Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > GI > Flashcards

GI Flashcards

1
Q

N/V Gastroenteritis or Drug PATHWAY

A

CTZ

Receptors: Serotonin & Dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

N/V Gastroenteritis or Drug PATHWAY TREATMENT

A

Top choices:
Dopamine receptor: promethazine&raquo_space; inexpensive, EPS SEs
Serotonin receptor: generic, still expensive

other options: antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

N/V Motion Sickness PATHWAY

A

Vestibular pathway

Receptors: Acetylcholine-muscarinic, histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

N/V Motion Sickness PATHWAY TREATMENT

A

First line:
Antihistamines&raquo_space; sedation
Anticholinergics (antimuscarinics)&raquo_space; CAN’T SEE, PEE, SPIT, SHIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

N/V Emotional/Anticipatory PATHWAY

A

Limbic system

Receptors: GABA, histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

N/V Emotional/Anticipatory PATHWAY TREATMENT

A

Benzodiazepines: INC activity of GABA, an inhibitory neurotransmitter

Antihistamines: Hydroxyzine DOC for its antiemetic/sedating properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Patient-specific treatment: PONV

A

5 HT3 blocker
phenothiazine
NK1 receptor blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Patient-specific treatment: PEDs

A

Phenothiazine
Antihistamine/Anticholinergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Patient-specific treatment: PREGNANCY

A

Antihistamine/Anticholinergic
5 HT3 blockers: controversial
Promethazine: controversial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Patient-specific treatment: CIINV

A

5 HT3 blockers
NK1 receptor blockers
Cannabinoid
Benzodiazepine
Corticosteroid
Metoclopramide
Phenothiazines
Antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

TREAT THE CAUSE

A

N/V is a SYMPTOM

most of the time, it is self-limiting = resolve on its own

newborn = congenital obstruction
infant = obstructive lesions, metabolic disease, nutrient intolerance
children/adolescents/adults = drug induced; metabolic disorders; GI disorder; Motility disorder; Acute abdomen; Infection of abdomen; CV disease; Neurological process; emotional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Phenothiazines MOA/USES

A

oldest
(-zine) = promethazine (phenergan) and prochlorperazine (compazine)

MOA: block dopamine in CTZ; block cholinergic, alpha1-adrenergic, histamine receptors in vomiting center

monotherapy in mild - mod nausea, or combo for severe nausea

block nausea from blood and CSF: pathogenic toxins, opiates, to much body electrolytes, partying, GI bug, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Phenothiazines ADVANTAGES/DISADVANTAGES

A

ADVANTAGES:
inexpensive, except SR form
variety of forms
viable and practical option for LONG-TERM USE

DISADVANTAGES:
causes sedation&raquo_space; CAUTION w/ CNS depressants
Preg C
NO anticonvulsants, Coumadin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Phenothiazines AEs

A

SAME AS ANTIPSYCHOTICS

Extra-pyramidal sx: tremors, tardive dyskinesia, dystonia
CONTRAINDICATED: Parkinson’s

AE: sedation, resp depression (NO children <2, elderly start low dose, resp disorders)
may suppress cough reflex

anticholinergic effects: dry mouth, dry eyes, blurred vision, urinary retention, urine color change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Antihistamines-Anticholinergics MOA/USES

A

MOA: block histamine and cholinergic receptors along vestibular pathway and in vomiting center

antihistamines: block H1 receptors, bind to central cholinergic receptors responsible for N/V
anticholinergics: DEC secretion of saliva and GI motility

BLOCK N/V originating from inner ear&raquo_space; motion sickness, vertigo

motion sickness: take 30-60 min before event
patch: apply 1-2 hrs before event and may reapply q3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Antihistamines-Anticholinergics MEDS

A

dimenhydrinate (dramamine)&raquo_space; Pre B
Diphenhydramine (benadryl)&raquo_space; Preg B
Hydroxyzine (vistaril, atarax)
meclizine (antivert)
scopolamine
trimethobenzamide (tigan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Antihistamines-Anticholinergics Contraindications

