Notes in 15 GI Drugs

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Status	Last Update	Fields
Published	07/30/2024	PPI Prototype: {{c1::Omeprazole}}
Published	07/30/2024	PPI bioavailability is {{c1::decreased to ~50%::INC/DEC}} by food
Published	07/30/2024	[QC] PPIs Maximal Action1) Resting Parietal Cell2) Stimulated Parietal Cell{{c1::B}}
Published	07/30/2024	PPIs become rapidly protonated within the canaliculus and trapped where it rapidly undergoes molecular conversion to its active form, {{c1::Thiop…
Published	07/30/2024	PPIs Duration of acid inhibition: {{c1::24}} hours but {{c1::3-4}} days of daily medication is required for full inhibition
Published	07/30/2024	PPIs undergo rapid first pass and systemic hepatic metabolism ({{c1::CYP2C19, CYP3A4::CYP}}) except {{c2::Rabeprazole}}, whose metabolism is towards {…
Published	07/30/2024	PPI w/ Highest pKa: {{c1::Rabeprazole}}
Published	07/30/2024	[VR]1. pKa of PPI2. Rapidity of drug activation{{c1::A}}
Published	07/30/2024	[QC] Rapidity of activation1. Omeprazole2. Rabeprazole{{c1::B}}
Published	07/30/2024	The PPI w/ the highest pKa is {{c1::Rabeprazole}}
Published	07/30/2024	PPIs inhibit {{c1::both fasting and meal-stimulated::fasting/meal-stimulated/both}} secretion
Published	07/30/2024	Proton Pump InhibitorsGive it {{c1::30 mins to 1 hour before breakfast::when should the patient take it}} since maximum concentration of PPI should be…
Published	07/30/2024	Proton Pump Inhibitors: Indications{{c1::GERD}}PUDNSAID-induced ulcerH. pylori-associated ulcerActively bleeding ulcerNon-ulcer dyspepsiaStress-relate…
Published	07/30/2024	Proton Pump Inhibitors: IndicationsGERD{{c1::PUD}}NSAID-induced ulcerH. pylori-associated ulcerActively bleeding ulcerNon-ulcer dyspepsiaStress-relate…
Published	07/30/2024	Proton Pump Inhibitors: IndicationsGERDPUDNSAID-induced ulcerH. pylori-associated ulcer{{c1::Actively bleeding ulcer}}Non-ulcer dyspepsiaStress-relate…
Published	07/30/2024	PPIs Indications:In actively bleeding ulcers, we give {{c1::continuous IV infusion::manner of administration}} or high dose oral therapy to maintain i…
Published	07/30/2024	PPI Prescription for Actively Bleeding Ulcer:{{c1::Initial bolus of 80 mg IV followed by constant infusion at 8mg/h or High dose oral/IV therapy 40 mg…
Published	07/30/2024	[VR]1. Omeprazole intake2. Digoxin bioavailability{{c1::B}}
Published	07/30/2024	PPI ADE: {{c1::Diarrhea}}
Published	07/30/2024	Can PPIs be given to pregnant women?{{c1::Y::Y/N}}
Published	07/30/2024	PPI ADE: With prolonged PPI use, ↓ absorption of {{c1::Vit B12, Fe, Ca, Mg, Zinc}}.
