Gastro Flashcards
1
Q
H2RA
A
Ranitidine
Famotidine
2
Q
T or F: PPIs need the acidity of the stomach for their activation
A
T
3
Q
PPI bind _____ to_____
A
Irreversible
H+K+ATPase @Parietal Cells
4
Q
Which step is inhibited with PPIs
A
Last step
5
Q
Most effective tx for Peptic Ulcer Disease
A
PPIs
6
Q
Tx for Errosive Esophagitis unresponsive to H2RA
A
PPIs
7
Q
First line of tx for Zollinger-Ellison Synd.
A
PPIs
8
Q
Tx for Gastropathy caused by NSAIDs
A
PPIs
9
Q
Clopidogrel + PPIs
A
↓ activation of PPIs
10
Q
Warfarin + PPIs
A
↓ Warfarin clearance
11
Q
Chronic use of PPIs
A
↑ Risk of Pneumonia
12
Q
MOA of H2RA
A
Reversibly competing with histamine for binding to H2 receptors @basolateral memb of parietals cells
↓adenyl cyclase activity → ↓cAMP levels → ↓protein kinase A activity →↓ phosphorylation and activation of H+K+ATPase
13
Q
Second line tx for inhibition of gastric acid
A
H2RA
14
Q
Contraindication of Omeprazole
A
Sevre Hepatic disease
15
Q
T or F: H2RA cross the Placenta
A
T
16
Q
Cytoprotective Agents
A
Misoprostol
Sucralfate
17
Q
Famotidine
A
Gastric Acid Secretion Inhibitor
18
Q
Ranatadine
A
Gastric Acid Secretion Inhibitor
19
Q
Cytoprotective agent: synthetic analogue of PGE1
A
Misoprostol
20
Q
MOA of Misoprostol
A
Inhibition of gastric acid (binds and activates the EP3 receptor @Parietal cells)
Stimulation of Mucus and Bicarbonate secretion
Enchancement of mucosal blood flow
21
Q
Misoprostol binds to which receptors
A
EP3 @Parietal Cells
22
Q
GI drug used for Medical Abortion
A
Misoprostol
23
Q
GERD @Pregnancy
A
Sucralfate
24
Q
Prophylaxis of Stress Ulcers
A
Sucralfate
(also… PPIs)
25
Cytoprotective agent that causes Diarrhea
Misoprostol
26
Cytoprotective agent that causes Constipation
Sucralfate
27
Development of Bezoars
Sucralfate
28
Cytoprotective agent contraindicated during Pregnancy
Misoprostol
29
Prophylaxis of NSAID induced gastric ulcers
Misoprostol
30
Sucralfate cannot be coadmin with:
PPI
H2 blockers
Aluminium containing acids
31
Sucralfate should be avoided @
Px with renal failure who are at risk of aluminium overload
32
GI drug that in acidic environment undergoes extensive cost-linking to produce a viscous, sticky polymer that adhers to epithelial cells and ulcer craters
Sucralfate
33
Sucralfate causes the stimulation of
Local production of PGs
Epidermal growth factor
34
Antacids
Aluminium Hydroxide
Magnesium Hydroxide
35
Aluminium Hydroxide
Antacid
36
Magnesium Hydroxide
Antacid
37
GI drug provide ONLY temporary relief of symptoms
Antacids
38
MOA of Antacids
Neutralize the excess of stomach acid that causes symptoms
39
T or F: Antacids treat underlying disease
F
40
Drug of choice for rapid symptom relief in acid reflux
Antacids
41
T or F: Antacids can also be used to tx symptoms of Esophagitis
T
42
Common adverse effect of antacids
Excessive bloating and belching
Hypokalemia
43
D2 receptor antagonist
Metoclopramide
Domperidone
44
Prokinetic with CENTRAL antiseptic effect
Metoclopramide
45
Prokinetic with PERIPHERAL antiseptic effect
Domperidone
46
T or F: Metoclopramide has NO influence in colon motility
T
47
Prokinetic indicated for Diabetic and Postsurgery Gastroparesis
Metaclopramide
48
Hyperemesis gravidum
Metaclopramide
@Pregnancy
49
Prokinetic with mayor Extrapiramidal effects
Metaclopramide
50
Adverse Effects of Metaclopramide
Mayor Extrapiramidal effects
Galactorrhea (due to hyperprolactinemia)
51
Prokinetic that can cause serious ventricular arrythmias
Domperidone
52
T or F: Both D2 Receptor antagonists causes Hyperprolactinemis
T
53
Contraindications of D2 Receptor Antagonists
Suspected small bowel obstruction
Procalcitonin dependent tumors
54
T or F: Metaclopramide is contraindicated in Parkinsons
T
55
Antidote for Extrapiramidal effects of Metaclopramide
Anticholinergic agents (Benztropine, Biperiden)
56
T or F: Domperidone crosses only minimally the placenta, hence the limited neurological effects
