Pharmacology Review

Flashcards to review acid-controlling, antiemetic, antidiarrheal, and adrenergic drugs along with cystic fibrosis, IBS, and glaucoma medications.

What is the role of hydrochloric acid secreted by the stomach?

Aids digestion, protects against infection, but can cause ulceration if the mucosal lining is irritated.

What are common causes of Peptic Ulcer Disease?

Helicobacter pylori (H. pylori) infection and prolonged use of NSAIDs.

What is the role of hydrochloric acid secreted by the stomach?

Aids digestion, protects against infection, but can cause ulceration if the mucosal lining is irritated.

What are common causes of Peptic Ulcer Disease?

Helicobacter pylori (H. pylori) infection and prolonged use of NSAIDs.

How do acid-controlling drugs work?

Decreasing hydrochloric acid production, inhibiting hydrochloric acid secretion, or neutralizing hydrochloric acid's effect.

Give examples of Proton Pump Inhibitors (PPIs).

Omeprazole, Pantoprazole, Esomeprazole (Prazoles)

What is the mechanism of action of PPIs?

Irreversibly inhibits the hydrogen/potassium ATPase enzyme system (the proton pump) of the gastric parietal cell, blocking the final step in acid production.

What are the indications for PPIs?

Peptic ulcer disease, GERD, erosive esophagitis, and Zollinger-Ellison syndrome.

Why are PPIs not for long-term use?

Due to potential side effects like increased risk of fractures, infections, and nutrient deficiencies.

When is the best time to administer PPIs?

In the morning before breakfast for better absorption.

How are PPIs used in treating peptic ulcer disease?

Often used with antibiotics to eradicate Helicobacter pylori (H. pylori).

What is the prophylactic use of PPIs?

To prevent stress ulcers, especially in ICU patients with NGTs or ventilators.

Give examples of H2 Blockers.

Cimetidine, Ranitidine, Famotidine, Nizatidine ( -tidines).

What is the mechanism of action of H2 blockers?

Selectively block H2 receptors on parietal cells, preventing histamine binding and reducing gastric acid secretion.

Why should Cimetidine be used with caution?

Smoking decreases effectiveness by increasing gastric acid production. Can cause gynecomastia and decreased libido due to antiandrogenic effects.

How should H2 blockers be administered with antacids?

Administer H2 blockers one to two hours before antacids to prevent decreased absorption.

What is the mechanism of action of Sucralfate?

Cytoprotective effect – adheres to the ulcer, protecting it from gastric acid, pepsin, and bile salts.

When should Sucralfate be taken?

On an empty stomach, at least 30 minutes before meals.

What is the mechanism of action of Antacids?

Neutralize acid but do not affect hydrochloric acid production; provide temporary relief of symptoms.

What are the side effects of Aluminum and calcium based antacids?

Cause constipation.

What are the side effects of Magnesium based antacids?

Cause diarrhea.

Why are aluminum and magnesium often combined in antacids?

To counteract side effects and balance bowel function.

Why is magnesium contraindicated in patients with renal disease?

Due to the risk of magnesium toxicity.

List Symptoms of Magnesium Toxicity.

Affects respiration and deep tendon reflexes (hyporeflexia), leading to muscle weakness and potential respiratory failure. Decreased urine output and altered pulse rates.

What is the magnesium toxicity treatment?

Calcium gluconate to counteract the effects of magnesium.

What should patients with renal disease take for antacids?

Aluminum-based antacids.

What can happen with long-term calcium based antacid use?

Rebound hyperacidity and potential for renal stone formation (calcium stones).

What are Serotonin Blockers (Setrons) used for?

First-line treatment for chemotherapy-induced nausea and vomiting (CINV).

Give an example of a Serotonin Blocker (Setron).

Ondansetron (Zofran).

When should Serotonin Blockers (Setrons) be administered?

30-60 minutes before chemotherapy to prevent nausea and vomiting.

What are Antihistamines used for?

As antiemetics, particularly for motion sickness and vertigo.

What are Anticholinergic Drugs used for?

Motion sickness; Scopolamine is often used as a transdermal patch.

What are Antidiarrheal Drugs used for?

To reduce or stop diarrhea caused by infections, medications, or other gastrointestinal disorders.

Why is Bismuth Subsalicylate contraindicated for children/teenagers with flu-like symptoms?

Due to the risk of Reye's syndrome from salicylate content.

What are laxatives used for?

Treat constipation by promoting bowel movements.

Give examples of Bulk-forming laxatives.

Metamucil, psyllium

How should Bulk-forming laxatives be taken?

Mixed with water before taking.

Give examples of Stool softeners

Docusate

Give examples of Emollients

Mineral oil

Give examples of Stimulant laxatives

Bisacodyl, Senna

Give examples of Osmotic laxatives

Polyethylene glycol, Lactulose

What is Methylnaltrexone used for?

