pharm poop drugs

antacids MOA

neutralize stomach acid

what do antacids do?

reduce heartburn & acid

antacids contraindications

kidney problems

GI obstruction

heart failure

pregnancy

when should antacids be taken?

1-2 hours before other meds (can cause chelation)

does giving antacids with water help?

increases absorption

what is chelation?

reduced drug absorption from chemical binding to another drug

aluminum salts adverse fx

constipation

which salts do people with renal failure usually take?

aluminum salts

examples of magnesium salts

magnesium hydroxide (milk of mag)

examples of aluminum combination salts

maalox (aluminum & mag), mylanta (aluminum, mag, & simethicone)

magnesium salts adverse fx

diarrhea

magnesium salts contraindications

renal disease (failing kidneys cannot excrete mag, so accumulation occurs)

examples of calcium salts

calcium carbonate (Tums)

calcium salts adverse fx

constipation, __**kidney stones**__, acid rebound

calcium salts contraindications

renal disease

what does simethicone do when combined with calcium salts?

reduces gas caused by calcium antacids

does sodium bicarbonate have fast or slow onset & duration?

quick onset, short duration

what does sodium bicarbonate do?

buffers HCl

sodium bicarbonate adverse fx

metabolic alkalosis

sodium bicarbonate contraindications

uncontrolled HTN, renal failure, heart disease

what is an example of an antiflatulent drug?

simethicone (GasX)

what does simethicone do?

relieves painful symptoms associated with gas

simethicone MOA

alters elasticity, breaking mucus-coated bubbles into smaller ones

simethicone contraindications

gas-producing foods (beans, broccoli, cauliflower, etc.)

simethicone adverse fx

increased expulsion (burping or farting)

example of H2 receptor antagonist

famotidine

H2 receptor antagonist MOA

reduce acid secretion

what are H2 receptor antagonists usually used for?

GERD, PUD, etc.

H2 receptor antagonists adverse fx

confusion, disorientation

famotidine: thrombocytopenia (less than 150k platelets)

what does smoking do when used with H2 receptor antagonists?

decreases effectiveness of the med

when should H2 receptor antagonists be used?

1-2 hours before antacids

examples of PPIs

omeprazole, pantoprazole, esomeprazole

what are PPIs?

proton pump inhibitors

PPIs MOA

stop HCl production

what are PPIs used for?

prophylaxis for stress ulcers

treatment of H. pylori induced ulcers

PPIs adverse fx

osteoporosis, C. diff, etc.

PPIs contraindications

use with warfarin or sucralfate

what does sucralfate do when used with PPIs?

delay absorption of PPIs

when should PPIs be taken?

30-60 minutes before a meal

what is sucralfate?

acid-controlling drug

what is sucralfate used for?

stress ulcers, PUD

active ulcers

sucralfate adverse fx

constipation, nausea, dry mouth

when should sucralfate be taken?

2 hours after all other drugs

1 hour before meals & at bedtime (3-4 times a day)

what is misoprostol?

acid-controlling drug

what is misoprostol used for?

prevention of NSAID induced ulcers

misoprostol adverse fx

abdominal cramps, diarrhea

misoprostol contraindications

PREGNANCY (must obtain 2-3 negative tests; can terminate pregnancies)

what can happen if antacids are used long-term?

can mask symptoms of serious underlying diseases

what are the 3 categories of antidiarrheal drugs?

absorbents, antimotility drugs, & probiotics

examples of absorbents

bismuth salicylate (Pepto-Bismol)

absorbents MOA

coat walls of GI tract, bind to causative bacteria or toxin & eliminates it through stool

what are absorbents used for?

milder cases of diarrrhea

absorbents adverse fx

reye’s syndrome, increased bleeding time, metallic stools, blue tongue, constipation, dark stools

absorbents contraindications

use with warfarin (increases bleeding time & interferes with absorption of vitamin k)

should bismuth salicylate be given to children?

