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GI Pharm


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Name some H2 blockers:
- cimetidine
- ranitidine
- famotidine
- nizatidine
What do H2 blockers do?
decrease acid secretion by parietal cells of stomach
Which cells release Histamine in response to Gastrin?
enterochromaffin like cells
When would you give an H2 blocker?
- peptic ulcer disease
- gastritis
- mild GERD
What are toxicities of cimetidine?
- inhibit P450
- antiandrogenic
- dec. renal excretion of Cr
What do Omeprazole & Lansoprazole do?
Proton pump inhibitors - irreversibly block axn of H/K ATPase of parietal cells, which pumps H+ into stomach lumen
When would you give a PPI?
- Zollinger Ellison syndrome
- peptic ulcer disease
- gastritis
How do Bismuth and sucralfate work?
Bind to ulcer base as physical shield from gastric acid. Allow ulcer to heal.
Bismuth is part of the triple therapy for H. pylori along with:
- tetracycline or amoxicillin
- metronidazole
What is Misoprostol and what does it do?
PGE-1 analog - increase stomach mucus barrier and decrease acid production
What 3 situations would you use Misoprostol?
- prevent NSAID-induced ulcer
- maintain PDA!
- induce labor!
For whom would you NOT use misoprostol?
Women of childbearing potential - abortion
What is a good drug to give a patient postoperatively, or after chemo, to prevent vomiting?
Ondansetron - 5HT3 antagonist
Pirenzepine & Propantheline =
Antimuscarinics for peptic ulcers - block M1 on ECL cells, M3 on parietal cells (dec. histamine release, dec. H+ release)
What are toxicities of Pirenzepine & Propantheline?
- tachycardia
- dry mouth
- difficulty focusing eyes
What is Infliximab used for?
Crohn's, rheumatoid arthritis - monoclonal Ab to TNFa
Toxicities of Infliximab?
- respiratory infection
- fever
- hypotension
Sulfasalazine is a combo of:
sulfapyridine (antibacterial) + mesalamine (anti-inflammatory)
Sulfasalazine is used for:
UC, Crohn's
Toxicities of Sulfasalazine?
- reversible oligospermia
- sulfa allergy
- malaise
- nausea
What happens if you overuse antacids?
- aluminum hydroxide --> constipation, hypophosphatemia
- magnesium hydroxide --> diarrhea
- calcium carbonate --> hypercalcemia, rebound acid rise
- all antacids --> hypokalemia

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