A

Antihistamines: CAUTION asthma, glaucoma, GI/GU obstruction
NO LACTATION

Anticholinergics: CAUTION: glaucoma, bladder neck obstruction, GI obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Antihistamines-Anticholinergics AEs

A

Antihistamines: sedation, drowsiness, confusion

Anticholinergics: CAN’T SEE, PEE, SPIT, SHIT
mydriasis, blurred vision, urinary retention, dry mouth, constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Benzodiazepines MOA/USES

A

MOA: blocks signals from limbic system from reaching vomiting center

usually used in combo w/ other agents for CINV

USES: N/V and provide an anxiolytic and amnesic effect

most beneficial w/ anticipatory N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Benzodiazepines DOC/Contraindications/AEs

A

DOC: Lorazepam

Preg D

CONTRAINDICATIONS: hepatic/renal failure

AE: CNS depression, paradoxical CNS stimulation

**MONITOR LFTs before dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Serotonin Receptor Blockers MOA/USES

A

MOA: block 5HT3 receptors (many in GI tract)

USES: initially for CINV, but expanded to radiation induced N/V and PONV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Serotonin Receptor Blockers AEs

A

oral administration encouraged

Preg B

AE: few
HA, fatigue, dizziness, constipation, pruritis, fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cannabinoids

A

MOA: unknown

does NOT involve CTZ

AE: sedation, ataxia, dysphonia, may develop tolerance to most AEs w/ repeated dosing, but NOT antiemetic effect

Appetite stimulant&raquo_space; the munchies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cannabinoids Routes PROBLEMS

A

Smoking: works like PCA, risk of high THC levels producing AEs

Vaporizing: patient control intake, risk HIGH initial blood levels, NOT easily nebulized, coughing/irritation

oral: predictable onset, absorption rate variable, first-pass effect; difficult to titrate optimum dose

