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Pharm Test 5 > Lec 2 - GI Drugs > Flashcards

Lec 2 - GI Drugs Flashcards

1
Q

Gastrin is released from ____ cells into the ____.

A

G, bloodstream

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2
Q

gastrin:
binds ___ cells via the ____ receptor, causing a release of histamine;
binds ____ cells, causing a release of acid;

which is the more important effect?

A

ECL, CCKb (more important);

parietal

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3
Q

Gastrin is release in response to _____ and _____

A

peptides, vagal stimulation

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4
Q

vagal effects:
ACH binds ____ receptors on ____ cells, causing an increase in acid release;
_____ binds G cells, causing gastrin release

A

M3, parietal;

GRP

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5
Q

Histamine is released from ____ cells. it binds ____ receptors, which are G __ coupled on parietal cells

A

ECL;

H2, s

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6
Q

what 2 endogenous molecules inhibit release of acid from parietal cells?

A

prostaglandins, somatostatins

Gi associated

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7
Q

what kind of pump releases acid? where are parietal cells located?

A

H+/K+ ATPase;

fundus and body of stomach

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8
Q

what kind of cell is somatostatin released from?

A

D cells

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9
Q

histamine activates a ___ dependent pathway. Ach and gastrin activate a ____ dependent pathway

A

cAMP, IP3/Ca2+

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10
Q

Antacids:

____ has a high neutralizing capacity; adverse effects include alkalosis and fluid retention

A

NaHCO3

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11
Q

MgOH2 has a ____ neutralizing capacity. the main side effect is ____

A

high, diarrhea

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12
Q

CaCO3 has a ____ neutralizing capacity. the main side effect is _____ syndrome, hypercalcemia, and nephrolithiasis

A

moderate, milk-alkali

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13
Q

AlOH3 has a high neutralizing capacity. adverse effects include ____ and hypo______

A

constipation, phosphatemia

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14
Q

simethicone (mylicon, phazyme) is a mild ____ that enhances release of ____.

A

surfactant; gas

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15
Q

H2 receptor antagonists end in “___”;

A

dine;

cimeti, raniti, famoti, nizatidine

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16
Q

H2 blockers are _____ antagonists. They reduce acid secretion in response to histamine, _____, and _____.

A

competitive, gastrin, Ach

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17
Q

which of the H2 blockers inhibits CYP enzymes and can cause thrombocytopenia? ( ie warfarin, phenytoin, sulfonylureas interaction)

A

cimetidine

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18
Q

cimetidine also has anti ___ effects. name 3 symptoms

A

androgenic;

gynecomastia, impotence, galactorrhea (due to prolactin)

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19
Q

proton pump inhibitors (PPIs) all end in “____”

A

prazole

ie omeprazole, lanso, esome, panto, dexlanso

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20
Q

PPIs are ____ that are activated by ___ pH; they are (irreversible or reversible) inhibitors

A

prodrugs, acidic;

irreversible

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21
Q

PPIs cause an increase in ____, which can result in ____ hypersecretion of gastric acids

A

gastrin; rebound

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22
Q

PPIs:
____ is a CYP2C19 inhibitor (warfarin, phenytoin, clopidrogel)

all cause a decrease in absorption of ___ and ____ due to increased gastric pH

A

omeprazole;

digoxin, ketoconazole

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23
Q

PPIs cause an increase risk of _____ infection and ____. they can cause _____

A

C diff, pneumonia;

osteoporosis

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24
Q

“Acid rebound” is more common with what type of drugs

A

H2 antagonists

25
Q

____ polymerizes and forms a protective barrier at ulcer sites. it requires a _____ pH

A

sucralfate, acidic

can decrease abs of tetracycline, digoxin, phenytoin

26
Q

_____ is a synthetic prostaglandin _ derivative. it causes decreased ____ secretion and increased _____ and ___ secretion

A

misoprostol, E1;

acid; bicarb, mucus

27
Q

H. pylori causes a reduction in ____ cell production of ____ and an increase in secretion of ____

A

D, somatostatin;

gastrin

28
Q

triple therapy typically used for H pylori:

