010815 upper GI pharm Flashcards Preview

Gastrointes > 010815 upper GI pharm > Flashcards

Flashcards in 010815 upper GI pharm Deck (44):
1

what role do prostaglandins play in upper GI?

PGI2 and PGE2 are protective:
decrease gastric acid production
increase mucus production

2

H+/K+ ATPase pump inhibitors are used for

gastric and duodenal ulcers
GERD
pathological hypersecretory conditions like Zollinger Ellison syndrome

3

list types of H+/K+ ATP ase pump inhibitors

the zoles

omeprazole
esomeprazole
lansoprazole

4

how do the H+/K+ ATPase pump inhibitors get targeted to their site of action?

they are prodrugs and only in the acidic gastric secretory canaliculi are they catalyzed to a sulfonamide

5

MOA of H+/K+ ATPase pump inhibitors

irreversibly inactivate the H+/K+ ATPase pump, so only way for the stomach to overcome it is to make new proton pumps!

6

metabolism of H+/K+ ATPase pump inhibitors

hepatic P450

7

side effects of H+/K+ ATPase pump inhibitors

few
chronic use-increased risk of bone fracture, increased risk of infection

8

MOA of H2 receptor antagonists

competitively bind to histamine H2 receptors on parietal cells. reversible binding.

9

list H2 receptor antagonists

cimetidine (inhibits P450)
ranitidine

the -dines

10

can develop tolerance to H2 receptor antagonists: true or false?

true

11

two main drug mechanisms for decreasing acid

H2 antagonist on parietal cell
proton pump inhibitors on parietal cell

12

in treating ulcers, what are the possible approaches?

decrease acid
increase protective mechanisms

13

sucralfate

sucrose sulfate and Al(OH)3

14

MOA of sucralfate

in stomach acid, forms a polymer gel in the acid environment. adheres to epithelial cells and ulcer craters to protect the ulcer by coating it from pepsin hydrolysis

15

antacids-list them

Al(OH)3
Mg(OH)2
CaCO3

16

which antacid produces CO2 as side effect?

CaCO3

17

which antacid has constipation as side effect? diarrhea?

constipation: Al(OH)3
diarrhea: Mg(OH)2

so Mg and Al are combined in many antacid preps to offset each other

18

cautions for antacids

avoid concurrent administration of antacids and drugs intended for systemic absorprtion (antacids can change drug absoprtion and elimination because they alter gastric and urinary pH)

19

bismuth subsalicylate

trivlanet bismuth and salicylate suspended in mix of magnesium aluminum silicate clay

called Pepto bismol

20

use of bismuth subsalicylate

ulcer

21

black stools, black tongue side effect comes from?

bismuth subsalicylate

22

antibiotic for H pylori consists of

multi agent antibiotic therapy (single one is ineffective)

23

tx strategy for NSAID related mucosal injury

if can't stop using NSAID:
reduce acid
replace prostaglandins (not used much)

24

treatment for active ulcers that are non-H pylori and non-NSAID

reduce acid

25

MOA of bismuth subsalicylate

unknown exactly

26

scopolamine most acts through

Ach (muscarinic) receptor--antagonist

27

dimenhydrinate mostly acts through

histamine H1 receptor--antagonist

28

granisetron and ondansetron mainly act through

serotonin receptor

29

metoclopramide mainly acts through

dopamine receptor

30

prochlorperazine mainly acts through

dopamine receptor

31

dexamethasone

steroid

32

use of scopolamine

motion sickness , post op nausea

33

use of dimenhydrinate

motion sickness
post op nausea

34

serotonin receptor antagonists--list them

ondansetron
granisetron

35

use of serotonin receptor antagonists

chemotherapy, irradiation related nausea

36

use of prochlorperazine

general use, not chemo nausea

37

dronabinol MOA

CB1 receptor agonist

38

use of dronabinol

prophylaxis of refractory, chemo induced vomiting

39

dexamethasone used for

in conjunction with other anti-emetics for chemo

40

aprepitant MOA

substance P and NK1 receptor antagnoist

41

use of aprepitant

combo therapy-usally given with serotonin antagonist and corticosteroid

42

metoclopramide

prokinetic agent
D2 antagonist

enhances gastric emptying by enhancing Ach release in myenteric plexus

43

use of metoclopramide

diabetic gastroparesis and GERD

44

erythromycin

acts similar to motilin
tx for diabetic gastroparesis (off label)