pharm final

aluminum hydroxide

amphojel, alternagel

aluminum hydroxide

class: antacid slow acting, low acid neutralizing capacity

MoA: binds to pepsin-facilitates ulcer healing, high affinity for phosphates

Aluminum hydroxide

used to treat hyperphosphatemia, peptic ulcer disease, and GERD

Aluminum hydroxide

side effects: constipation, hypophosphatemia, unrelieved symptoms and tarry stools if not on iron

magnesium hydroxide

milk of magnesia, MOM

magnesium hydroxide

class: antacids

MoA: alkaline compounds that neutralize acidity, rapid acting

magnesium hydroxide

contraindicated with undiagnosed abdominal pain (ruptured appendix, intestinal obstruction, renal impairment)

Be cautious with diuretics

magnesium hydroxide

used for treatment/prevention of hypomagnesemia, bowel evacuant, peptic ulcer disease, GERD

magnesium hydroxide

side effects: diarrhea, magnesium toxicity, CNS depression, unrelieved symptoms and tarry stools if not on iron

calcium carbonate

TUMS

calcium carbonate

class: antacids

MoA: releases CO2 in the gut causing eructation

calcium carbonate

used for treatment/prevention of hypocalcemia, peptic ulcer disease, GERD, can assist with bone health

calcium carbonate

side effects: constipation, acid rebound, milk-alkali syndrome

magnesium/aluminum hydroxide

Maalox

magnesium/aluminum hydroxide

class: antacid

MoA: alkaline compounds that neutralize acidity

magnesium/aluminum hydroxide

used together to combat diarrhea, peptic ulcer disease, GERD

magnesium/aluminum hydroxide

side effects: diarrhea, unrelieved symptoms and tarry stools if not on iron

psyllium

metamucil

psyllium

class: bulk-forming laxatives

MoA: absorb H2O to form viscous gel, softens and forms a bolus in intestinal tract, produced formed stools (12-72 hours)

psyllium

avoid if narrowing of intestinal lumen or peristalsis is impacted, contraindicated in appendicitis and obstruction, careful of misuse, need to take with 8oz of water

psyllium

used for MI, bed rest, meds that constipate, hemorrhoids, pre-op/pre-testing

temporary treatment of constipation, diverticulosis, IBS, reduce discomfort for ileostomy/colostomy

psyllium

side effects: esophageal/feeding tube obstruction

docusate sodium

colace

colace

class: surfactant laxative

MoA: lowers surface tension allowing H2O into feces, inhibits absorption and stimulates secretion of water in intestinal wall

colace

contraindicated in appendicitis and obstruction, use cautiously in pregnancy

colace

used for MI, bed rest, meds that constipate, hemorrhoids, pre-op/pre-testing

colace

side effects: mild cramps, diarrhea

bisacodyl

dulcolax

bisacodyl

class: stimulant laxative

MoA: stimulate intestinal motility and increase the amount of H2) and electrolytes in the intestine

bisacodyl

contraindicated in appendicitis and obstruction, abused by the public

bisacodyl

used for opioid induced constipation, treatment of slow intestinal tract, pre-op and bowel procedures

bisacodyl

side effects: diarrhea and cramping

magnesium citrate

class: osmotic laxative

MoA: hyperosmolar salts pull water into intestine and increases bulk of feces, increasing peristalsis

magnesium citrate

contraindicated in appendicitis and obstruction

magnesium citrate

used for MI, bed rest, meds that constipate, hemorrhoids, pre-op or pre-testing

magnesium citrate

side effects: dehydration, magnesium toxicity, fluid retention, exacerbate HF, HTN, edema

magnesium hydroxide

class: osmotic/saline laxative

MoA: hyperosmolar salts pull water into intestine and increases bulk of feces increasing peristalsis

magnesium hydroxide

contraindicated for renal dysfunction, appendicitis, obstruction

magnesium hydroxide

used for MI, bed rest, meds that constipate, hemorrhoids, pre-op/pre-testing

magnesium hydroxide

side effects: fluid retention (CHF, edema, RI), ARF in patients taking diuretic

omeprazole

prilosec

omeprazole

class: proton pump inhibitor

MoA: blocks the final common pathway of gastric acid production --> inhibits basal and stimulated acid release, irreversible blockage of ATPase

omeprazole

used for peptic ulcer disease, prevention of stress ulcers in hospitals

omeprazole

side effects:

short term: headache, diarrhea, nausea, pneumonia

long term: risk for gastric carcinoma and hip fractures

misoprostol

cytotec

misoprostol

class: prostaglandin E, antiulcer

MoA: suppresses gastric acid secretion, promotes secretion of bicarbonate and mucus, maintains blood flow

misoprostol

used for prevention of gastric ulcers, caused by long term therapy with NSAIDs, peptic ulcer disease

misoprostol

side effects: diarrhea, abdominal pain, dysmenorrhea

metoclopramide

reglan

metoclopramide

class: dopamine antagonist, antiemetics

MoA: PNS mimetic, cholinergic, increased CRTZ threshold, increased GI emptying

metoclopramide

contraindicated with alcohol, cough meds, CNS depressants

no driving after

causes dry mouth (suck on candy)

