition
| dopamine d2 antagonists and serotonin receptor agonist. enters CNS for antiemesis |
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|
Term
| metcoloparmide clincial uitlity |
|
Definition
sypmatomtic releif in gastricm otor failure.
treamtn of symapotmtic GERD in combo with atnisecretory agents.
antiemetic agnet- for cnacer chemotherpay , medical procedures where gastric contetns may be aspirated. |
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|
Term
| metocolparmide adverse effects |
|
Definition
extrapyramidal sympotms, anxiety, depresison, other cns symtpoms.
- icnreasign pitauritary lactin, causign galactorrhea, gyecomastia, impotence,menstrual disorders. |
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Term
| bulk forming laxatives name |
|
Definition
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|
Term
| bulk forming laxatives moa |
|
Definition
| indegetsticllic hydrophillic colloids absorb water and form bulk that distends colon promoting peristalasis |
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|
Term
| adverse effects of bulk forming laxatives |
|
Definition
| bacterial digestion leads to bloating/gas |
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|
Term
|
Definition
| softenign of stool permits water and lipids to penetrate |
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|
Term
| stool softener adminsitration |
|
Definition
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|
Term
|
Definition
| colace, glycerin suppository ,a nd mineral oil |
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|
Term
|
Definition
| argents are soluble compoudnsth at dont get absorbed, increasing stool liquidity |
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|
Term
|
Definition
| milk ofm agnesia, sorbitol and lactulose |
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|
Term
|
Definition
| surgical bowel emptying osmotic laxative |
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Term
|
Definition
| surgical emptyign laxative osmotic |
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|
Term
|
Definition
| these agents induce bowel movements bystimaultign enteric nervosu system and secretion of electrolytes/fluid. |
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|
Term
|
Definition
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|
Term
| antidarrheal agents usage |
|
Definition
| mild to moderate acute diarrhea, not bloody or high fever though |
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|
Term
| antidiarrheal agents, name |
|
Definition
| diphenoxylate, loepramide |
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Term
|
Definition
| inbhitie ach release via presynaptic opiod recpetors in ENs. |
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|
Term
|
Definition
| inbhitie ach release via presynaptic opiod recpetors in ENs. |
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|
Term
| irritibale bowel sydnrome : diarrhea symtpoms treatment |
|
Definition
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|
Term
| IBS consitpaition symtpom treamtnt |
|
Definition
| fibert suplpemetnand osmotic laxatives |
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Term
| ibs chronci abodminal pain |
|
Definition
| low doses of TCA (amitriptyline, desiparmine)- help withotu altering mood. ,also 5-ht3 ecpetor antagonists, since 50ht3 receptors, actiate pain sensations in enteric systemc |
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|
Term
|
Definition
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|
Term
| 5 aminosalicylates mechanism of action |
|
Definition
| nsaid that works topcially in areas of diseased mucosa |
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Term
|
Definition
| sulfalazina, oslalaizne, balsalazide. |
|
|
Term
|
Definition
| first lineagents for trematnet of milde- meoderate ulcerative colitis, firrst line for mile to moderate crohns diseas einvoling prox colon or distal ileum |
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|
Term
|
Definition
| first lineagents for trematnet of milde- meoderate ulcerative colitis, firrst line for mile to moderate crohns diseas einvoling prox colon or distal ileum |
|
|
Term
| sulfalazine adverse effects |
|
Definition
| due tosystemic effects of sulfapyrdidine metabolite |
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|
Term
| glucoroctiouds clincial use |
|
Definition
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|
Term
| most common glucoridtoics for ibd |
|
Definition
| prednisone andpredinosolne |
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|
Term
|
Definition
|
|
Term
| budenoside administration |
|
Definition
| controlled release oral formulaion. glucoritcoid |
|
|
Term
| budenoside pharmacokinetics |
|
Definition
| rapid firs tpass hepatic metaoblism with bioavailabilty of 10 percent |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| azathiprioen and 6 mercaptourpine use |
|
Definition
| used for ulcerative colitis and crohns disease induction and maintenance of remission |
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|
Term
|
Definition
| folate antimetabolite to induce and maintain remission in corhns disease |
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|
Term
|
Definition
| influximad, adlimumab, certozliumab |
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|
Term
|
Definition
| for patients with moderate to severe corhns with inadequte repsonset o conventionalt herpaies. |
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|
Term
|
Definition
| only anti tinf used for ulcerative colitis- also only used for tnf refracotyr to other forms of therapy |
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|
Term
|
Definition
| severe predispostion infeciton i.e. bacterial supresison and Tb, due to th1 suppresive effects |
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|
Term
| anti integrin therapy moa |
|
Definition
| integrins mediate of luekcoyte adheison to vascular walls |
|
|
Term
|
Definition
|
|
Term
| adverse effects of antiintegrin therapy |
|
Definition
| reactivation of human polyoma virus. |
|
|
Term
|
Definition
| moderate to severe crohsn diseasei npatients who wont respond to anything else. |
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