| Hint | Answer |
|---|
| Ranitidine class | |
| Group MOA: Lipophilic weak bases. Prodrugs are protonated & concentrated in parietal cell canaliculus; converted to the active thiophilic sulfonamide cations, which inactivate H+/K | |
| Omeprazole class | |
| MOA: Competitive inhibition of parietal cell __ receptor (decreases cAMP). Effective at inhibiting nocturnal acid secretion (stim by histamine), modest impact on meal-stim acid sec | |
| Use: GERD (best); PUD ('triple tx' w/ clarithromycin & amoxicillin or metronidazole); prevent stress-related mucosal bleeding; gastrinoma & other hypersecretory conditions | |
| MOA: Negatively charged. A salt of sucrose complexed w/ sulfated Al hydroxide. Forms a viscous paste that selectively binds to ulcers or erosions | |
| SE: Belching & met alkalosis (CO2); diarrhea or constipation; fluid retention; hypercalcemia (milk-alkali syndrome); decreased absorption of other meds | |
| MOA: Decrease intragastric acidity by reacting w/ gastric HCl to form a salt & water | |
| Cimetidine class | |
| Misoprostol class | |
| Sodium Bicarbonate class | |
| P-kinetics: Inhibit p450 drug metabolism. Inhibits gastric first-pass metabolism of ETOH, esp. in women. | |
| SE: Safe. Black stool, dark tongue (liquid formulations). Salicylate tox (N/v, sweating, tachypnea, tinnitus, fever) | |
| Contraindications: All are metabolized by hepatic p450 cytochromes. Altered intragastric acidity affect other drug bioavailability. | |
| Sucralfate class | |
| SE: Diarrhea, cramping abd pain (10-20%). Stimulates uterine contractions (abortifacient) | |
| Lansoprazole class | |
| Bismuth Subsalicylate class | |
| SE: gynecomastia, impotence, galactorrhea (interferes w/ the metabolism of estrogen - enhancing estrogen activity) | |
| Rabeprazole class | |
| Aluminum hydroxide class | |
| Use: Dyspepsia, acute diarrhea | |
| | Hint | Answer |
|---|
| P-kinetics: Administered as inactive prodrugs. Enteric-coated for delayed release (acid-labile) | |
| Use: NSAID-induced peptic ulcer | |
| Group MOA: Inhibits both fasting & meal-stimulated acid secretion (Inhibits the final common pathway) | |
| Nizatidine class | |
| Pantoprazole class | |
| Calcium carbonate class | |
| MOA: PGE1 analog. Noncompetitive inhibition of histamine-mediated cAMP production in parietal cells Mucosal prostaglandins stim secretion of bicarb and mucus | |
| Famotidine class | |
| SE: Safe (< 3% diarrhea, HA, fatigue, constipation)l cross placenta, in breast milk; block cardiac H2-R (rapid IV-high HR-low BP); CNS (confusion, hallucination,agitation) | |
| Esomeprazole class | |
| P-kinetics: Inhibits gastric first-pass metabolism of ETOH, esp. in women | |
| Magnesium hydroxide class | |
| Use: Dyspepsia, acid-peptic disoders | |
| Use: GERD (longer duration than antacids), PUD (replaced by PPI), prevention of bleeding from stress-related gastritis | |
| The S-isomer (active) of omeprazole | |
| Racemic mixture of R- and S- isomers | |
| P-kinetics: Short half-life (TID or QID) | |
| SE: Safe (1-5% diarrhea, HA, abd pain); lower oral vit B12 absorption; resp & enteric infxns (gastric acid prevents colonization & infxn of GI); elev serum gastrin (feedback mechan | |
| Use: GI bleeding | |
| MOA: Coats ulcer & erosions/ Inhibits intestinal prostaglandin & Cl secretion | |
| SE: No systemic adverse effect (not absorbed), constipation (under 2% d/t aluminum salt) may bind to other meds | |
|
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