take 30 minutes after meals

metoclopramide

used to suppress post-op nausea and vomiting, suppress emesis from anticancer drugs

metoclopramide

side effects: restlessness, extrapyramidal reactions, neuroleptic malignant syndrome, anxiety, arrhythmias, gynecomastia

ondansetron

zofran

ondansetron

class: serotonin antagonist, antiemetics

MoA: blocks serotonin receptors in the CRTZ and on afferent vagal neurons in upper GI tract

ondansetron

contraindicated with alcohol, cough meds, CNS depressants, no driving after, causes dry mouth (suck on candy)

ondansetron

used to prevent nausea and vomiting from radiotherapy and anesthesia

ondansetron

side effects: headache, diarrhea, dizziness

cimetidine

tagamet

cimetidine

class: histamine (H2) receptor antagonist

MoA: blocks H2 receptors in parietal cells reducing the secretion of gastric acid

cimetidine

used for peptic ulcer disease, reflex esophagitis, GERD, Zollinger-ellison syndrome, heartburn, acid indigestion, sour stomach

cimetidine

side effects: gynecomastia, reduced libido, impotence, diarrhea, dizziness, renal impairment, confusion, hallucinations, lethargy

sucrarafate

carafate

sucrarafate

class: gastric protective agent

MoA: creates a protective barrier against acid and pepsin becomes viscous and sticks to ulcer, requires acid environment

sucrarafate

used for peptic ulcer disease, acute therapy and maintenance therapy of duodenal ulcers

sucrarafate

side effects: constipation

sucrarafate

interacts with theophylline, digoxin, warfarin, fluroquinolones, give one hour before meals, do not give with antacids or H2 antagonist

diphenoxylate/atropine

lomotil

lomotil

class: antidiarrheals, local acting

MoA: decreases hypermotility and peristalsis

lomotil

used for soothing effect on irritated bowel

lomotil

side effects: addiction (opiate physical dependence) (mix of atropine and demerol)

famotidine

pepcid

pepcid

class: histamine receptor antagonist

MoA: blocks H2 receptors in parietal cells reducing secretion of gastric acid

pepcid

used for peptic ulcer disease, more potent, less side effects, fewer drug interactions so used most frequently

levodopa/carbidopa

Sinemet, Parcopa

levodopa/carbidopa

class: dopamine agonist, antiparkinson

MoA: reduces symptoms by increasing dopamine synthesis, enters brain, restores balance between dopamine and AcH, carbidopa enhances levodopa

levodopa/carbidopa

used for severe symptoms of parkinsons

most effective therapy

levodopa/carbidopa

side effects: nausea and vomiting, psychosis, visual hallucinations, vivid dreams, paranoia, anxiety cognitive impairment, insomnia, impulse control, behavioral changes, dyskinesias

entacapone

comtan

entacapone

class: catecol-methyltransferase inhibitor, antiparkinson

MoA: inhibits metabolism of levodopa

entacapone

interactions with antihypertensive, adrenergic agonist, beta-adrenergic agonists

entacapone

used for management of motor fluctuations

entacapone

side effects: nausea, constipation, yellow-orange urine, dyskinesias, orthostatic hypotension, hallucinations, sleep disturbances, impulse control

donepezil

aricept

donepezil

class: cholinergic, anti-alzheimer

MoA: reversible inhibition of cholinesterase

donepezil

used for mild, moderate or severe AD, slows progression of disease, doesn't stop it

donepezil

side effects: nausea, diarrhea, bradycardia, fainting, falls, fall-related fractures

memantine

namenda

memantine

class: N-methyl-D-aspartate antagonist, anti-alzheimer

MoA: blocks neuronal receptors for N-methyl-D-aspartate

memantine

used for moderate to severe AD, better tolerated than cholinesterase inhibitors

memantine

side effects: dizziness, headache, confusion, constipation

interferon-beta

class: interferon, anti-MS

MoA: antiviral and immunoregulatory properties produced by interacting with specific receptor sites on cell surfaces may explain beneficial effects

interferon-beta

cautious with previous suicidal tendencies, seizures, CHF, pregnancy

interferon-beta

used for MS, reduces severity and frequency of attacks, reduces development of brain lesions detectable by MRI

interferon-beta

side effects: flu, hepatotoxicity, myelosuppression, depression, suicidal thoughts

mitoxantrone

class: immunosupressant

MoA: binds with DNA and inhibits topoisomerase

mitoxantrone

used for MS, decreases clinical attack ratem reduces development of new brain lesions, slows progression of disability

mitoxantrone

side effects: myelosuppression, cardiotoxicity, fetal harm, reversible hair loss, nausea, amenorrhea, blue-green tined urine/skin

amitriptyline

elavil

amitriptyline

class: tricyclic antidepressants, antidepressant

MoA: by inhibiting the uptake pumps for NE and serotonin, TCA causes this transmitter to accumulate in synaptic space, intensifying transmission