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Flashcards in E2. GI tract Deck (57):
1

What are the four groups of drugs that treat or prevent ulcers (Anti-ulcer medications)?

– Antacids
– Prostaglandin analogues
–Gastroprotectants
–Systemic/oral direct antacids

2

What two groups make up your antacid drugs?

H2 blockers and proton pump inhibitors

3

List the drugs that are known as H2 blockers. (4)

Cimetidine, Ranitidine, Nizatidine, Famotidine

4

List the three drugs that are known as proton pump inhibitors.

5

Which of the following is wrong about antihistamine "H2" blockers?
A. Inhibits gastric acid and pepsin secretion
B. Competitive inhibition of H2 receptors
C. Oral or injectable
D. All of the above are correct
E. all of the above are false

D. All of the above are correct

6

True or false:
Cimetidine is the original H2 blocker, and effects G.I. motility.(26/1A more info on drug)

False, it does not affect G.I. motility.

7

Which of the following is true about Famotidine?
A.

E. All of the above is true

8

Look at slide 27/1A

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9

How do proton pump inhibitors(PPI) work? (Slide 28/1A)

You reversibly inhibited hydrogen/potassium/ATPase proton pump resulting in decreased hydrochloric acid production.

10

Which is more potent, H2 blocker class or proton pump inhibitors?

Proton pump inhibitors

11

A dog has come into your clinic, the owner is complaining that the dog seems to be having stomach pains. After running tests and collecting a history you come to the conclusion that the dog has NSAID-induced gastric ulcers. What drug should you use to treat this?
A. Misoprostol
B. Sucralfate
C. Cimetidine
D. Dolasetron
E. Meclizine

A. Misoprostol (look at slide 29/1A for more information on this drug)

12

Look at slides 30 – 31/1A

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13

Look at the slides 1-3

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14

What are the three drugs that increase the autonomic and enteric nervous system activity?

15

What are the three drugs that decreased the autonomic and enteric nervous system activity?

16

Where the three groups of drugs that increase or decrease G.I. motility?

– Prokinetics
– antidiarrheal's
– laxatives/cathartics/enemas

17

What can antagonize metoclopramide? On what receptor and where does it work?

It can be antagonized by anti-cholinergics and opioids. It works peripherally as a 5-HT agonist, stimulates cholinergic receptors in the gastrointestinal track

18

How does metoclopramide affect gastric emptying and intestinal transit time?

It accelerates gastric emptying and improves intestinal transit.

19

How can Metoclopramide be given? What's the duration of effect?

It can be given orally or by injectable. It has a short duration of effect (dose 2 to 3 times daily, better as a constant rate infusion)

20

True or false: metoclopramide is contraindicated if there is a G.I. obstruction or bleeding.

True

21

How does Domperidone work?(antagonists/agonist, where)

It is a dopamine antagonist that acts centrally and peripherally.

22

Which drug has less CNS penetration, domperidone or metoclopramide?

Domperidone

23

How can you tell which drugs are serotonin agonist? Name both drugs.

They both end in "apride".
Cisapride and Mosapride

24

What receptors do Cisapride and Mosapride work on?

5-HT4 receptor agonists in enteric neurons.
*indirectly increase parasympathetic input. Also block dopamine (but less than metoclopramide does)

25

What is the only way you can get cisapride in the US?
It has an prokinetic effect on all parts of the GIT, along with what part of the horse?(7/1B)

By compounding.

The colon

26

Is Mosapride available in North America? What are its uses?

It is not available in North America. And it stimulates motility in the small intestine and cecum of horses, along with possibly being able to treat G.I. ulcers in canines.

27

How can Cisapride and Mosapride be given?

Oral formulation only.

28

Look at slide 8/1B for more prokinetic drugs.

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29

What are the two possible treatments for diarrhea? (NOT SPECIFIC!!!!)(9/1B)

Nonpharmacologic and pharmacologic therapy.

30

What are the three groups of drugs that can be used to treat diarrhea?

Opioids, protectants/absorbents, anti-cholinergic's

31

How do opioids work as antidiarrheal's? (MOA)
What are the two drugs that fit in this category?

