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HLST220: Pharmacology > Chapter 83: Other GI Drugs > Flashcards

Chapter 83: Other GI Drugs Flashcards

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1
Q

antiemetics are given

A

to supress nausea and vomitng

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2
Q

ematic response

A

complex reflex that occurs after activation of vomiting center in the medulla oblongata

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3
Q

what receptors are involved in the emetic response

A
  • seratonin glucocorticoids, substance P, neurokinin, dopamine, acetylcholine, histamine
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4
Q

dopamine D2 antagonists examples

A

prochlorperazine

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5
Q

seratonin antagonists example

A

ondansetron

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6
Q

antihistamines (h1 antagonists) example

A

dimenhydrinate

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7
Q

glucocorticoids examples

A

dexamethasone

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8
Q

neurokinin 1 receptor antagonists examples

A

aprepitant

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9
Q

cannabinoids examples

A
  • dronabinol
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10
Q

antiemetic drug classes

A
  • dopamine antaginists
  • seratonin antagonists
  • antihistamines
  • anticholinergics
  • benzodiazepine (GABA)
  • glucocorticoids
  • neurokinin 1 receptor antagonists
  • somatostatin analogues
  • cannabinoids
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11
Q

Seratonin receptor antagonists is used for

A

chemotherpay induced nausea and vomiting (aka antineoplastic induced)
- associated with radiotherapy and anesthetia
- severe morning sickness in pregancy

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12
Q

Serotonin receptor antagonists MOA

A

blockes 5-HT3 on afferent vagal nerve

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13
Q

seratonin receptor adverse effects

A

headache, constipation, prolonged Qt interval, seratonin syndrome

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14
Q

Glucocorticoids are used for

A

short term for more serious nausea and vomiting
- post opp

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15
Q

Neurokinin receptor antagonists are used for

A

prevention of postperative nausea and vomiting and CINV

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16
Q

neurokinin receptor antagonists –> Aprepitant [emend] side efects

A

fatigue, dizziness, GI upset, possible liver injury

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17
Q

neurokinin receptor antagonists –> Aprepitant [emend] drug interactions

A

oral contraceptives become ineffective , warafarin

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18
Q

three primary benefits of Benzodiazepines –> lorazepam [Ativan]

A
  • sedation
  • supression of anticipatory emesis
  • production of antrograde amnesia
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19
Q

Dopamine antagonists –> prochlorperazine [Stemetil] side effects

A
  • extrapyramidal reactions
  • anticholinergic effects
  • hypotension and sedation
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20
Q

Dopamine antagonists –> metoclopramide [Reglan, Maxeran] is used for

A

postoperative nausea and vomiting, opiods, toxins, radiation therapy. SOmetimes used in hyperemesis gradivarum