sublingual: patient controlled, rapid onset, less AEs, ONLY IN UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
NK1 Receptor Antagonists
newest aprepitant (emend) Crosses BBB to occupy NK1 receptors MOA: inhibit substance P from binding to NK1 receptor = no N/V augment activity of 5HT3 receptor blockers
26
NK1 Receptor Antagonists AEs
AE: fatigue, dizziness, hiccups, **elevated LFTs CYP3A4 inducer **can cause life threatening reactions when combined w/ certain drugs
27
N/V Other Meds
Metoclopramide: A Prokinetic Corticosteroids: used for CINV MOA: unknown BEWARE GI irritation, Hyperglycemia AE: steroid psychosis, HA, insomnia, glucose intolerance >> long-term use Antacids: coat the stomach or neutralize acid
28
GERD Patho
relaxed LES or cardiac sphincter allows contents to be splashed into esophagus ACID burns esophageal tissue
29
GERD Causes
30
GERD Risk Factors
31
GERD Diagnostic criteria
32
PUD Patho
supply and demand: supply of gastric assaults > gastric defenses types: duodenal and gastric ulcers
33
PUD Causes
Duodenal: 1st: H. pylori 2nd: NSAIDs Gastric: H. pylori INC acid and pepsin secretion, NSAIDs, impaired mucosal protection, pyloric stenosis, chronic gastritis
34
PUD Risk Factors
smoking NSAIDs ETOH H. pylori
35
PUD Diagnostic criteria
36
H2 Receptor Antagonists MOA/USES "-idine" ranitidine, famotidine
MOA: reduce HCl secretion by blocking one of the triggers of H+ production USES: self-tx heartburn NO first-line tx GERD Used as maintenance after PPI for GERD Used in PUD for continued acid suppression after ulcer healed
37
H2 Receptor Antagonists Contraindications
CAUTION: elderly, renal patients = CNS effects
38
H2 Receptor Antagonists AEs
antiandrogen (gynecomastia, impotence) CNS: confusion, agitation, psychosis, depression, disorientation hematologic: rare, but need to monitor drowsiness, dizziness, N/V/D, constipation **may raise LFTs, d/c if it does
39
H2 Receptor Antagonists Interactions
Antacids DEC absorption uses CYP450 pathway: cimetidine
40
PPI MOA/USES
MOA: inhibit H/K/ATPase pump, blocking the final step in H+ secretion
41
PPI Contraindications
Contra: hypersensitivity CAUTION: hepatic dysfunction, elderly
42
PPI AEs
Common: dizziness, drowsiness, abd pain, constipation, diarrhea, flatulence long-term = nutrient deficiencies, INC risk c diff, INC hip fracture, gastric CA
43
PPI Interactions
Food DEC absorption
44
Antacids
MOA: neutralize acid CAUTION: renal issues or hypercalcemic state (renal calculi) Drug absorption effect: give other agent first, take antacid 2 hrs later Be careful of Na content
45
Sucralfate
alkaline aluminum salt MOA: binds to necrotic tissue at ulcer site; protective barrier to acid, pepsin, bile salts USES: duodenal ulcers NOT from H. pylori stress ulcer prophylaxis PREGNANCY SAFE EMPTY STOMACH AVOID ANTACIDS AE: constipation may DEC absorption of drugs = separate dosing by 2 hrs
46
Misoprostol
inhibit gastric secretion by inhibiting histamine-stimulated cycle Mod DEC in pepsin concentration produces UTERINE CONTRACTIONS NO PREGNANCY CAUTION: renal impairment, >65 yo AE: diarrhea
47
GERD algorithm
48
PUD algorithm
49
H. Pylori MULTI-TREATMENT
First-line: 1) PPI, amoxicillin, clarithromycin 2) PPI, clarithromycin, metronidazole Second-line: 1) PPI, amoxicillin, clarithromycin, tinidazole 2) bismuth subsalicylate, metronidazole, tetracycline, PPI Salvage tx only: PPI, amoxicillin, levofloxacin
50
Diarrhea PATHO
Osmotic: pulls water into intestine (lactose intolerance, high sugar intake, poorly absorbed salts) Secretory: Cl secretion, disrupt NaCl reuptake (cholera, celiac disease, crohn's, bacterial endotoxins) Exudative: inflammation of mucosa (enteritis, colitis, inflammatory conditions) Altered Intestinal Motility: INC motility = DEC reabsorption (bowel resection, vagotomy, meds)
51
Diarrhea CAUSES
infections medications disease states
52
Diarrhea Diagnostic
INC in frequency of loose, watery stools over a period of 24-48 hrs
53
Constipation CAUSES
diet lifestyle meds disease
54
Bulk forming laxatives fiber lax
preferred agents for constipation relief pull water into stool to swell and INC stool bulk bulk stimulates movement of intestines NO tx opioid induced constipation Can be used as antidiarrheal work in 12-24 hrs
55