Asked on central and peripheral opioid receptors to inhibit propulsive motility, increase segmental motility, decreased intestinal secretion and inhibit defecation reflex.

Diphenoxylate (Lomotil®) and Loperamide (Immodium®)

32

True or false: Diphenoxylate does not cross the blood brain barrier.

False. Loperamide Does not cross the blood brain barrier.

33

Which drug would you use for diarrhea when you need a drug with a fast onset?
A. Loperamide
B. Diphenoxylate
C. Cisapride
D. Metoclopramide
E. Two of the above

A. Loperamide
* Loperamideas a faster onset, longer duration and better efficacy than Diphenoxylate. (10/1B for more information)

34

Name the drugs that are GI protectants/adsorbents. (6)

35

What is an issue with using Bismuth subsalicylate in cats?

Potential toxicity for cats

36

What is a possible side effect of using Bismuth subsalicylate?

Will turn your stool very dark/black.

37

How do G.I. protectants/adsorbents work?

Nonabsorbed compounds that coat the GI mucosa or
physically bind to toxic compounds in the lumen.

38

How do anticholinergics work?

Block muscarinic receptors in the GIT to inhibit motility and secretions. Usually labeled as anti-spasmodics or spasmolytics.

39

In what animal is anticholinergics generally contraindicated for use in?(12/1B)

Horses.

40

What are you two different types of laxatives? (General not drug names)

Emollient laxatives and simple bulk laxatives.

41

How do Emollient laxatives work?
Name the three things that fall under this category.

Acted as mechanical surfactants or lubricants/stool softener's.

42

How do simple bulk laxatives work?
Name the three things that fall under this category.

Absorb water and it's swell, reflexively stimulate GI movement.

43

What are your two different types of Cathartics? (ten. not exact drug names)

Osmotic Cathartics and irritant Cathartics.

44

How do Osmotic Cathartics work? Name the 5 things that fall under this category?

Nonabsorbed particles that attract water into the GI lumen

45

How do Irritant Cathartics work? Name the 3 things that fall under this category?

Irritate the GI mucosa to stimulate motility and secretion.

Castor oil, phenophthalein, bisacodyl (Dulcolax®)

46

True or False:
Phosphate containing enemas can be used in cats.

False. Phosphate containing enemas should NOT be used in
cats!

47

What can be used for enemas? (8)

48

What is Pancreatic enzyme replacement therapy used for?
How is it given?

Treatment for Exocrine Pancreatic Insufficiency (EPI) (so lifelong treatment is necessary.)

Given orally with each meal.

49

What are the three "drugs" used for treatment of Exocrine Pancreatic Insufficiency (EPI)?

50

Which is the cheapest treatment for Exocrine Pancreatic Insufficiency (EPI)?
A. Viokase
B. Pancreazyme
C. raw pancreas
D. Any of the above (they cost about the same)
E. None of the above, let the animal DIE!!! HAHAHA (If you pick this answer I will hurt you!)

C. raw pancreas

51

Which is the best treatment for Exocrine Pancreatic Insufficiency (EPI)? What is the issue with it?
A. Viokase
B. Pancreazyme
C. raw pancreas
D. Any of the above
E. None of the above, let the animal DIE!!! HAHAHA (If you pick this answer I will hurt you!)

A. Viokase
Is expensive.

52

Which is the most common treatment for Exocrine Pancreatic Insufficiency (EPI)? Why?
A. Viokase
B. Pancreazyme
C. raw pancreas
D. Any of the above
E. None of the above, let the animal DIE!!! HAHAHA (If you pick this answer I will hurt you!)

B. Pancreazyme
Because it's cheaper than the best option, but more reliable than the cheapest.

53

Look at slide 16/1B

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54

What are the two big drugs used to treat liver disease?

Lactulose and Ursodiol.

55

One drug is used in the management of hepatic encephalopathy?

Lactulose

56

How is Lactulose given, and how does it work?

It is generally given orally. It will ion trap ammonia in the colonic lumen to enhance removal from the body.

57

Look at slide 19/1B

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