Opioid antagonist used if usual laxatives are ineffective in relieving constipation caused by opioid use.

What is lactulose used for?

Laxative and also used for hyperammonemia by promoting the excretion of ammonia in the stool.

What are Pancreatic enzymes used for?

To aid in digestion and absorption in Cystic Fibrosis patients. Example: pancrelipase

What is Lubiprostone used for?

Used for constipation in IBS patients by increasing fluid secretion in the intestine, promoting bowel movements.

What are the contraindications for Laxatives?

Gastrointestinal Obstruction and should not be used for long-term use as it can cause rebound constipation and dependency

Why should some herbal medications be discontinued before surgical procedures?

To minimize the risk of excessive bleeding; garlic, ginger, ginkgo biloba, ginseng, and feverfew.

What is another name for Adrenergic drugs?

Sympathomimetic drugs

What effects do adrenergic drugs have?

Increase in heart rate, vasoconstriction, bronchodilation.

Where are Alpha-1 Adrenergic Drugs located?

In blood vessels.

Where are Beta-1 Adrenergic Drugs located?

In the heart.

Where are Beta-2 Adrenergic Drugs located?

Concentrated in bronchioles.

What are Alpha-1 Adrenergic Agonists used for?

To increase blood pressure; called vasopressors. Used to treat hypotension.

Give examples of Alpha-1 Adrenergic Agonists

Epinephrine, phenylephrine, norepinephrine.

What are Alpha-2 Agonists used for?

Decrease norepinephrine release, thus lowering blood pressure. Used in the treatment of hypertension.

What are the names of Beta Blockers end in?

Olol (e.g., metoprolol, atenolol, propranolol).

What should be monitored when a patient is taking beta blockers?

Heart rate regularly because it can cause bradycardia (slow heart rate).

What should you monitor for in patients taking beta blockers regarding Fluid Retention?

Weight gain (2 lbs/day or 5 lbs/week), dyspnea (difficulty breathing), edema, orthopnea (can't breathe lying flat), crackles in lungs.

What do Alpha Adrenergic Blockers names often include?

Zosin (e.g., prazosin, terazosin, doxazosin).

What is Phentolamine used for?

Used to diagnose pheochromocytoma and treat extravasation.

What is Tamsulosin primarily used for?

Benign prostatic hypertrophy (BPH) to relieve urinary symptoms of enlarged prostate.

What is an Important Drug Interaction of Tamsulosin?

Should not be taken with erectile dysfunction (ED) drugs (sildenafil, tadalafil) because it can cause severe hypotension.

What should patients do if they start wheezing while on a nonselective beta blocker?

Stop the medication and contact their provider because this indicates bronchospasm.

What can happen if you discontinue beta blockers or alpha blockers abruptly?

Can cause rebound hypertension, so gradual tapering is necessary to prevent withdrawal symptoms.

What should you advise patients regarding taking adrenergic blockers?

To change positions slowly because this helps prevent dizziness and falls from hypotension, especially orthostatic hypotension.

What is another name for Cholinergic Drugs?

Parasympathomimetic drugs

List the Cholinergic Drug responses.

Decreased heart rate, constriction of pupils, increased peristalsis and GI motility, increased urination.

What does SLUDGE stand for?

Salivation, Lacrimation, Urination, Defecation, Gastric upset, Emesis

What is the effect of Anticholinergic Drugs?

Cause dryness (dry mouth). They block the action of acetylcholine.

What side effects are caused by Anticholinergic Drugs?

Dry mouth, constipation, urinary retention, tachycardia.

Name Cholinergic drug effects to remember (SLUDGE plus the three B's)

Bronchorrhea, Bradypnea, Bradycardia

What is Donepezil used for?

Alzheimer's disease. It improves cognitive function by increasing acetylcholine levels in the brain.

What should be reported immediately regarding donepezil use?

Muscle weakness or cramping because this could indicate cholinergic crisis.

What is Bethanechol used for?

Post-surgery to stimulate urination in patients with difficulty voiding. It helps to empty the bladder.

How does dopamine affect in low doses?

Increases blood flow to kidneys, brain, and mesentery, increasing urine output.

What do Adrenergic Bronchodilators primarily affect?

Bronchioles, GI, and heart; less impact on blood vessels and blood pressure.

What is Mirabegron (Myrbetriq) used for?

To treat overactive bladder. It has fewer anticholinergic side effects.

What is Epinephrine used for?

Anaphylactic shock. It reverses the symptoms of anaphylaxis.

What is Atropine used for?

Reversal of cholinergic crisis. It counteracts the effects of excessive acetylcholine.

What is Memantine used for?

Alzheimer's disease. It works by regulating glutamate activity in the brain.