GI

Question 1

What ways do acid-reducing agents stop ulcers?

Answer 1

PPI, Histamine blockers, anticholinergic agents, prostaglandins also inhibit proton pump

Question 2

Calcium Carbonate (Tums) MOA, Class, AE

Answer 2

Antacids.
MOA: neutralized gastric acidity
AE: Constipation

Question 3

What happens to the absorption or Drug-drug interaction with Antacids?

Answer 3

increased pH causes reduced absorption of acidic drugs and increased absorption of basic drugs

Question 4

What to look out for when taking Antacids?

Answer 4

Electrolyte imbalance

Avoid taking within 2 hours window of other oral medication

Question 5

Ending for H2 Receptor Antagonists

Answer 5

(-tidine)

Question 6

Primary use for H2 Antagonists

MOA

Answer 6

Primary use: treat acid reflux and heal ulcers

MOA: reduce secretion of stimulated acid

Question 7

When do you take H2 receptor Antagonist with food?

Answer 7

90 min before eating

Question 8

AE H2 Receptor Antagonists?

Answer 8

diarrhea, muscle pain, can cause gynecomastia b/c affinity to androgen receptors

Question 9

PPI MOA:

Answer 9

irreversibly inhibits H+/K+ - ATPase pump on parietal cell membrane which blocks final step in acid secretion into lumen of stomach

Question 10

Primary purpose PPI

Answer 10

treat acid reflux and heal ulcers (shown to be more effective than H2 receptor antagonists)

Question 11

PPI endings

Answer 11

(-prazole)

Question 12

Why dont you take PPI with food?

Answer 12

because it decreases the bioavailability

Question 13

AE PPI

Answer 13

long-term use associated with gastric polyps, altered calcium metabolism (decreased bone mineralization), some cardiovascular abnormalities, long-term use has higher risk C.diff

Question 14

MOA Bismuth chelate (pepto-bismol)

Answer 14

Appears to coat ulcer, enhance prostaglandin synthesis, increase gastric mucous epithelial cell growth to protect against H. pylori-induced ulcers.

Question 15

Sucralfate MOA

Answer 15

An aluminum salt of sucrose that forms a protective coating over the ulcer; used for high-risk cases (trauma, burns, ARDS, major surgery, etc).

Question 16

Misoprostol MOA

Answer 16

Synthetic prostaglandin analog (PGE2) that inhibits acid secretion; used to prevent NSAID-induced ulcers

Question 17

H. pylori infection can cause

Answer 17

chronic gastritis, PUD, GERD, gastric cancer

Question 18

Treatment for H. pylori

Answer 18

acid-controlling drug + antibiotic

Question 19

Drug class to treat N/V (8)

Answer 19

Anticholinergics, Antihistamines, Neuroleptic, Prokinetic, Serotonin blockers, Neurokinin-1 receptor blockers, Cannabinoids, Phosphorated carbohydrate solution (Emetrol)

Question 20

scopolamine (Transderm Scop)

MOA, drug class, AE

Answer 20

Anticholinergics
MOA: binds to ACh receptors on vestibular nuclei
AE: dizziness, drowsiness, dry mouth, blurred vision, dilated pupils, difficulty with urination

Question 21

Meclizine drug class, MOA, AE

Answer 21

Antihistamines
MOA: inhibit vestibular input to the CTZ
AE: dizziness and sedation

Question 22

Neuroleptic drugs MOA

Answer 22

block dopamine receptors in CTZ

Anticholinergic actions

Question 23

Neuroleptic drugs AE

Answer 23

dry eyes, urinary retention, long-term use can lead to extrapyramidal symptoms, tardive dyskinesia

Question 24

Prokinetic drugs ex

MOA

Answer 24

metoclopramide

block dopamine in CTZ

Question 25

Prokinetic drug AE

Answer 25

sedation, diarrhea, weakness, Prolonged use causes extrapyramidal signs

Question 26

Serotonin blockers end with | name one drug

Answer 26

-setron | ondansetron

Question 27

Serotonin blockers MOA

Answer 27

block serotonin receptors in GI tract, CTZ, and vomiting center

Question 28

Serotonin blockers AE

Answer 28

dizziness, diarrhea, [no extrapyramidal signs]