Published	07/30/2024	Potassium Competitive Acid Blocker (PCAB) Prototype: {{c1::Vonoprazan}}
Published	07/30/2024	[QC] Rapidity of acid suppression1. PPI 2. PCAB{{c1::B}}
Published	07/30/2024	[QC] Undergoes CYP2C19 metabolism1. PPI 2. PCAB{{c1::A}}
Published	07/30/2024	[QC] Influenced by meals1. PPI 2. PCAB{{c1::A}}
Published	07/30/2024	[QC] Bioavailability if taken after meals1. PPI 2. PCAB{{c1::B}}
Published	07/30/2024	[QC] Acid stability1. PPI 2. PCAB{{c1::B}}
Published	07/30/2024	[QC] Acid suppression at night1. PPI 2. PCAB{{c1::B}}
Published	07/30/2024	[QC] H. pylori eradication rate1. PPI 2. PCAB{{c1::B}}
Published	07/30/2024	[QC] Healing rate of severe reflux esophagitis1. PPI 2. PCAB{{c1::B}}
Published	07/30/2024	Potassium Competitive Acid Blocker (PCAB): Vonoprazan{{c1:: ::just take a look at these}}Adverse effects:
Published	07/30/2024	H2 Receptor Antagonists (HR2A) Prototype: {{c1::Cimetidine}}
Published	07/30/2024	H2RA bioavailability is affected by food intake.{{c1::FALSE::T/F}}
Published	07/30/2024	H2RA crosses BBB and placenta.{{c1::TRUE::T/F}}
Published	07/30/2024	Which H2RA has the longest duration of action?{{c1::Famotidine}}
Published	07/30/2024	H2RA tolerance can develop via upregulation of H2 receptors, that occurs between 3-6 days after intake.{{c1::FALSE, should be downregulation::T/F}}
Published	07/30/2024	H2RA Indications:{{c1::GERDPUDNon-ulcer dyspepsiaStress-related gastritis::Give 4}}
Published	07/30/2024	H2 Receptor Antagonists (HR2A): Dosage{{c1:: ::just take a look at this}}
Published	07/30/2024	H2 Receptor Antagonists (HR2A): QC: CYP450 binding1) Cimetidine2) Famotidine{{c1::A}}
Published	07/30/2024	[VR]1. HR2A intake2. Ethanol bioavailability{{c1::A}} except for {{c1::Famotidine}}
Published	07/30/2024	H2RA can cause mental status changes.{{c1::TRUE, remember that it can cross the BBB, hence CNS side effects::T/F}}
Published	07/30/2024	Can H2RAs be given to pregnant px?{{c1::Yes. Although it can cross the placenta, it has no known teratogenic effects}}
Published	07/30/2024	H2RA ADE:Most significant endocrine side effect of Cimetidinein Men: {{c1::Impotence, Gynecomastia}}in Women: {{c1::Galactorrhea}}
Published	07/30/2024	AntacidsMOA: 1) Gastric Acid Neutralization2) {{c1::↑ mucosal prostaglandin production}} --> which is protective to the mucosa3) {{c1::Binds with b…
Published	07/30/2024	Antacids: DosageGive {{c1::1-3}} hours {{c1::after::before or after}} meals and at {{c1::bedtime}}120 mEq Mg-Al combination per dose
Published	07/30/2024	Antacids ADE:Na-Bicarbonate: {{c1::Belching}}Ca-Carbonate: {{c1::Belching}}Al-Hydroxide: {{c1::Constipation}}Mg-Hydroxide: {{c1::Diarrhea}}
Published	07/30/2024	[QC] Rapidity of action1. Sodium bicarbonate2. Magnesium hydroxide{{c1::A}}
Published	07/30/2024	Antacids can be taken without any regards to intake of other drugs.{{c1::FALSE::T/F}}
Published	07/30/2024	Mucosal Cytoprotective Agents:{{c1::Sucralfate}}{{c1::Colloidal Bismuth Compound}}{{c1::Prostaglandin analogs}} ({{c2::misoprostol}}, {{c2::rebampide}…
Published	07/30/2024	Sucralfate & Colloidal Bismuth Compound MOA:{{c1::Polymerization and selective binding to necrotic ulcer}}{{c1::Stimulates prostaglandin and bicar…
Published	07/30/2024	Sucralfate ADE:{{c1::Constipation}}{{c1::Nausea}}
Published	07/30/2024	{{c1::Colloidal Bismuth Compound}} - Mucosal protective agent that has a direct antimicrobial activity against H. pylori
Published	07/30/2024	Colloidal Bismuth ADE: {{c1::Blackening of stool}}{{c1::Salicylate toxicity}}
Published	07/30/2024	{{c1::Prostaglandin analogs}} - mucosal cytoprotective agent that reduces incidence of NSAID-induced ulcers and ulcer complications.
