Term
| Side Effects of Cimetidine |
|
Definition
| antiandrogen effect, can cause gynecomastia, decreased libido, & sexual dysfunction in men; sometimes used to treat masculinization (hirsutism) in females; it can intefere with metabolism of other drugs metabolized by cytochrome P450 enzymes |
|
|
Term
| Drug Interactions with Cimetidine |
|
Definition
| potentiates or prolongs actions of drugs metabolized by liver (warfarin, phenytoin, theophylline, phenobarbital, many benzodiazepines, propanolol, nifedipine, digoxin, quinidine, tricyclic antidepressants |
|
|
Term
| Side Effects of H2-Histamine Antagonists |
|
Definition
| HA, dizziness, nausea, myalgia, skin rashes, itching; |
|
|
Term
|
Definition
| cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), nizatidine (Axid) |
|
|
Term
|
Definition
| omeprazole (Prilosec), esomeprazole (Nexium), lansoprozole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex) |
|
|
Term
|
Definition
| sodium bicarbonate, calcium carbonate (TUMS), magnesium hydroxide + aluminum hydroxide (Maalox) |
|
|
Term
|
Definition
| sucralfate (Carafate), misoprostol (Cytotec), bismuth subsalicylate (Pepto Bismol) |
|
|
Term
| antimicrobials used to treat H. pylori infections |
|
Definition
| bismuth subsalicylates (Pepto Bismol), clarithromycin (Biaxin), amoxicillin, metronidazole (Flagyl) |
|
|
Term
| Factors that contribute to integrity of Mucus Barrier in Stomach/GI |
|
Definition
1) blood flow to mucosa;
2) ability of mucosal cells to reproduce;
3) certain prostaglandins play important role in regulating mucus production; |
|
|
Term
|
Definition
| prostaglandin analog available for prevention of NSAID-induced ulcers |
|
|
Term
| Sodium Bicarbonate (Alka Seltzer, Baking Soda) |
|
Definition
neutralizes acid by:
HCl + NaHCO3 --> NaCl + H2O + CO2;
CO2 causes distention;
- rapid onset, short duration of action;
- well absorbed --> systemic metabolic alkalosis;
Uses:
- occasional symptomatic relief of heartburn, mild gastritis, NOT useful in tx of PUD; |
|
|
Term
|
Definition
neutralizes acid by:
CaCO3 + 2HCl --> CaCl2 + H2O + CO2;
- 10% is absorbed, some degree of alkalosis possible;
- Pts w/ poor renal fcn: "Milk Alkali" syndrome - alkalosis, hypercalcemia, kidney stones, renal damage;
Uses:
- occasional symptomatic relief of heartburn, gastritis & PUD, NOT for long-term use;
Drug Interactions: forms complex w/ drugs; |
|
|
Term
| Drugs that interact with neutralizing agents (calcium carbonate [TUMS], magnesiumOH + aluminumOH [Maalox]) |
|
Definition
| digitalis glycosides, tetracyclines, phenytoin |
|
|
Term
| magnesium hydroxide (Milk of Magnesia) |
|
Definition
neutralizes acid by:
Mg(OH)2 + 2HCl --> MgCl2 + 2H2O;
- no CO2 produced;
- poorly absorbed;
- MgCl2 --> laxative --> Common SE is diarrhea;
- May accumulate in renal insufficiency --> hypermagnesemia;
- drug interactions |
|
|
Term
|
Definition
neutralizes acid by:
Al(OH)3 + 3HCl --> AlCl3 + 3H2O;
- poorly absorbed;
- astringent effect, causes constipation;
- forms insoluble salt w/ phosphate --> hypophosphatemia;
- drug interactions;
- Adverse systemic effects: osteodystrophy, myopathies, dementia, seizures; |
|
|
Term
| Uses for Neutralizing Agents |
|
Definition
- used for symptomatic relief of heartburn, gastritis, and peptic ulcer dx;
- no longer primary drugs for PUD; |
|
|
Term
| H2-Histamine Antagonists - cimetidine (Tagamet), ranitidine (Zantec), famotidine (Pepcid), nizatidine (Axid) |
|
Definition
- very effective agents;
- reduce amount of acid secreted in response to histamine, vagal stimulation, ACh, and gastrin;
Uses:
- acute and preventive treatment of relapses in PUD; |
|
|
Term
| Proton Pump Inhibitors - omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex) |
|
Definition
- proton pump inhbition - very effective, some activity vs. H. pylori;
- inactive prodrugs, takes 3-4 days to reach full effects;
- take on an empty stomach;
Uses:
- tx of GERD, PUD, & Zollinger Ellison syndrome;
- prevention of stress ulcers and prevention of NSAID-induced ulcers;
Side Effects:
- few, but marked inhibition of acid secretion can lead to microbial overgrowth of upper GI tract w/ chronic use; |
|
|
Term
|
Definition
aluminum salt of sulfated sucrose;
polymerizes in acidity of stomach forming a sticky, viscous material that binds to exposed proteins in ulcer crater, forming a protective barrier;
- most effective if taken before meals;
- do not use antacids 1/2 hr before or after taking this drug;
- very safe & effective;
- Side Effect: constipation;
- Causes drug interactions |
|
|
Term
|
Definition
analogue of PGE1;
- increases mucus production & may reduce acid secretion;
- Side Effect: prostaglandin analog that can induce uterin contractions
C/I - pregnant females, females who can become pregnant;
SEs: diarrhea, abdominal distress, HA, dizziness; |
|
|
Term
|
Definition
antigas, antiflatulent action;
- surface active, anti-foaming agent taht facilitates formation of large gas bubbles in upper GI tract allowing them to be "burped" out;
- used alone or in combo w/ other GI drugs; |
|
|