no - it is a form of aspirin

which drug is a form of aspirin?

bismuth salicylate

what are the two categories of antimotility drugs?

anticholinergics & opiates

examples of anticholinergic antimotility drugs

beladonna alkaloids (atropine, hydrocyamine)

anticholinergic antimotility drugs MOA

slow movement through GI tract

what are antimotility drugs used for?

more severe cases of diarrhea

anticholinergic antimotility drugs adverse fx

drying effects: **dry skin**, flushing, hypotension, urinary retention, **blurred vision**

examples of opiate antimotility drugs

loperamide, diphenoxylate

opiate antimotility drugs MOA

decrease bowel motility & relieve rectal spasms

what is diphenoxylate normally combined with & why?

atropine - diphenoxylate has high rates of abuse, so when it is combined with atropine, the adverse fx prevent people from wanting to use it too much

opiate antimotility drugs adverse fx

respiratory depression, hypotension, urinary retention

diphenoxylate (when combined with atropine): dry mouth, tachycardia, vision changes

examples of probiotics

lactobacillus acidophilus (Bacid)

probiotics MOA

supply missing bacteria to GI tract, suppress growth of diarrhea-causing bacteria

what are probiotics used for?

antibiotic-induced diarrhea

what are the five categories of laxatives?

bulk-forming, emollient, hyperosmotic, saline, stimulant

what do all laxatives cause?

electrolyte imbalances

examples of bulk-forming laxatives

psyllium (Metamucil)

bulk-forming laxatives MOA

absorb water to increase bulk

what are bulk-forming laxatives used for?

IBS, acute & chronic constipation

bulk-forming laxatives adverse fx

impaction, esophageal blockage, **fluid disturbance**

which laxatives can be taken every day long-term with no problems?

bulk-forming laxatives

examples of emollient laxatives

docusate sodium, mineral oils

emollient laxatives MOA

stool softeners: allow more water & fat to be absorbed into the stool

lubricants: lubricate fecal matter (soften BM)

what are emollient laxatives used for?

fecal impaction

emollient laxatives adverse fx

skin rashes, decreased absorption of vitamins, lipid pneumonia

examples of hyperosmotic laxatives

polyethylene glycol, glycerin, lactulose

hyperosmotic laxatives MOA

increase fecal water content

hyperosmotic laxatives adverse fx

rectal irritation

examples of saline laxatives

magnesium hydroxide (Milk of Mag), magnesium citrate

saline laxatives MOA

increase osmotic pressure in GI tract

saline laxatives adverse fx

magnesium toxicity, cramping, increased thirst

saline laxatives contraindications

renal insufficiency (can cause magnesium toxicity)

examples of stimulant laxatives

senna, bisacodyl

stimulant laxatives MOA

increase peristalsis via nerve stimulation

stimulant laxatives adverse fx

discolored urine, rectal irritation, nutrient malabsorption

are laxatives used for all abdominal pain?

not unless you know what causes the constipation

what are the 7 categories of antiemetic/antinausea drugs?

anticholinergics, antihistamines, antidopaminergics, neurokinin receptor antagonists, prokinetics, serotonin blockers, THC

antiemetics/antinausea drugs MOA

most work by blocking one of the vomiting pathways

antiemetic/antinausea drugs adverse fx

many cause drowsiness

ondansetron: prolonged QT (monitor heart)

prokinetic drugs: long-term use can cause tardive dyskinesia

antiemetic/antinausea drugs contraindications

anticholinergics: glaucoma

examples of anticholinergic antiemetic/antinausea drugs

scopolamine

examples of antihistamine antiemetic/antinausea drugs

dimenhydrinate, diphenhydramine, meclizine, hydroxyzine

examples of antidopaminergic antiemetic/antinausea drugs

promethazine, droperidol

examples of prokinetic antiemetic/antinausea drugs

metoclopramide

examples of serotonin blockers

ondansetron

examples of THC drugs

dronabinol