Published	07/30/2024	{{c1::Misoprostol}} - Prostaglandin analog that cannot be used during pregnancy as it may cause abortion
Published	07/30/2024	{{c1::Rebamipide}} - Prostaglandin analog that acts as an antioxidant for scavenging of reactive oxygen species
Published	07/30/2024	Eradication rate for H pylori should be at least {{c1::80}}%
Published	07/30/2024	Recommended regimen for H pylori eradication:{{c1::PPI 40 mg::include amount}}{{c1::Amoxicillin 1 g}}{{c1::Clarithromycin 500 mg}}Dose: Taken {{c1::tw…
Published	07/30/2024	Recommended regimen for H pylori eradication:PPI 40 mgAmoxicillin 1 gClarithromycin 500 mgIf px is allergic to amoxicillin or clarithromycin?{{c1::Met…
Published	07/30/2024	GI ULCERS Goals of Treatment: Pain ReliefMedicines (highest priority to lowest):{{c1::Antacids}} > {{c1::H2RA}} > {{c1::PPI}} > {{c1::PG}}
Published	07/30/2024	Alvimopan is an {{c1::opioid antagonist::MOA}} which causes {{c1::↓::↑/↓}} emesis
Published	07/30/2024	Goals of Treatment: Healing the GI ulcer & Preventing complicationsMedicines (highest priority to lowest):{{c1::PPI}} > {{c1::H2RA}} > {{c1:…
Published	07/30/2024	GI ULCERS Goals of Treatment: Reduce Recurrence{{c1::HP Eradication}}{{c1::Maintenance}}{{c1::(-) Risk factors}}
Published	07/30/2024	PROKINETIC AGENTSClasses under this include:{{c1::Cholinomimetic agents}}{{c1::Dopamine D2 receptor antagonists}}{{c1::Macrolides}}{{c1::5-HT4 Recepto…
Published	07/30/2024	PROKINETIC AGENTSCholinomimetic agents drugs: {{c1::Bethanechol}}, {{c1::Neostigmine}}
Published	07/30/2024	Prokinetic Substituted Benzamide D2 Antagonist Representative Drugs: {{c1::Metoclopromide}}{{c1::Domperidone}}
Published	07/30/2024	PROKINETIC AGENTSMacrolides drugs: {{c1::Erythromycin}}, {{c1::Azithromycin}}
Published	07/30/2024	Bethanechol MOA as a Prokinetic Agent: {{c1::M3 Agonist}}
Published	07/30/2024	Neostigmine MOA as a Prokinetic: {{c1::Acetylcholinesterase inhibitor}}
Published	07/30/2024	PROKINETIC AGENTS - D2 receptor antagonistsBrand NameMetoclopramide: {{c1::Plasil}}Domperidone: {{c1::Motilium}}
Published	07/30/2024	D2 Antagonists MOA as Prokinetic Agents:{{c1::Blocks the inhibitory effect of dopaminergic receptors}}Blocks D2 receptors in the {{c1::chemorecep…
Published	07/30/2024	GERD who’s symptoms do not improve with PPI, give {{c1::Centrally Acting Prokinetic D2 Antagonists}}
Published	07/30/2024	PROKINETIC AGENTS - D2 receptor antagonists[QR] Crosses BBB thus will manifest with CNS adverse effects:1. Metoclopramide2. Domperidone{{c1::A}}
Published	07/30/2024	{{c1::Metoclopramide::Prokinetic Agent}} ADE: Tardive dyskinesia
Published	07/30/2024	PROKINETIC AGENTS - D2 receptor antagonists[QR] Adverse effect include galactorrhea, gynecomastia, impotence, menstrual disorders1. Metoclopramide2. D…
Published	07/30/2024	{{c1::Macrolides::Prokinetic Agent}} - Directly stimulates motilin receptors on GI smooth muscle and promote MMC
Published	07/30/2024	PROKINETIC AGENTS - Macrolides{{c1::IV Erythromycin}} can be beneficial in some patients with {{c2::gastroparesis}}
Published	07/30/2024	PROKINETIC AGENTS - MacrolidesNot used for long periods of time {{c1::as tolerance rapidly develops::due to?}}
Published	07/30/2024	Anti emetic drug of choice: {{c1::antihistamine, antimuscarinic}}
Published	07/30/2024	Serotonin 5-HT3 AntagonistsIndication{{c1::offset vomiting due to postoperative vomiting, post radiation vomiting, chemotherapy, or drug induced vomit…
Published	07/30/2024	Centrally Acting D2 Antagonists Representative Drugs:Phenothiazines: {{c1::Prochlorperazine, promethazine, thiethylperazine}}Butyrophenones: {{c1::Dro…
Published	07/30/2024	Centrally Acting D2 Receptor AntagonistsSubstituted BenzamidesDrugs: {{c1::Metoclopramide, Trimethobenzamide::2}}MOA: D2 receptor antagonist; pro…
Published	07/30/2024	[QC] Sedating Property for Anti-emesis1. Diphenhydramine2. Meclizine{{c1::A. Thus, we use 1 for px undergoing chemotherapy and 2 for motion sickness a…
Published	07/30/2024	Motion Sickness DOC:{{c1::Hyoscine (Scopolamine)}}
Published	07/30/2024	{{c1::Aprepitant/Fosaprepitant (IV)}} MOA:Selective NK1 antagonist that {{c2::crosses::does not cross/crosses}} BBB