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21
Q

Cannabinoids
- Dronabinol [Marinol]
- nabilone [cesamet]
is used for

A

CINV or for appetite stimualtion

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22
Q

Cannabinoids
- Dronabinol [Marinol]
- nabilone [cesamet] adverse effects

A

drowsiness, tachycardia, hypotension

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23
Q

Cannabinoids
- Dronabinol [Marinol]
- nabilone [cesamet]
adminstration

A

oral capsules

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24
Q

what are the three types of CINV emesis

A
  • anticipatory
  • acute
  • delayed
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25
anticipatory
occurs before drugs are given
26
acute
- onset within minutes to a few hours
27
delayed
onset 1 day or longer after drug adminstration
28
hyperemesis gravidarum
- dehydration, ketonuria, hypokalemia, loss of 5% or more of body weight
29
first line therapy drugs for nausea and vomiting in pregancy
Doxylamine plus vitamin B
30
drugs used in nasuea and vomiting in pregnancy
Doxylamine - prochlorperazine, metoclopramide, and andoansetron
31
drugs for motion sickness
Scoplamine [Teansderm-V]
32
Scoplamine [Teansderm-V] side effect
- dry mouth - blurred vision - drowsiness
33
Scoplamine [Teansderm-V] administration
transdermal patch
34
antihistamines - Dimenhydrinate [gravol] - meclizine [bonamine] side effects
- sedation - dry mouth, blurred vision, urinary retention, constipation
35
what is the most commonly used anti-emetic
dimenhydrinate
36
diarrhea causes
- infection, maldigestion, inflammation, functional disorders of the bowel
37
diarrhea complications
dehydration and electrolyte depletion
38
what are the two major groups of antidiarrheals
- specific antidiarrheal drugs - nonspecific antidiarrheal drugs
39
opiods - loperamide [imodium] is used for
diarrhea and to reduce the volume of discharge from ileostomies
40
Nonspecific antidiarrheal agents
- paregoric - opium tincture - bismuth subsalicylate [pepto bismol] - bulk forming agents (fibre) - anticholinergic antispasmodics (atropine)
41
travellers diarrhea is mainly caused by
ingestion of food/beverages contaminated with pathogens - escherichia coli
42
escherichia coli
- usually self limiting - symptoms include nausea and vomiting, fever, cramps
43
travelers diarrhea treatment
- ciprofloxacin - norfloxacin - bismuth subsalicylate
44
IBS is characterized by
cramping and abdominal pain, nausea; bloating and heartburn
45
IBS red flags
- fever - weight loss over 10lbs - bleeding rectal / stools - new symptoms in clients under 50 - severe symptoms
46
IBS differential diagnosis
- IBD - infectious diarrhea - colorectal polyp/cancer - CBC, ESR, CRP, Celiac stool occult blood
47
what are the 4 groups of drugs used for IBS
- antispasmodics - bulk forming agents - antidiarrheals - tricyclic antidepressants
48
IBS cause
unknown casue
49
Linaclotide [constella] use
IBS
50
Linaclotide [constella] MOA
- gaunylate cyclase agonist - induces intestinal and bicarbonate secretion resulting in increased intestinal motility
51
Linaclotide [constella] adverse effect
diarrhea, abdominal pain
52
Linaclotide [constella] dose
72-290mcg daily teken 30 mins before first meal of the day
53
eluxadoline [viberzil] use
IBS-D in adults
54
eluxadoline [viberzil] MOA
mixed mu opioid receptor agonist and delta antagonist
55
eluxadoline [viberzil] adverse effects
Gi (constipation), dizziness, fatigue
56
eluxadoline [viberzil] warnings
pancreatitis in glients without gullbladder
57
eluxadoline [viberzil] dose
100 mg BID with food
58
Inflammatory Bowel Disease (IBD)
- crohns disease - ulcerative colitis
59
crohns disease
- characterized by transdermal inflammation - usually affects terminal ileum - severity diffrences: pain level, types of meds
60
Ulcerative colitis
- inflamamtion of mucosa and submucosa of the colon and rectum - may cause rectal bleeding - severity diffrences: <4 to >10 stools per day
61
Drugs for IBD
- 5 Aminosalicylates (sulfasalazine; 5-ASA) - glucocorticoids (hydrocortisone; prednisone) - immunosuppressant (azathioprine) - Immunomodulators (infliximab) - antibiotics
62
5 aminosalicylates example
Sulfasalazine [Salazopyrin]
63
Sulfasalazine [Salazopyrin] is used for
acute episodes of mild to moderate ulcerative colitis; also used during admission
64
Sulfasalazine [Salazopyrin] adverse effects
nausea, fever, rash, hematological
65
budesonide [entocort] is used for
mild to moderate crohns disease that involves the ileum and ascending colon
66
prolonged use of glucocorticoids can cause
severe adverse effects, including adrenal suppression, osteoporosis, increased susceptibility to infection, and a cushingoid syndrome
67
immunosuppressants example
Azathioprine [Imuran]
68
Azathioprine [Imuran] is used for
induce and maintain remission in both ulcerative colitis and crohns disease
69
Azathioprine [Imuran] adverse effects
pancreatitis and neutropenia
70
immunomodulators examples
Infliximab [Remicade]
71
Infliximab [Remicade] is used for
moderate to severe crohns disease and can be used for ulcerative colitis
72
Infliximab [Remicade] adverse effects
infections, infusion reactions, increased risk of lymphoma
73
antibiotics is crohns disease
can help control symptoms
74
antibiotic use in ulcerative colitis
antibiotics largely ineffective
75
antibiotics example
- metronidazole [flagyl] - ciprofloxacin [cipro]
76
metronidazole [flagyl]
- long term therapy is required - prolonged use of high dose risk of peripheral neuropathy
77
Ciprofloxacin [Cipro]
highly effective in patients with mild or moderate crohns disease
78
prokinetic agents
increase tone and motility of GI tract supress emesis
79
prokinetic agents examples
Metoclopramide [Reglan, Maxeran]
80
Metoclopramide [Reglan, Maxeran] uses PO
diabetic gastroparesis and suppression of gastroesophageal reflux
81
Metoclopramide [Reglan, Maxeran] therapeutic uses IV
supression of postoperative nausea and vomiting, supression of CINV, faciliation of small bowel intubation and facilitation of radiologic examination of GI tract
82
Metoclopramide [Reglan, Maxeran] adverse effects
- high dose therapy: sedation, diarrhea common - long term high dose therapy: can cause irreversible tardive dyskinesia (TD)
83
pancreatic enzymes is used for
deficency of digestive enzymes
84
Pancrelipase mixture
lipase, amylases, and proteases prepared from hog pancreas
85
pancreatic enzyme example
Pancrelipase
86
Pancrelipase adverse effects
abdominal discomfort, flatulence, headache, diarrhea, cramping
87
Pancrelipase administration
dose individually; taken with every meal and snack
88
Anorectal preparations
- symptomatic relief of hemorrhoids and other anorectal disorders
89
anorectal preperations examples
- local anesthetics (pramoxine) - anti inflammatory (hydrocortisone) - emollients (glycerin) - astringents (witch hazel)

HLST220: Pharmacology (46 decks)

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