Pharmacology for Peptic Ulcer Disease, Gastrointestinal Disorders, and Depression

Practice flashcards covering the pharmacological management of peptic ulcer disease, gastrointestinal disorders (antiemetics, laxatives, antidiarrheals), and medications for depressive disorders based on the lecture notes.

H. pylori eradication therapy

A treatment regimen that includes a combination of two or three antibiotics for $14$ days to increase effectiveness and minimize medication resistance.

Histamine2-receptor antagonists

Medications like Cimetidine and Famotidine that block H2 receptors to suppress gastric acid secretion and lower the concentration of hydrogen ions.

Cimetidine (H2 antagonist complications)

Can result in blocked androgen receptors (decreased libido, gynecomastia, impotence) and CNS effects such as hallucinations and restlessness, especially in older adults.

Proton pump inhibitors (PPIs)

Medications such as Omeprazole that block basal and stimulated acid production by irreversibly inhibiting the enzyme that produces gastric acid.

Rebound acid hypersecretion

A complication of PPI use where acid levels spike after discontinuation; managed by tapering the dose slowly and using antacids for discomfort.

Sucralfate

A mucosal protectant that changes into a viscous substance in the stomach's acidic environment, adhering to an ulcer for up to $6$ hours.

Antacids (Aluminum/Magnesium Hydroxide)

Medications used to neutralize gastric acid; aluminum and calcium types cause constipation, while magnesium types cause diarrhea.

Misoprostol

A Prostaglandin E analog used to prevent gastric ulcers in clients taking long-term NSAIDs; it is contraindicated during pregnancy unless used for labor induction.

Ondansetron

A serotonin antagonist that prevents emesis by blocking serotonin receptors in the chemoreceptor trigger zone (CTZ) and on afferent vagal neurons.

Aprepitant

A Substance P/neurokinin1 antagonist used in combination with a glucocorticoid and serotonin antagonist to prevent CINV and postoperative nausea.

Prochlorperazine

A dopamine antagonist that prevents emesis by blocking dopamine receptors in the CTZ; can cause extrapyramidal symptoms (EPSs).

Dronabinol

A cannabinoid reserved as second-line therapy for CINV and used to increase appetite in clients who have AIDS.

Scopolamine

An anticholinergic medication administered transdermally behind the ear to prevent and treat motion sickness.

Serotonin syndrome

A potentially lethal condition beginning $2$ to $72$ hours after antidepressant treatment, characterized by confusion, agitation, tremors, and hyperpyrexia.

Extrapyramidal symptoms (EPSs)

Adverse effects including restlessness, anxiety, and spasms of the face and neck; treated with anticholinergics like diphenhydramine.

Psyllium

A bulk-forming laxative that softens fecal mass and increases bulk, identical to the action of dietary fiber.

Bisacodyl

A stimulant laxative that increases intestinal peristalsis and the volume of water and electrolytes in the intestines.

Diphenoxylate plus atropine

An antidiarrheal that activates opioid receptors in the GI tract to decrease motility; atropine is added to discourage ingestion of high doses.

Metoclopramide

A prokinetic agent that blocks dopamine and serotonin receptors in the CTZ and augments acetylcholine to increase upper GI motility.

Alosetron

A selective 5-HT3 blocker approved only for female clients with severe, management-resistant IBS-D.

Sulfasalazine

A 5-aminosalicylate that decreases inflammation by inhibiting prostaglandin synthesis; used for Crohn's disease and ulcerative colitis.

Selective Serotonin Reuptake Inhibitors (SSRIs)

A class of antidepressants, including Fluoxetine, that block the reuptake of serotonin in the synaptic space to intensify its effects.

SNRIs (Venlafaxine/Duloxetine)

Medications that block the reuptake of both norepinephrine and serotonin, used for depression, anxiety, and chronic pain.

Bupropion

An atypical antidepressant that inhibits norepinephrine and dopamine uptake; used for depression and as an aid for smoking cessation.

Tricyclic antidepressants (TCAs)

Medications like Amitriptyline that block norepinephrine and serotonin reuptake; maximum effects may not be seen until $4$ to $8$ weeks.

Hypertensive crisis (MAOI interaction)

A severe reaction resulting from the intake of dietary tyramine while taking MAOIs, characterized by headache, nausea, and extreme blood pressure increase.

Tyramine-rich foods

Foods like aged cheese, pepperoni, salami, avocados, figs, bananas, smoked fish, and red wine that must be avoided by clients on MAOIs.

Bruxism

An adverse effect of SSRIs involving teeth grinding, which can be managed with a mouth guard or by adding a low dose of buspirone.

Mydriasis

Dilation of the pupils, an adverse effect of Venlafaxine (SNRI) that can increase ocular damage in clients with glaucoma.

Tardive dyskinesia

A complication of high-dose, long-term Metoclopramide therapy involving repetitive involuntary movements that must be reported immediately.