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Flashcards in GASTROINTESTINAL Deck (43):
1

Which H2 blocker is the most potent blocker of the CYP450 system?

cimetidine

1

What are the AE of misoprostol? In whom is it contraindicated?

diarrhea; CI in pregnant because abortifacient

1

What effect does metoclopromide have on colon transport time?

NONE, it only affects the stomach and LES

2

Cimetidine can cause the release of what anterior pituitary hormone?

prolactin i.e. causes gynecomastia

2

Which receptor is antagonized by PPI's?

H/K ATPase on parietal cells

2

Which GI drug is a D2 receptor antagonist?

metoclopromide

4

Misoprostol is a PG__1 analog

E

4

What other disorder aside from constipation can lactulose be used to treat, why?

hepatic encephalopathy because gut flora degrade it into lactic and acetic acid which help to draw out ammonia, thus decreasing their hyperammonemia

5

What electrolyte imbalance may be caused by ALL antacids?

hypokalemia

6

3 indications for H2 blockers?

PUD, gastritis, and MILD esophageal reflux

6

Which osmotic laxative is also an antacid?

Magnesium hydroxide -- this explains diarrhea being an AE

7

People on PPI's are at increased risk of what infection?

Clostridium difficile (contrarily, these drugs are used to treat infections with H pylori)

9

Which osmotic laxative is also used to Tx hepatic encephalopathy?

lactulose

10

All H2 blockers end in _____ while all PPI's end in ________

dine; prazole

10

What are 4 osmotic laxatives?

Magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose

12

Sulfasalazine would be contraindicated in treating a patient with an allergy to what?

sulfa drugs i.e. it contains sulfapyridine

12

What ist he black box warning on metoclopromide?

tardive dyskinesia

13

What is the toxicity of octreotide?

can cause steatorrhea, and nausea/cramping

14

Which antacids can chelate and decrease absorption of tetracyclines?

CaCO3 or just Ca containing antacids

16

Which antacids cause constipation and which cause diarrhea?

Aluminum containing ones cause constipation and Mg containing ones cause diarrhea (Mg = Must Go)

17

Why would metoclopromide possibly work for GERD (it isnt indicated for it, just asking about a concept)

it increases LES tone

19

What are 3 clinical indications for misoprostol?

prevent NSAID-induced ulcers, maintain patent ductus arteriosus, induce labor by ripening cervix

19

What are 4 clinical indications for octreotide?

ACUTE variceal bleeding, VIPoma, carcinoid syndrome, and acromegaly

19

What are the major AE of infliximab?

infection and reactivation of latent TB, fever, hypotension

20

A man with ulcerative colitis is receiving treatment but finds that he and his wife cannot conceive, why?

sulfasalazine causes reversible oligospermia

21

How do PPI's inhibit the receptor?

IRREVERSIBLY

23

Which antacid is most likely to cause cardiac arrest?

Magnesium hydroxide

25

In which way do H2 blockers antagonize the receptor?

REVERSIBLY

27

Which H2 blockers decrease renal secretion of creatinine?

cimetidine and ranitidine

29

Which cells are affected by H2 blockers and PPI's?

parietal cells (secrete H and IF)

30

Which antacids can cause a rebound increase in acid and hypercalcemia?

Calcium Carbonate

31

Infliximab is a monoclonal antibody against ______. What 3 diseases can it Tx?

TNF alpha; Crohn's, UC, and Rheumatoid arthritis

33

What are the indications for metoclopromide?

Diabetic and Post-Surgery Gastroparesis and it is used as an anti-emetic

34

What is the MOA of ondansetron?

centrally acting 5-HT3 antagonist, prevents emesis in chemotherapy

35

What antibiotic can be used to Tx gastroparesis? MOA?

erythromycin; motilin analog

36

Which antacids can cause proximal muscle weakness, osteodystrophy, and seizures

Aluminum containing ones, in addition to constipation

37

Which drugs are used to bind to the base of ulcers and promote healing and can also be used to Tx travelers diarrhea?

Bismuth and Sucralfate

38

Who might abuse osmotic laxatives? And the Tx for their disorder is?

Bulimics; SSRI's

39

In whom is metoclopromide contraindicated?

patients with small bowel obstruction or Parkinson's disease

40

In addition to PUD, GERD and gastritis (which are indications for H2 blockers), PPI's can additionally Tx what disease?

Zollinger Ellison Syndrome

41

What is sulfasalazine a combination of?

Sulfapyridine ( a sulfa drug) and 5 aminosalycylic acid

42

What drug is given in the treatment of acute variceal bleeding? MOA?

octreotide; long acting somatostatin analog

43

If a man was given a drug for "stomach problems" and developed gyncecomastia, what was he most likely given?

cimetidine it has antiandrogenic effects