Bulk forming laxatives CONTRAINDICATIONS
esophageal strictures GI ulcerations GI stenosis GI obstruction CAUTION: DM (carb content from fiber)
56
Bulk forming laxatives AEs/INTERACTIONS
AE: INC flatulence INC bloating abd fullness, cramping N/V w/ excess use INTERACTIONS: contains aspartame AVOID gluten intolerance quinolones or TCN = absorption blocking
57
Hyperosmotic laxatives
INC osmotic pressure = stimulates intestinal motility does not degrade colonic bacteria so less bloating supp for promotes rectal stimulation
58
Hyperosmotic laxatives CONTRAINDICATIONS
lactulose: CAUTION DM Appendicitis, acute abd, fecal impaction, intestinal obstruction long-term use causes dependence not useful: IBS, severe bloating or fullness
59
Hyperosmotic laxatives AE
glycerin: safest; may cause rectal irritation GI upset Diarrhea nausea cramps bloating
60
Saline laxatives
draw water into intestine via osmosis = INC intraluminal pressure = INC motility similar to hyperosmotic lax used as pre-procedure PREP
61
Saline laxatives CONTRAINDICATIONS/AE
Contraindications: low salt diet renal disease = hypoK, hyperMg, hypoCa, hyperNa CAUTION ELDERLY AE: dehydration
62
Saline laxatives INTERACTIONS
separate administration from: Azoles antifungals quinolones TCN
63
Stimulant laxatives bisacodyl, senna, castor oil
INC peristalsis of intestine, promote fluid accumulation AVOID long-term tx work 6-10 hrs after oral administration; 15-120 min after rectal administration
64
Stimulant laxatives CONTRAINDICATIONS
acute abdomen fecal impaction intestinal obstruction may cause exacerbation of hemorrhoids or rectal fissures
65
Stimulant laxatives AEs
N/V abd cramping laxative dependence
66
Surfactant laxatives (stool softeners) docusate sodium docusate calcium
DEC surface tension of liq contents of bowel Incorporates more liq into stool forming a softer mass LOC to prevent straining PREVENT CONSTIPATION -- NO TX combo w/ fiber products
67
Surfactant laxatives CONTRAINDICATIONS/INTERACTIONS
NO contraindications useful in those on restricted Na diets interaction w/ mineral oil--INC absorption which INC risk for liver toxicity
68
Surfactant laxatives AEs
well-tolerated stomach upset mild cramping diarrhea throat irritation **PEARL: can be used to soften cerumen before irrigation**
69
CONSTIPATION TREATMENT
TLCs First-line: bulk-forming lax Second-line: MOM Third-line: stimulant (high abuse potential; mineral oil)
70
Antimotility Agents Loperamide Diphenoxylate w/ atropine
Derivative of OPIATES Slows GI motility by effecting intestinal musculature INC transit time = INC absorption
71
Antimotility agents CONTRAINDICATIONS/AEs/INTERACTIONS
Contraindications: exacerbate infectious diarrhea by DEC expulsion of infecting organism AE: Abd discomfort, constipation, dry mouth NO CHILDREN <4 Atropine SE INTERACTIONS: diphenoxylate = CNS depression Loperamide - HIGH first pass effect = CAUTION LIVER FAILURE
72
Atypical antidiarrheals
antisecretory, antimicrobial, adsorbent properties TX: traveler's diarrhea contains salicylate: CAUTION ASA sensitivity or treatment NO CHILDREN = Reye's syndrome AE: black stools, black tongue, tinnitus
73
Adsorbents (Kaolin, pectin, attapulgite) Donnagel, Kaopectate)
Adsorb water and solidify stools given after each BM until diarrhea resolved AE: constipation, feeling of fullness, upset stomach, bloating, flatulence relatively safe interactions: may adsorb nutrients and meds
74
Absorbents polycarbophil (fibercon, fiberall)
absorbs water from GI tract AE: constipation, feeling of fullness, upset stomach, bloating, flatulence relatively safe interactions: may adsorb nutrients and meds
75
Diarrhea TREATMENT
TLCs: diet (low fiber, lactose free, gluten free, BRAT) First-line: LOPERAMIDE Second-line: Adsorbent or bismuth subsalicylate; do NOT use bismuth w/ flu in <18yr Third-line: diphenoxylate w/ atropine
76
Anthelmintic (PINWORMS) Pyrantel pamoate
Reece's pinworm medicine OTC KILLS ADULT WORM ONLY, DOSE REPEATED (for eggs) NO PREGNANT AE: rash, HA, dizziness, sleepiness, N/V May take w/ food
77
Anthelmintic (PINWORMS) Mebendazole
RX needed = KILLS ADULT WORMS Preg C AE: angioedema, fever, dizziness, HA, rash, abd pain, N/V/D tablet can be crushed and mixed w/ food

Pharmacology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions