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Interim 5 > Anti Emetic Preperations > Flashcards

Anti Emetic Preperations Flashcards

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1
Q

Anti emetic preperations

A

5 HT3 receptor antagonist - ondansetron
NK1 receptor antagonist - Aprepitant
H1 receptor antagonist - Dimenhydrinate

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2
Q

Anti secretary agents

A

Proton pump inhibitors -omeprazole
H2 RA - Famotidine

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3
Q

Antiemetic and gastrokinetic agents

A

Metoclopramide, Domperidone

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4
Q

Drugs that suppress intestinal peristalsis

A

Loperamide

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5
Q

Intestinal antispasmodics

A

Mebeverine

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6
Q

Intestinal antiinflammatory drugs and immunomodulators

A

Mesalazine, Budesonide, Infliximab, Natalizumab

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7
Q

Antacids

A

Aluminium hydroxide, magnesium hydroxide, calcium carbonate

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8
Q

Laxatives

A

Bisacodyl,lactose,Macrogol

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9
Q

Enzyme preparation for pancreas

A

Pancreatin

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10
Q

Bile acid preperations

A

Ursodeoxycholic acid

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11
Q

Most common cause of GERD

A

Reduced gastric cardiac tone and gastro kinetic disorders

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12
Q

Stomach cardiac tone can be reduced by various medications like

A

anticholinergics,No donor,CCB, benzodiazepines

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13
Q

Imp factors causing ulcerative disease

A

H.pylori and NSAIDS

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14
Q

Causes of constipation

A

Hypothyroidism, hypokalemia ( due to poor diet or prolonged diuretic therapy),medications like opioids

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15
Q

Laxatives are not used for constipation from

A

Opioid receptor agonists

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16
Q

Cyclizine -

A

histamine antagonist

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17
Q

Zone involved in nausea and vomiting

A

Area postrema chemoreceptor trigger zone outside BBB

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18
Q

Ondansetron (5HT3 receptor antagonists) action

A

Blocks n.vagus afferent innervation signals caused by 5HT3 receptor irritation in small intestine and area postrema

Anti emetic effect

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19
Q

Clinical use of ondansetron

A

Nausea and vomiting caused by chemotherapy, radiation therapy and prevention of postoperative nausea and vomiting

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20
Q

NK1 receptor antagonist ( Aprepitant) clinical use

A

nausea and vomiting caused by chemotherapy, radiation therapy and prevention of post operative nausea and vomiting

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21
Q

Recommended combination of antiemetic agents

A

Ondansetron+ dexamethasone, Aprepitant+ dexamethasone, Ondansetron+ dexamethasone+Aprepitant

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22
Q

Metoclopramide ( D2 receptor antagonist) action

A

Area postrema D2 receptor antagonist, 5HT3 receptor antagonist-, Gastrointestinal D 2 receptor antagonist,M 1 receptor agonists,5 HT4 agonist

Increase esophageal sphincter tone,accelerate gastric emptying
Gastrokinetic effects

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23
Q
A
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24
Q

Clinical use of metoclopramide ( D2 receptor antagonist)

A

Nausea and vomiting caused by chemotherapy radiation therapy
Symptomatic nausea, vomiting (. migraine)

