Drug Name



Drug Name |Clinical Use |MOA |Toxicity / Side fx |Special Notes | |

|Antihistamines |

| |Long-term mild to moderate | | |Inhaled; Less efficacious than |

|Cromolyn Sodium |asthma prophylactic |Inhibits mast cell degranulation |Minimal / None |glucocorticoids, but w/o side fx |

| |Allergies; motion sickness; | |Anti-muscarinic (blurred vision, dry |t½ ~4h; Cannot block |

|Diphenhydramine (Benadryl® |Better as prophylactic than |H1 receptor antagonist |mouth, gastric distress, dysuria) & |bronchoconstrictive fx of LTD4 or PAF|

|and other combo agents) |as histamine reversal agent. |(1st generation) |sedative fx; insomnia, hallucination, |(epi-like agent req’d. |

| | | |CNS stimulation w/ intoxication | |

| | | |Little crosses BBB @ therapeutic |t½ ~12-24h; Claritin® and Allegra® |

|Cetirizine (Zyrtec®) |Same as above |H1 receptor antagonist |doses, so virtually NO CNS or |similar; (see also note above) |

| | |(2nd generation) |anti-muscarinic fx | |

| | | |Significant anti-androgen fx |Highly specific: H2 receptors ONLY – |

|Cimetidine (Tagamet®) |Potent anti-ulcer agent, GERD|H2 receptor antagonist; blocks HCl |(gynecomastia, impotence, menstrual |major pathway of parietal cell |

| | |release from parietal cells |problems, hyper-prolactinemia); |stimulation! In trauma cases, given |

| | | |crosses placenta; Potent P450 |i.v. in the ICU (stress ulcers) |

| | | |inhibitor | |

| | | | |5-12X more potent than cimetidine; |

|Ranitidine (Zantac®) |Potent anti-ulcer agent, GERD|H2 receptor antagonist; blocks HCl |Less P450 inhibition than cimetidine. |80% healing duodenal ulcer in 40d; |

| | |release from parietal cells | |NOT anti-androgenic; High doses |

| | | | |useful in GERD |

|Gastroenteric Drugs |

| |Peptic ulcer disease; |PGE analog – protects epithelial cell, | | |

|Misoprostol |prophylactic w/pts. Requiring|promotes mucous secretion / inhibits acid| | |

| |large doses of NSAIDS |secretion | | |

|NaHCO3 (AlkaSelzer® = Na/K | |Antacid: neutralizes stomach HCl |Systemic alkalosis; acid rebound; |Very potent: pH goes to 7! Rapid |

|bicarb and citrate) |Peptic ulcer disease | |enormous Na+ load to hypertensive pt. |acting. |

| | | |Acid rebound (gastrin release), | |

|CaCO3 (Tums®) |Peptic ulcer disease |Antacid: neutralizes stomach HCl |systemic alkalosis and hypercalcemia; |Strong, rapid acting. |

| | | |renal stones with PO4; Constipates | |

| | | |Much more soluble than Ca or Al salts,| |

|Mg++ salts: Mg(OH)2, MgCO3 |Peptic ulcer disease |Antacid: neutralizes stomach HCl |toxic systemic fx in renal |Less rapid neutralization – less acid|

|(Phillips M.O.M.®) | | |insufficiency; Cathartic (exerts |rebound |

| | | |osmotic pressure) | |

| | | |Binds phosphate: promotes | |

|Al+++ salts (Rolaids®) |Peptic ulcer disease |Antacid: neutralizes stomach HCl |osteomalacia; blocks gut absorption |Less rapid neutralization – less acid|

| | | |(Fe, tetracylines, etc.); Constipates |rebound |

| | | |– slow gastric emptying. | |

| | |Antacids: neutralize stomach HCl; | |Some combo. antacids also contain |

|Combinations: |Peptic ulcer disease |constipating Al salts counteract | |simethicone (Phazyme®), which breaks |

|Maalox®; Mylanta® | |cathartic Mg salts; also combine fast and| |bubble surface tension to release gas|

| | |slaw acid neutralization action | |from GI tract. |

| | | |Dry mouth, tachycardia, ocular | |

|Atropine |Was used as adjuvant for PUD |Anticholinergic (non-specific |disturbances, increased IOP w/narrow |Bottom line: |

| | |anti-muscarinic, M1, M2 & M3 receptor); |angle glaucoma, ↓ sweat, urinary |DON’T USE IT!! |

| | |decreases gastric secretions, but also… |retention, and some CNS depression. | |

| | | |(MAD, RED, HOT, BLIND, DRY). | |

| | |Mucosal protectant: neg. charged sulfate | |Complex of sucrose-SO4 and Al+++; |

|Sucralfate (Carafate®) |Peptic ulcer disease |groups complex with pos. charged amino |Constipation (it has Al+++!) |poorly absorbed: take B4 meals; need |

| | |groups of proteins in crater to form | |pH ................
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