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Pharmacology Drugs > Gastrointestinal > Flashcards

Flashcards in Gastrointestinal Deck (21)
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1
Q

What types of drugs are used for gastrointestinal ulcers?

A
  • Anatacids
  • Alginates
  • Proton pump inhibitors
  • H2 antagonists
2
Q

What are examples of proton pump inhibitors?

A
  • Omeprazole,
  • Lansoprazole
  • Esomeprazole (active of omeprazole)
  • Rabeprazole
  • Pantoprozole
3
Q

What is the mechanism of action of proton pump inhibitors?

A
  • Binds to active pumps so taken after eating
  • Max efficacy after 2-3 days
  • Takes a few days to completely stop its effect as de novo synthesis of the channels are required
4
Q

Why is the effect of PPIs not instantaneous?

A

-Delayed effect as not all pump active all the time

5
Q

What are the uses of proton pump inhibitors?

A
  • Inhibit all acid and decreases
  • Zollinger ellis syndrome
  • Gastric and Duodenal ulcers
6
Q

What are the side effects of proton pump inhibitors?

A
  • C.difficile risk especially when being taken with antibiotics
  • Has an effect on calcium metabolism so long-term osteoporosis
7
Q

What are the examples of H2 antagonists?

A
  • Cimetidine

- Ranitidine

8
Q

What is the mechanism of action of H2 antagonists?

A
  • Blocks H2 receptor

- Dose twice daily due to short half life of the drug

9
Q

What are the uses of H2 antagonists?

A
  • Cheap
  • Safe
  • Inhibits stomach excretion
10
Q

What are the side effects of H2 antagonists?

A
  • Loose stools
  • Even if you block one pathway you can still get the other pathways working to produce acid
  • Cimetidine can give gynaecomastia so avoid in men
11
Q

What are examples antacids?

A

Aluminium hydroxide (Maalox)

12
Q

What is the mechanism of action of antacids?

A

-Works as buffers due to being alkali so gives a temporary relief

13
Q

What are the uses of antacids?

A

Used for temporary relief of ulcer

14
Q

What is an example of alginates?

A

-Gaviscon (compound alginate)

15
Q

What is the mechanism of action of alginates?

A

-Forms a layer over gastric mucosa to prevent further insult to the mucosa

16
Q

What are the uses of alginates?

A

Relief from ulcers

17
Q

What is the treatment for eradicating H.Pylori?

A

Triple therapy: Clarithromycin, Amoxicillin, Lansoprazole

18
Q

What is the step-up approach to Gastrointestinal disease?

A
  • Lifestyle
  • Antacids? Alginates
  • H2 receptor antagonist
  • PPI

More GP

19
Q

What is the step-down approach to Gastrointestinal disease?

A
  • PPI
  • H2 receptor antagonist
  • Antacids/Alginates
  • Lifestyle

More hospital

20
Q

What are the principles of treatment of peptic ulceration?

A
  • Stop NSAIDs - combined NSAIDS with acid suppression and still get rid of H.pylori
  • H2 receptor antagonist/PPI
  • H pylori eradication
21
Q

How is oesophagitis treated?

A
  • Healing and maintenance
  • Degree of oesophagitis

-Complication: Barret’s oesophagus which is columnar transformation of squamous epithelial to match the gastric cell. Risk factor for oesophageal carcinoma. Treated with ongoing full acid suppression for life at the maximum dosage