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25
SE of metoclopramide
Extrapyramidal disorders, hyperprolactinemia ,Torsades de pointes risk
26
Domperidone action ( D2 receptor antagonist)
Area postrema and gastrointestinal D 2: receptor antagonist - antiemetic and gastrokinetic effects,has minimal crossing of BBB compared to metclopramide
27
Clinical use of Domperidone
Symptomatic nausea and vomiting
28
SE of Domperidone
Increase in QT interwal - torsades de pointes risk
29
Major shortcoming of antacid
High dose, frequent use and short term action ( 1 to 3 hrs)
30
Proton pump inhibitors -omeprazole action
Delays basal, nocturnal and dietary stimulation of gastric acid secretion ( anti secretory effect)
31
Clinical use of ppi- omeprazole
GERD, reflux esophagitis,ulcer disease,H pylori infection, Dyspepsia, prevention of NSAIDS induced ulcers
32
PPI in acid medium is converted to sulphanamide which couple with proton pump to cause
Irreversible potassium pump blockade of parietal cells.It acts independent of stimulants
33
Stable anti secretary effect of ppi occurs after
3 to 5 days
34
SE of PPI can be
Fe,vit B12,Mg,Ca deficiency, increased susceptibility to infection, rebound hypergastrinemia,renal imparement
35
Interactions of PPI( omeprazole
CYP 2 C19 gene polymorphism - affect metabolism and efficacy of other drugs
36
H2 receptor antagonist ( Famotidine) action
Anti secretory effect of gastric acid
37
2 weeks on Famotidine ( H2:receptor antagonist can cause
Tolerance
38
Clinical use of Famotidine
Ulcer disease and GERD
39
Antacids react with HCl to create
Soluble chloride
40
Clinical use of antacids
Hyperacidity and heart burn
41
SE of antacids
Alhydroxide can cause constipation, calcium absorption cause kidney disease - hypercalcaemia
42
Interactions of antacids
With other drugs,so 2 HR interval needed
43
Pancreatin( enzyme preparation of pancreas) action
Digestive enzyme replacement ( amylolytic, proteolytic, lipolytic effect)
44
Clinical use of pancreatin
Exocrine pancreatic failure
45
Chewing pancreatin can cause damage to
Ral mucosa
46
To prevent constipation by pancreatin
Extra fluid recommended
47
Ursodeoxycholic acid ( bile acid preperations) action
Decrease cholesterol saturation in bile,reduce conc of toxic bile acid litholytic effect,choleretic effect ( increase bile secretion)
48
Clinical use of ursodeoxycholic acid
Gall stone disease, biliary cirrhosis ( cholangitis), bile Dyspepsia
49
CI of ursodeoxycholic acid
Biliary obstruction
50
Intestinal peristalsis suppressant ( loperamide) action
Peripheral my opioid receptor agonists in plexus mesentericus- decrease peristalsis and cause fluid and electrolytes retention
51
Clinical use of loperamide ( intestinal peristalsis suppressant)
Acute non infectious diarrhea,IBS
52
SE of loperamide
Constipation
53
Irritant and prosecretory laxative
Bisacodyl
54
Bisacodyl ( irritant and prosecretory laxative)
Increase peristalsis,inhibits fluid and electrolytes absorption and stimulation of secretion in colonc
55
Clinical use of bisacodyl ( irritant and prosecretory laxative
Constipation of various genesis, intestinal cleansing prior to surgery of diagnostic manipulation
56
Osmotic laxative - lactulose action
Stimulate osmotic peristalsis,pH of colon reduced and ammonia absorption decreased ( hepatic desintoxication)
57
Macrogol ( osmotic laxative) action
Liquifies intestinal content
58
Clinical use of lactulose and macrogol
Symptomatic treatment of constipation, intestinal cleansing prior to surgery or diagnostic manipulation( Macrogol), encephalopathy induced by hepatic cirrhosis ( lactulose)
59
60
Selective myotropic intestinal antispasmodics
Mebeverine
61
Mebeverine ( selective myotropic intestinal antispasmodics action
Inhibits parasympathetic effect without effect on intestinal peristalsis
62
Clinical use of mebeverine ( selective myotropic intestinal antispasmodics) use
IBS,GI tract smooth muscle spasm ( no anticholinergic SE)
63
64
Amino salicylate ( Mesalazine/ 5 ASA) action
Anti inflammatory and Immunosuppressive
65
Clinical use of mesalazine ( amino salicylate)
Ulcerative colitis
66
SE of mesalazine ( amino salicylate)
Agranulocytosis, thrombocytopenia, hypersensitivity reactions
67
Budesonide (GC) local ( rectal)and systemic , action
Anti inflammatory and Immunosuppressive
68
Clinical use of Budesonide ( GC)
Chrons disease and ulcerative colitis

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