Question 29

Serotonin blocker can be combined with to control chemo-induced emesis

Answer 29

Corticosteroids

Question 30

Neurokinin-1 receptor blockers uses and MOA

Answer 30

drug to prevent emesis from chemotherapy MOA: blocks Substance P from binding to NK-1 receptor, prevents both central and peripheral stimulation of vomiting centers

Question 31

Neurokinin-1 receptor blockers AE

Answer 31

GI issues, Steven-Johnson syndrome

Question 32

Cannabinoids uses

Answer 32

block acute and delayed emesis, used for chemo-induced nausea/vomiting

Question 33

Cannabinoids AE

Answer 33

blurred vision, dry mouth, weakness, tachycardia or bradycardia, CNS symptoms (confusion, anxiety, mood changes)

Question 34

Phosphorated carbohydrate solution (Emetrol) MOA and uses

Answer 34

MOA: relaxes GI tract smooth muscle | Used for mild cases of intestinal flu or food-borne causes

Question 35

Classes that treat Diarrhea

Answer 35

Absorbents, Anticholinergics, Intestinal flora modifiers, Opiates

Question 36

Absorbents drug examples, MOA

Answer 36

``` bismuth subsalicylate (Pepto-Bismol), attapulgite (Kaopectate) MOA: binds to bacteria causing diarrhea to carry them out with feces ```

Question 37

Absorbents AE: what to look out for

Answer 37

aspirin product: use with caution in children recovering from flu/chickenpox, increased bleeding time, GI bleed Decrease effectiveness of many drugs

Question 38

Anticholinergics drug ex, MOA, What to look out for

Answer 38

atropine MOA: reduce peristalsis of GI tract Because of AE, rarely first choice for treatment

Question 39

Intestinal flora modifiers uses

Answer 39

bacterial products obtained from Lactobacillus organisms (like probiotics)- great to use when someone is taking antibiotics Normally resides in intestines to keep “bad” bacteria in check Helps restore normal balance to suppress harmful organisms

Question 40

Opiates drug ex, MOA

Answer 40

diphenoxylate (Lomotil) decrease GI motility and propulsion Slowing transit time in intestines = absorption of water and electrolytes

Question 41

Opiates AE

Answer 41

sedation, dizziness, constipation, nausea, vomiting, respiratory depression, bradycardia, hypotension, urinary retention

Question 42

What Laxatives to treat constipation

Answer 42

Bulk-forming, Emollient, Hyperosmotic, Saline, Stimulant

Question 43

Bulk-Forming Laxatives drug ex, MOA Require to?

Answer 43

methylcellulose (Citrucel) MOA: increase water absorption  softens and increases bulk of intestinal contents Require to drink lots of water

Question 44

Hyperosmotic Laxatives drug ex, | MOA

Answer 44

lactulose, polyethylene glycol (Miralax) | creates gradient that draws fluid into colon to increase stool fluid content and stimulate peristalsis

Question 45

Hyperosmotic Laxatives AE

Answer 45

abdominal bloating, rectal irritation, electrolyte imbalance

Question 46

Saline laxatives | MOA

Answer 46

Similar to hyperosmotic– osmotic pressure pushes water/electrolytes into intestines

Question 47

Saline laxatives AE

Answer 47

salts may cause issues with individual with diminished cardiac or renal function, electrolyte imbalance

Question 48

Emollient Laxatives ex, MOA

Answer 48

``` docusate sodium (Colace) facilitate water and fat absorption into stool, lubricate fecal matter and intestinal wall ```

Question 49

Emollient Laxatives AE

Answer 49

decreased vitamin absorption, electrolyte imbalance

Question 50

Stimulant laxative ex, MOA

Answer 50

Senna | MOA: stimulates peristalsis through enteric nervous system

Question 51

Stimulant laxative AE

Answer 51

Danger of long-term use: dependence and damage to intestinal cells/loss of colon function

Question 52

Position avoided when with patients with GERD

Answer 52

should avoid lying flat (supine) Avoid increased intra-abdominal pressure Avoid exercise immediately after meals

Question 53

Vomiting and diarrhea lead to... make sure to ...

Answer 53

Dehydration and electrolyte imbalance | Encourage fluids during PT sessions

Question 54

smoking decrease effectiveness in what drug class

Answer 54

H2 Blockers