Anti-Kinetic Drugs (Quiz 4) Flashcards
(45 cards)
1
Q
what is gastroparesis
A
- failure of the stomach to empty properly
2
Q
what does motilin do
A
- stimulate motility
3
Q
what does dopamine do for motilityhow
A
- inhibits motility- inhibitory presynaptic dopamine receptor (D2)
4
Q
what does acetylcholine do for motility
A
- stimulates motility
5
Q
MOA of Metoclopramide
A
- inhibition of dopamine D2 receptor- increase contraction and motility
6
Q
Toxicities of Metoclopramideshort or long term use
A
- acute dystonia - short term- tardive dyskinesia - long term- hyperprolactinemia- anxiety, restlessness, depression
7
Q
what are acute dystonia and tardive dyskinesia known as
A
- extrapyramidal symptoms (EPS)
8
Q
how EPS’s causedimportant brain parts involved
A
- inhibition of central dopamine pathway that regulates skeletal muscle movement- substantia nigra- dorsal striatum
9
Q
how does Metoclopramide cause hyperprolactinemia
A
- inhibits central dopamine pathway that inhibits release of prolactin- therefore excessive prolactin secreted
10
Q
Erythromycin MOA
A
- motilin receptor agonists
11
Q
side effect of Erythromycin
A
- GI distress
12
Q
pharmacokinetics issues with Erythromycin
A
- tachyphylaxis (desensitization) after 10-14 days
13
Q
what drug do you use if metoclopramide fails
A
- erythromycin
14
Q
MOA of Neostigmine
A
- indirect acting cholinergic agonist- inhibits acetylcholinesterase and increases amount of acetylcholine at synapse
15
Q
toxicities of Neostigmine
A
- pro parasympathetic effects- excessive saliva production- decreased CO- bradycardia
16
Q
what is the antidote to Neostigmine
A
- atropine
17
Q
role of prostaglandin E2
A
- inhibits gastric acid secretion
18
Q
MOA of Sucralfate
A
- polymerizes at low pH of stomach- negatively charged so binds positively charged proteins in stomach ulcer- forms a barrier
19
Q
types of antacids
A
- NaHCO3- CaCO3- Al(OH)3- Mg(OH)2
20
Q
MOA of antacids
A
- directly neutralize stomach acid
21
Q
toxicity of NaHCO3
A
- metabolic alkalosis
22
Q
toxicity of Mg(OH)2 and Al(OH)3how do we solve this
A
- diarrhea- constipation- combine the two to off-set each other’s toxicities
23
Q
toxicity of antacidshow
A
- hypophosphatemia- molecules are insoluble and prevents PO4 absorption
24
Q
which are the antihistamines
A
- Ranitidine- Famotidine- Cimetidine
25
MOA of Antihistamines
- competitive, reversible inhibitors of H2 receptor in parietal cells
26
can acid-peptic antihistamines significantly cross the blood brain barrier
- no
27
pharmacodynamics issue with Antihistamines
- other pathways may compensate for blockage and build up tolerance
28
important toxicity of Cimetidinewhich drugswhat's the exception to the rule
- drug interactions due to inhibition of CYP enzymes- will reduce their clearance- warfarin- anti-epileptics- theophylline- clopidogrel - doesn't get activated- oral contraceptives
29
importance of theophylline
- low therapeutic index
30
proton pump inhibitor drugs
- omeprazole- esomeprazole- lansoprazole- pantoprazole- rabeprazole
31
MOA of PPIs
- irreversible non competitive antagonist of H+/K+ pump
32
toxicities of PPIs
- C. diff infection- hypomagnesia- vitamin B12 malabsorption - AIN
33
pharmacokinetics issues with PPIs
- pH trapping drives them into secretory canaliculus
34
MOA of Misoprostol
- prostaglandins E2 analog- inhibits gastric H+ secretion
35
toxicities of Misoprostsal
- promotes abortion of fetus
36
what are some neurotransmitters associated with signals that affect vomiting
- dopamine- serotonin- acetylcholine- neurokinin
37
MOA of Ondansetronwhat's it used for
- serotonin antagonist- anti-emetic
38
Toxicities of Odansetron
- prolonged QT interval
39
MOA of Prochlorperazine and promethazinewhat are they used for
- D2 receptor antagonists- anti-emetic
40
toxicities of Prochlorperazine and promethazine
- acute dystonia- tardive dyskinesia- prolonged QT
41
for what conditions do you use sucralfate
- GERD (pregnancy)
42
for what conditions to you use antacids
- GERD
43
for what conditions do you use antihistamines
- GERD- peptic ulcer disease
44
for what conditions do we use PPIs
- GERD- peptic ulcer disease- Zollinger-Ellison syndrome- NSAID associated ulcers- H. pylori eradication
45
for what conditions do we use misoprostol
- NSAID associated ulcers