A

amoxicillin (or metronidazole) + clarithromycin + PPI (or H2 blocker)

also bismuth salt

29
Q

_____ is used in treatment of mild diarrhea and eradication of H pylori

A

bismuth subsalicylate`

30
Q

____ is a D2 receptor antagonist

A

metroclopramide

31
Q

blockade of D2 receptors in the myenteric plexus leads to increased _____ release. also has anti ___ effects

A

Ach;

emetic

32
Q

metroclopramide:

used for post-surgery and _____ gastroparesis, ____, and anti-emesis

A

diabetic, GERD

33
Q

side effects of metroclopramide:

____ effects, CNS ____, hyper_____

A

parkinsonian, sedation, prolactinemia (ie gynecomastia, galactorrhea)

34
Q

what macrolide is prokinetic? it is a ____ agonist

A

eryrthromycin, motilin

35
Q

cisapride, tegaserod, and prucalopride are all withdrawn from the market. they are ____ agonists

A

5-HT4

36
Q

linaclotide is an activator of _____. it used used for ____, such as in IBS

A

guanylate cyclase 2, constipation

37
Q

linaclotide:

increased intracellular ____ causes increased secretions and decreased ____

A

cGMP;

pain

38
Q

sennam biscaodyl, cascara, and castor oil all stimulate ____. they open ___ channels in the intestinal mucosa to facilitate movement of ions and water into the intestinal lumen

A

peristalsis, Cl-

39
Q

lubiprostone is a specific ___ activator. it is used for chronic ____, such as in IBS

A

Cl C2;

constipation

40
Q

name 2 bulk laxatives, besides bran and milk of magnesia

A

psyllium, methycellulose

41
Q

bulk laxatives are ____ fibers that draw water into the gut lumen, leading to ____ and ____

A

soluble;

distention, peristalsis

42
Q

lactulose is a ____ laxative that is used to treat what disease?

A

osmotic, hepatic encephalopathy

43
Q

MgOH, magnesium citrate, and polyethylene glycol are ____ laxatives

A

osmotic

44
Q

____ is a stool surfactant that lubricates the lower bowell

A

docusate

45
Q

dicyclomine is a _____. it treats diarrhea

A

anti-cholinergic

46
Q

2 opiates typically used in diarrhea. which is given with atropine to prevent addiction?

A

diphenoxylate and loperamide;

diphenoxylate

47
Q

anti-diarrheals are contraindicated in what 2 conditions?

A 
inflammatory disease (ie ulcerative collitis);
bacteria induced diarrhea
48
Q

kaolin and pectin absorb potential intestinal ____ and water

A

toxins (ie anti-diarrheal)

49
Q

_____ is indicated for patients with HIV/AIDS on retroviral therapy. it blocks ____ and Ca activated Cl channels

A

cofrelemer;

CFTR

50
Q

aloesetron is a ____ receptor antagonist. it used used for women with chronic ___, such as in IBS

A

5HT3;

diarrhea

51
Q

alosetron blocks visceral afferent ___ ____ and _____ colon motility

A

pain sensation, decreases

52
Q

aloestron can cause fatal _____

A

ischemic colitis

53
Q

3 systems that feed into the vomiting center. what is the vomiting center?

A

vestibular, area postrema, gastric receptors;

Nucleus tractus solitarius

54
Q

in addition to metroclopramide, name 2 other D2 antagonists

A

promethazine, prochlorperazine

55
Q

meclizine and _____ are anti-emetic via anti Ach effects

A

scopalamine

56
Q

ondansetron (or granisetron) is a ____ receptor antagonist. they decrease ____ stimulation

A

5HT3, vagal

57
Q

ondansetron is used to treat nausea and vomiting associated with ____. it is combined with ____, which is a NK1 antagonist

A

chemo;

aprepitant

58
Q

dronabinol and nabilone are ______ aka synthetic _____

A

cannabinoids, THC

Pharm Test 5 (12 decks)

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