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GI: Key Information > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

side effect of CCBs and phenytoin

A

gingival hypertrophy due to biting own gums

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2
Q

three drug classes that reduce acid secretion

A
  1. proton pump inhibitors
  2. histamine H2 receptor antagonists
  3. muscarinic ACh receptor antagonists
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3
Q

example of a PPI

A

omeprazole

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4
Q

features of PPIs

A
  • activated in an acidic environment

- repeat dosing required

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5
Q

what are PPIs used in?

A
  • peptic ulcer
  • GORD
  • Zollinger-Ellison syndrome
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6
Q

examples of H2RAs

A

ranitidine

cimetidine

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7
Q

what are H2RAs used in?

A

peptic ulcer

reflux oesophagitis

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8
Q

example of ACh receptor antagonist

A

pirenzepine

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9
Q

use of ACh receptor antagonists

A

now obsolete

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10
Q

two mucosal strengtheners

A
  1. sucralfate

2. bismuth chealate

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11
Q

features of sucralfate

A

bind to positively charged ulcer base increasing mucus, etc.

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12
Q

features of bismuth chealate

A

toxic towards H. pylori (in combination with antibiotics and H2RAs)

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13
Q

what are laxatives

A

agents used to treat constipation

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14
Q

what are purgatives

A

agents used to promote evacuation

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15
Q

when should laxatives and purgatives not be used?

A

if there is a physical bowel obstruction

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16
Q

when should laxatives and purgatives be used?

A
  • staining damaging to health (angina)
  • defecation is painful (haemorrhoids)
  • purge the bowel before surgery
  • treat drug-induced or bedridden constipation
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17
Q

mechanism of action of bulk laxatives

A

indigestible polysaccharide polymers that improve stool consistency

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18
Q

example of a bulk laxative

A

methycellulose

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19
Q

examples of stimulant purgatives

A
  • bisacodyl

- sodium picosulfate

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20
Q

mechanism of action of osmotic laxatives

A

poorly absorbed solutes

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21
Q

examples of osmotic laxatives

A

magnesium sulfate
magnesium hydroxide
sodium citrate
lactulose

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22
Q

examples of faecal softeners

A

docusate sodium orally

arachis oil as enema

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23
Q

two examples of glucocorticoids used in IBD

A

prednisolone

budesonide

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24
Q

which IBD are aminosalicylates used in?

A

UC

25
Q

examples of aminosalicylates

A
  • sulfasalazine
  • mesalazine
  • olsalazine
  • balsalazide
26
Q

drug and radiation-induced emesis

A
  • chemotherapy and radiotherapy release 5-HT and substance P
  • PONV (anaesthetic)
  • dopamine agonists D2 receptor in CTZ e.g. levodopa
  • morphine
  • cardiac glycosides e.g. digoxin
27
Q

six classes of anti-emetic drugs

A
  1. 5-HT3 receptor antagonists
  2. muscarinic ACh receptor antagonists
  3. histamine H1 receptor antagonists
  4. dopamine receptor antagonists
  5. NK1 receptor antagonists
  6. CB1 receptor agonists
28
Q

examples of 5-HT3 antagonists

A

ondansetron

palonosetron

29
Q

what are 5-HT3 antagonists used in?

A
  • chemotherapy and radiation-induced emesis

- PONV

30
Q

what happens in subsequent treatments of 5-HT3

A

become less effective (overcome by addition of corticosteroid and NK1 receptor antagonist)

31
Q

adverse of 5-HT3 receptor antagonists

A

constipation

headaches

32
Q

examples of muscarinic ACh receptor antagonists used in motion sickness

A

hyosine

scopolamine

33
Q

what are muscarinic ACh receptor antagonists used in?

A

motion sickness (block at multiple sites)

34
Q

adverse of muscarinic ACh receptor antagonists in motion sickness

A

block parasympathetic ANS causing blurred vision, urinary retention, dry mouth and sedation

35
Q

examples of histamine H1 receptor antagonists

A

cyclizine

cinnarizine

36
Q

what are histamine receptor antagonists used in?

A
  • motion sickness
  • acute labyrinthitis
  • irritants in the stomach
37
Q

what do histamine H1 receptor antagonists block?

A

vestibular nuclei

NTS

38
Q

adverse of H1 receptor antagonists

A

CNS depression and sedation

39
Q

examples of dopamine receptor antagonists

A

domperidone

metoclopramide

40
Q

when are dopamine receptor antagonists used?

A

drug induced vomiting

GI disorders

41
Q

mechanism of action of dopamine receptor antagonists

A

block D2 and D3 in CTZ

42
Q

adverse of metoclopramide (crosses BBB)

A

disorders of movement

43
Q

example of NK1 receptor antagonist

A

aprepitant

44
Q

when are NK1 receptor antagonists used?

A

in combination with 5-HT3 and dexamethasone in delayed phase

45
Q

example of CB1 receptor agonists

A

nabilone

46
Q

when are CB1 receptor agonists used

A

if other chemo-induced emesis drugs are ineffective

47
Q

example of anti-motility agents used in diarrhoea (morphine-like/opioid drugs)

A
  • codeine
  • loperamide
  • diphenoxylate
48
Q

when is ursodeoxycholic acid used?

A

dissolve small or medium sized gall stones

49
Q

adverse of ursodeoxycholic acid?

A

diarrhoea

50
Q

what is given to relieve biliary spasm

A

atropine

GTN

51
Q

examples of bile acid sequestrants

A

colveselam
colestipol
colestyramine

52
Q

mechanism of action of bile acid sequestrants

A

bind to bile acids and prevent there reabsorption

53
Q

when are bile acid sequestrants used?

A

Hyperlipidaemia
cholestatic jaundice (itch)
bile acid diarrhoea

54
Q

adverse of bile acid sequestrants

A
  • diarrhoea

- reduced absorption of fat soluble vitamins and thiazides

55
Q

describe hepatic encephalopathy

A

in hepatic failure detoxification of urea fails leading to toxic levels of NH3 affecting the CNS

56
Q

two treatment options for hepatic encephalopathy

A
  • lactulose

- antibiotics

57
Q

role of lactulose in hepatic encephalopathy

A

converts NH3 to NH4+

58
Q

antibiotics role in hepatic encephalopathy

A

suppress colonic flora and inhibit ammonia generation

59
Q

examples of antibiotics used in hepatic encephalopathy

A

neomycin

rifamixin

GI: Key Information (24 decks)

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