Published	07/30/2024	{{c1::Dronabinol (Tetrahydrocannabinol/THC)}} - major psychoactive chemical in marijuana used as an appetite stimulant and antiemeticTHC analog: {{c1:…
Published	07/30/2024	Corticosteroids as Anti-EmeticsRepresenatative Drugs: {{c1::Dexamethasone & Methylprednisolone}}MOA: {{c1::Enhance efficacy of 5HT3 anta…
Published	07/30/2024	{{c1::Lorazepam/Diazepam}}used prior to initiation of chemotherapy to reduce anticipatory vomiting or vomiting caused by anxiety
Published	07/30/2024	29f710326e2a4c1a8c08f91d33c8390d-oa-1
Published	07/30/2024	29f710326e2a4c1a8c08f91d33c8390d-oa-2
Published	07/30/2024	29f710326e2a4c1a8c08f91d33c8390d-oa-3
Published	07/30/2024	Not all gallstones can be dissolved. Only {{c1::cholesterol-containing}} stones
Published	07/30/2024	Bile Acid AgentsUrsodiol (Ursodeoxycholic Acid or UDCA)MOA{{c1::dissolves cholesterol stones by increasing the bile acid pool by 30%-50%}}Dosage{{c1::…
Published	07/30/2024	Pancreatic Enzyme SupplementsIndication{{c1::if patients have malabsorption producing chronicdiarrhea}}2 preparations{{c1::Pancreatinin, Pancrelipase}…
Published	07/30/2024	Drugs for Active Variceal Bleeding if endoscopy cannot be done:{{c1::Somatostatin & Octreotide}}MOA{{c2::↓ of glucagon release and other gut …
Published	07/30/2024	Drugs for Active Variceal Bleeding: {{c2::Vasopressin & Terlipressin::2}}MOAsplanchnic arterial vasoconstriction and ↓ portal venous pressure…
Published	07/30/2024	Prophylaxis for Initial and Recurrent Variceal Bleeding DOC:{{c1::Non-selective Beta Blockers}}MOAReduce {{c1::portal venous pressure via a decrease i…
Published	07/30/2024	Parenteral glutamine is recommended in patients receiving parenteral nutrition (critically ill patients)Enteral glutamine should be considered in {{c1…
Published	07/30/2024	Antioxidants should be considered in all critically ill patients, particularly {{c1::Se}}
Published	07/30/2024	Enteral formulas enriched with fish oils are recommended in patients with {{c1::Acute Respiratory Distress Syndrome}}
Published	07/30/2024	{{c1::Bulk-Forming Laxatives}} - Complex plant polysaccharide or cellulose derivatives that swell on contact with water, leading to distention of colo…
Published	07/30/2024	{{c1::Osmotic Laxatives}} - Soluble but non-absorbable compounds → obligate increase in fecal fluid → increase in stool liquidity
Published	07/30/2024	Most commonly used products contain powdered psylliumseeds, methylcellulose, or raw bran{{c1::Bulk-forming Laxatives}}
Published	07/30/2024	Osmotic Laxative Representative Drugs:{{c1::Magnesium oxideSorbitol and LactuloseMagnesium citrate, Sodium phosphatePolyethylene glycol (PEG)::4}}
Published	07/30/2024	Osmotic laxatives don't lead to intravascular volume depletion and electrolyte imbalance.{{c1::F::T/F}}
Published	07/30/2024	{{c1::Stool surfactant agents (Softeners)}} MOA: Soften stools permitting water and lipids to penetrate
Published	07/30/2024	Stool Surfactant Agents (Softeners) Representative Drugs:{{c1::Docusate (enema)Glycerin suppositoryMineral oil::3}}
Published	07/30/2024	Stool Surfactant Agent (Softeners) ADE: {{c1::↓ absorption of fat-soluble vitamins when used long-term}}
Published	07/30/2024	{{c1::Anthraquinone Derivatives}} Representative Drugs: Aloe, Senna, Cascara
Published	07/30/2024	Diphenylmethane Derivative Prototype: {{c1::Bisacodyl}}
Published	07/30/2024	{{c1::Castor Oil}} - Potent stimulant laxative hydrolyzed in the upper SI to {{c2::ricinoleic acid}} (local irritant that stimulates intestinal motili…
Published	07/30/2024	Tegaserod & Prucalopride MOA as Laxatives: {{c1::Stimulates second-order neurons to promote the peristaltic reflex}}
Published	07/30/2024	Tegaserod & Prucalopride Indications: {{c1::Chronic constipation, IBS constipation}}
Published	07/30/2024	Tegaserod ADE: {{c1::Serious cardiovascular events due to QT prolongation}}
Published	07/30/2024	Opioid-induced constipation DOC: {{c1::Methylnaltrexone::Opioid Antagonist}} and {{c1::Lubiprostone::Ca Channel Activator}}
Published	07/30/2024	Short-term use in postoperative ileus after a small and large bowel resection (Capsule) DOC:{{c1::Alvimopan}}
Published	07/30/2024	Cl- Channel Activators are used in {{c1::chronic constipation}} and {{c1::IBS-C}}.
