Bowel Disorders/Gastrointestinal Cond. Flashcards

1
Q

Parasympathetic

A

Rest and digest, inc peristalsis

Driven by acetylcholine (Ach)

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2
Q

Sympathetic

A

Fight or Flight, dec peristalsis

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3
Q

Serotonin receptors

A

5-HT4 inc motility and Ach release

5-HT3 involved emesis

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4
Q

u Opiod receptor

A

Decrease acid secretion and propulsive waves

Increase constipation and water absorption

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5
Q

Simple nausea relief

A

Antihistamines
Antacids
Peppermint and ginger

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6
Q

Ondansetron (zofran) MOA

A

Blocks 5-HT3 receptors in vomiting centers of brain

Pregnancy X

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7
Q

Antihistamines and anticholinergics (Emesis)

A

Simple nausea and motion sickness

Scopolamine(hyoscine)
Dramamine(dimenhyrdinate)
Benadryl(diphenhydramine)

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8
Q

Scopolamine MoA

A

M1 cholinergic receptor antagonist

Blocks Ach

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9
Q

Benadryl MoA

A

H1 antagonist

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10
Q

D2 receptor antagonists (Emesis)

A

Used as antipsychotics and severe nausea/vomiting

Metoclopramide(reglan)
Prochlorperazine(compazine)
Haloperidol (halfol)

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11
Q

Prochlorperazine (Compazine) MoA

A

Block D2 receptors

Can have anticholinergic effects

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12
Q

Metoclopramide (Reglan) MoA

A

Antagonize 5-HT3 amd D2 receptors
Agonize 5-HT4 in stomach

Ok for pregnant women

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13
Q

Cannaboid receptor agonist

A

Dronabinol (Marinol)

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14
Q

Dronabinol (marinol) MoA

A

CB receptor agonist->antiemetic

Increase appetite

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15
Q

Types of Diarrhea

A

Osmotic
Infectious
Travellers
Hormonal

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16
Q

Osmotic Diarrhea

A

Too much salt pulled into stool

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17
Q

Infectious diarrhea

A

Treat infection, for example use bismuth salts (pepto bismol)

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18
Q

Travellers diarrhea Drugs

A

Ciproflaxin
Norfloaxin
Metronidazole

19
Q

Ciproflaxin amd Norfloaxin MOA

A

Cholera tx

Bind to DNA gyrase preventing bacteria from replicating

20
Q

Metronidazole MoA

A

Inhibit bacterial DNA synthesis

21
Q

Hormonal diarrhea

A
VIPoma
Octretide(Sandostatin)
22
Q

Octreotide(Sandostatin) MoA

A

Somatostatin analog/receptor agonist that reduces VIP secretion

23
Q

Opioids for diarrhea MoA/ Drugs

A

stimulate u receptor to dec propulsion/motility and inc water reabsorption

Difenoxin (Motofen) -active
Diphenoxylate ( Lomotil) prodrug
Loperamide(Imodium) go to OTC

24
Q

What is added to D D L opiods for diarrhea?

A

Atrophine

anticholinergic

25
Q

Bulk-Forming laxative (C)

A

Metamucil (psyllium mucilloid)

insoluble fiber is bulk forming

26
Q

GI Stimulant (C)

A

Bisacodyl (Correctol, Dulcolax)
Senna (Ex-Lax, Senokot)

MoA-Irritate bowel mucosa to facilitate GI motility

27
Q

Stool softeners (C)

A

Docusate (Dulcolax stool softener)

MoA- water and fats pulled into stool to facilitate motility

28
Q

Saline and osmotic cathartics (C)

A
Lactulose (chronulac)
Magnesium hydroxide (milk of mag)
Polyethylene glycol (miralax)

MoA- pull water into stool

29
Q

Opioid induced constipation drug

A

Naloxegol (movantik)

MoA- opioid receptor blocker

30
Q

Herbal Agents(C)

A

Senna and flaxseed

31
Q

Why is mineral oil discouraged?

A

interfere with absorption of fat soluble vitamins

32
Q

Irritable Bowel Syndrome (IBS)

A

Normal operation of digestive tract is impaired without the presence of detectable organic disease

no prototype drug

33
Q

Inflammatory Bowel Disease (IBD)

A

Crohn’s Disease- TH1 mediated/ intestine or colon

Ulcerative colitis -TH2 mediated/ wall of colon

34
Q

Anti-Inflammatory Drugs for IBD

A

Sulfsalazine(azulfadine)
Olsalazine(dipentum)
5-aminosalicylic acid (mesalazine)

MoA-decrease inflammatory cytokines and arachidonic acid relaese (cox 1/2)

35
Q

Corticosteroids for IBD

A

Prednisone
Methylprednisolone

MoA- immune suppressor via stimulating GRE in nucleus

36
Q

Concerns using Prednisone with a flare?

A

Can cause immune cells to leave the blood and hide symptoms since immune system is suppressed

37
Q

Immunosuppressants for IBD

A

Azathioprine (imuran)
Methotrexate
Cyclosporin

38
Q

Azathiprine MoA

A

decrease cell division- immune suppression

39
Q

Methotrexate MoA

A

Blocks IL-1B at receptor, key cytokine in inflamm.

40
Q

Cyclosporin MoA

A

Inhibits caclineurin which decreases IL-2 which inhibits t cell production

41
Q

Biologics for IBD

A

Ustekinumab (stelara)
Tofacitinib (xeljanz)
Infliximab (remicade)

42
Q

Infliximab (remicade) MoA

A

monoclonal antibody binds TNFa

43
Q

Ustekinumab (stelara) MoA

A

monoclonal antibody inhibitig IL-12 and -23

last drug for crohn’s

44
Q

Tofacitinib (xeljanz) MoA

A

Jak/ STAT inhibitor

black box warning/ last drug for UC