Aluminum carbonate gel

calcium carbonate

Magaldrate

magnesium hydroxide

aluminum hydroxide

simethicone

Reduce acid in stomach don't need to be absorbed to provide pharmacological effect all reactions are in the GI

Diarrhea, constipation, electolyte imbalance aluminum accumulation

These interfere with the absorbtion of oral drugs

Cimetidin Famotidine

Nizatidine Ranitidine

Absorbed rapidly and completly from GI tract

Absorbtion may be delayed by antacids

Drug is metabolized in the liver

H2 block histamine from stimulating the acid secreting parietal cells of the stomach

USED to promote healing

povide long term treatment in cases of zollinge-ellison or similar

Decrease gastric acid in severly ill patients

Esomoprazole pantoprazole

lansoprazole rabeprazole

omeprazole

PPI'S are usually given PO they have an intric coating to get them through the stomach they don't do well in acid

USES short term tratment of active gastric ulcers

active duodenal ulcers

erosive esophagitis

Active with H pylori (combined with antibiotics)

Long term use with zollinger-ellison or similar

Used to combat inflammation, unlike ASA the effects on platelet aggregation (clotting) are temporary

NSAIDS block Cox 1 and 2 (non selective) or Cox 1 (selective)

only one selective NSAID on market-celecoxib

Non selective-Ibuprofen, diclofenac, etodolac, fenoprofen, flurbiprofen,

All are metabolized by the liver and excreted by kidneys, COX-1 is good it maintains the lining of the stomach

COX-2 is bad it produces inflammation

Grouped into generations 1-4

1st generation include cefadroxil, cefazolin, sodium

2nd-cefaclor, cefprozil, cefoxitin, cefuroxime axetil

3rd-cefaclor, cefprozil, cefoxiin, fefuroxime axetil

4th cephalosporins include cefepime hydrochloride

Penicillin and cephalosporins are chemically similar watch for cross-sensitivity

Not absorbed from GI well or at all

second and third generation cross blood brain barrier

All are secreted primarily unchanged by the kidneys

WORK by inhibiting cell wall synthesis damages the cell wall allows natural defense to destroy cell

1st G- gram+

2nd G- gram-

3rd G- gram -

4th G- both

Aminoglycosides

Destroy bacteria gram- some gram+ mycobacteria some protozoa

some examples include amikacin sulfate, gentamicin sulfate, kanamycin sulfate, neomycin sulfate, paromomycin sulfate,

absorbed poorly from GI tract parenterally after injection aminoglycoside absorption is rapid and complete

cross placental barrier but not the blood brain barrier

aminoglycosides aren't metabolized, they're excreted primarily unchanged by the kidneys

BACTERICIDAL they kill bacteria

May cause OTOTOXICITY (ear damage)

Antibacterial four groups

Natural penicillins penicillin G benzathine, penicillin G potassium, Penicillin G procaine, penicillin G sodium

Penicillinase-resistant penicillins- dicloxacillin, nafcillin, oxacillin

Aminopenicillins- amoxicillin, ampicillin

extended-spectrum penicillins carbenicillin, ticarcillin

Oral administartion penicillins are absorbed minly in the duodenum and the upper jejunum of the small intestine

Most penicillins should be given on an empty stomach (one or two hours before or after a meal)  disributed widely to most areas of the body also appers high concentrations in urine making them good to fight UTI's

excreted 60% unchanged in urine

Bactericidal in action

widest coverage of families of bacterium from G+ to G-

ROUTES oral or IM