Published	07/30/2024	{{c1::Lubiprostone}}Cl- channel activatorTreatment of opioid-induced constipation in patients receiving palliative care for advanced illness (SQ …
Published	07/30/2024	Lubiprostone ADE:{{c1::Category C in pregnancy}}{{c1::nausea due to increase gastric emptying}}
Published	07/30/2024	{{c2::Linaclotide}} - Minimally absorbed, short amino acid peptides stimulate Cl channels and activate guanylate cyclase-C on lumi…
Published	07/30/2024	Linaclotide ADE:{{c1::Diarrhea (common)}}
Published	07/30/2024	Linaclotide is contraindicated in {{c1::pediatric px}}
Published	07/30/2024	When will these laxatives elicit their pharmacologic effects:Osmotic laxativesSodiumphosphatesMagnesium sulfateMilk of magnesiaMagnesium citrate{{c1::…
Published	07/30/2024	When will these laxatives elicit their pharmacologic effects:Castor oil{{c1::1-3 Hours}}
Published	07/30/2024	When will these laxatives elicit their pharmacologic effects:Stimulant laxativesBisacodylSennaCascara sagrada{{c1::6-8 Hours}}
Published	07/30/2024	When will these laxatives elicit their pharmacologic effects:Bulk-forming laxativesBranPsylliumMethylcellulose{{c1:: 1-3 days}}
Published	07/30/2024	When will these laxatives elicit their pharmacologic effects:Surfactant laxativesDocusatesLactulose{{c1:: 1-3 days}}
Published	07/30/2024	Antidiarrheals can be used in bloody diarrhea, high fever, and in systemic toxicity.{{c1::F::T/F}}
Published	07/30/2024	{{c1::Loperamide}} - Antidiarrheal opioid {{c2::a::anta/a}}gonist that {{c2::does not cross::does not cross/crosses}} the BBB
Published	07/30/2024	{{c1::Diphenoxylate}} -  Antidiarrheal opioid {{c1::ag::antag/ag}}onist often w/ {{c2::atropine}} added to discourage overdose
Published	07/30/2024	Bile Salt-Binding Resins - {{c1::↓::↓/↑}} diarrhea caused by excess fecal bile acids
Published	07/30/2024	Somatostatin/Octreotide Indications:{{c1:: Variceal GI bleeding,Gl neuroendocrine tumors (Carcinoid, VIPoma), Pancreatic fistula::3}}
Published	07/30/2024	IBS DOC: {{c1::Anticholinergics (Dicyclomine, Hyoscyamine), Cl Channel Activators (Lubiprostone, Linaclotide)::2 Classes (bonus, also give the represe…
Published	07/30/2024	Proton pumps are synthesized after {{c8::18}} hours
Published	07/30/2024	in a PPI trial used for clinical diagnosis of GERD, give PPI the usual dose, {{c1::twice}} a day for {{c1::2}} weeks. If the manifestation disappears,…
Published	07/30/2024	PPIs will heal DU within {{c1::4-6}} weeks and GUs within {{c1::6-8}} weeks
Published	07/30/2024	When administering PPIs for px w/ stress-related gastritis/bleeding, maintain intragastric pH >{{c1::4}}
Published	07/30/2024	PPIs may lead to {{c1::↑}} gastrin levels
Published	07/30/2024	PROKINETIC AGENTS - Cholinomimetic agentsNeostigmine Indication as a Prokinetic Agent: {{c1::acute colonic pseudo obstruction of Ogilvie's syndrome::w…
Published	07/30/2024	Chronic use of {{c2::anthraquinone}} derivatives (e.g., aloe, senna, cascara) leads to brown pigmentation of the colon ("melanosis coli")
Published	07/30/2024	Non Variceal Bleeding (Bleeding from PUD) DOC: {{c2::Parenteral PPI}}
Status	Last Update	Fields