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GI/Liver > Lec 12 GI Pharm > Flashcards

Lec 12 GI Pharm Flashcards

1
Q

What type of drug: neutralizes acid

A

antacids

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2
Q

What 2 types of drugs: decreased acid secretion?

A
  • H2 antagonist

- proton pump inhibitor [omeproazole]

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3
Q

What 2 drugs: increase gastric emptying

A
  • metoclopramide

- domperidone

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4
Q

What 3 drugs: increase tone of LES?

A
  • metoclopramide
  • cisapride
  • bethanechol
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5
Q

What 2 drugs: mucosal protection?

A
  • sucralfate

- alginate

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6
Q

What drug: increased esophageal acid clearance?

A

metoclopramide

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7
Q

What dysphagia to just solids vs dysphagia to solids + liquids sugest?

A

just solids = mechanical cause

solids + liquids = motility disorder

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8
Q

What are 4 factors that aid in esophageal acid clearance?

A
  • saliva
  • esophageal peristalsis
  • gastric emptying
  • intact esophageal mucosa
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9
Q

What is action of motilin?

A

hormone made in duodenum; pro-motility –> increases phase II contractions of MMC

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10
Q

What is an example of a motilin agonist?

A

erythromycin

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11
Q

What is action of prostaglandins in gastric defense?

A
  • stimulate mucous production
  • epithelial cell repair
  • bicarbonate
  • mucosal blood flow
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12
Q

What is mech of antacids?

A

local neutralization of acid

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13
Q

Bismuth compound: mech

A

Bind to ulcer base, providing physical protection and allowing HCO3– secretion to reestablish pH gradient in the mucous layer.

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14
Q

Misoprostol: mech

A

PGE1 analog.

production and secretion of gastric mucous barrier,acid production.

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15
Q

Misoprostol: toxicity

A

Diarrhea.

Contraindicated in women of childbearing potential (abortifacient).

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16
Q

proton pump inhibitors: mech

A

Irreversibly inhibit H+/K+ ATPase in stomach parietal cells.

17
Q

Name the 5 proton pump inhibitors

A 
Omeprazole
lansoprazole
esomeprazole
pantoprazole
dexlansoprazole
18
Q

PPI: clinical use

A

peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syndrome.

19
Q

PPI: toxicities

A

Increased risk of C. difficile infection, pneumonia.

Hip fractures, serum Mg2+ with long-term use.

hypergastrinemia

20
Q

What is the common initial treatment for H pylori?

A

triple therapy

proton pump inhibitor + clarithromycin + either amoxicillin or metronidazole

21
Q

Metoclopramide: mech

A

D2 receptor antagonist.

increases resting tone, contractility, LES tone, motility. Does not influence colon transport time.

22
Q

What is clinical use of metoclopramide?

A

Diabetic and post-surgery gastroparesis, antiemetic for chemo

GERD

23
Q

Metoclopramide: toxicity

A

parkinsonian effects. Restlessness, drowsiness, fatigue, depression, nausea, diarrhea.

Drug interaction with digoxin and diabetic agents.

Contraindicated in patients with small bowel obstruction or Parkinson disease (D1-receptor blockade).

24
Q

What is antidote to metoclopramide?

A

anti-cholinergic like atropine

GI/Liver (36 decks)

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