T
57
5-HT4 receptor Antagonist
Cinitaprida
58
Cinitrapida
Prokinetic
5-HT4 receptor antagonist
59
Prokinteic indicated @px who has failed ALL standard therapeutic modalities and who have undergone through dx evaluation (including ECG)
Cinitaprida
60
Why is Cinitrpida no longer available in the US
bc of its potential to induce serious and occasionally fatal cardiac arrythmias
61
Laxatives (4)
Castor Oil
Glycerin
Plantage Psyllium
Senosides A-B
62
Stimulant laxative
Senosidos A-B
63
Ricinelic acid (active agent) acts primarily @small intestine
Castor Oil
64
Effects of Castor Oil
stimulates secretion of fluid and electrolytes
speed up intestinal transit
65
Laxative characterized for its unpleasant taste
Castor Oil
66
Laxative used as enema and suppositories
Glycerin
67
MOA of Glycerin
↑ osmotic pressure → draws water to the lumen
68
Bulk forming laxative
Plantage Psyllium
69
MOA od Senosides A-B
stimulation of epithelial cell secretion of electrolytes into the colon lumen
causes myenteric neuronal depolarization → colon peristalsis
70
Melanosis coli
Senosides A-B
71
Antimetic
Dronabinol
Ondasteron
Aprepitant
72
Antimetic: cannabinoid receptor antagonist
Dronabinol
73
Antimetic: 5HT3 receptor antagonist
Ondasteron
74
Antimetic: Aprepitant
NK1 antagonist
75
Aprepitant
Antimetic
76
Dronabidol
Antimetc
77
Dronabinol Clincal uses
Cytotoxic drug-induced emesis (chemotherapy)
Stimulate apetite
78
Adverse effects of Dronabinol
Psychoactive
many CNS effects
Palpitations, bloodshot eyes
79
T or F: Onastern has only peripheral antimetic effect
F
Central = area postrema
Peripheral = inhibition of vagus nerve
80
Most effective antiemetic for Cytotoxic drug induced emesis (chemotherapy)
5HT3
Ondastron
81
Radiation induced emesis
Ondasteron
82
Antiemetic that can cause QT interval prolongation (tornadoes point)
Ondasteron
Aprepitant
83
Antiemetic that can cause serotonin syndrome
Ondasteron
84
MOA of Apretitant
Inhibition of NK1 receptors @solitary nucleus & area postrema = CENTRAL antiemetic effect
85
Antiemetic that also inhibits substance P induced vomiting (pharyngeal or gag reflex)
Aprepitant
86
Antidiarrheals
Cholestryamine
Loperamide
Octreotide
Bismuth
87
Antidiarrheal: bile acid sequestrants
Cholestyramine
88
Antidiarrheal: MOR agnonists
Loperamide
89
Antidiarrheal: SST receptor agonist
Octreotide
90
Adsorbents Antidiarrheals
Bind to diarrhea causing toxins --> cannot act in cell of GI tract
Bismuth
Cholestryamine
91
Sticky insoluble resin
Cholestryamine
92
Used to tx bile acid malbasroption
Chelestryamine
93
tongue and stool turn black
Bismuth
94
Antidiarrheal that causes ototoxicity
Bismuth
95
Antidiarrheal that should be avoided in pediatric px
Bismuth
96
Antidiarrheal that ca cause discoloration and erosion of the teeth
Cholestyramine
97
Antidiarrheal that affects absorption of fat soluble vitamins
Cholestyramine
98
Antidiarrheal opiods
Loperamide
99
First line tx for travelers diarrhea
Loperamide
100
Antidiarrheal that can cause constimation, abdominal cramps, paralytic ileus and toxic megacolon
Loperamide (Opioids)
101
Contraindication of Loperamide
<4yo
Px with QT prolongation
102
Antidiarrheal that causes ↑LFTs
Cholestyramine
103
Contraindications of Choletyramine
Hypertriglicerdemia
104
Loperamide effects in GI tract
inhibits:
intestinal peristalsis
fluid secretion
↑sphincter tone
105
Best initial tx for chemotherapy-induced diarrhea
Loperamide
106
Antidiarrheal that inhibits 5HT
Octreotide
107
Antidiarrheal that can be given IV or SC
Octreotide
108
Dumping Syndrome
Octreotide
109
Diarrhea associated with carcinoid tumors or VIP secreting tumors
Octrotide
110
Long term use of Octreotide
Gallstone formation
111
T or F: Bismuth has antisecretory, antiinflamatory and antimicrobial effects
T
112
Antidiarrheal also used in the quadruple eradication of H.pylori
Bismuth
