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Flashcards in GI 375 - 380 Deck (54):
1

name of the drug that blocks gastric/pancreatic lipase

orlistat

2

what is the clinical app of orlistat?

weight loss (dec breakdown and absorption of dietary fats)

3

side effects of orlistat?

steatorrhea, dec absorption of fat-soluble vitamins

4

side effects of ondansetron?

QT polongation, headache, constipation

5

what type of antibiotic also causes QT prolongation?

macrolides

6

what is the target of ondansetron?

5HT3

7

2 functions of ondansetron?

1. dec vagal stimulation
2. powerful central acting antiemetic

8

what is metoclopramide?

D2 receptor antagonist

9

what is the clinical app for metoclopramide?

diabetic and postsurgery gastroparesis, antiemetic

10

2 conditions that are contraindicated to metoclopramide?

small bowel obstruction, parkinson dz

11

metoclopramide can interact with what kinds of drugs?

digoxin, diabetic agents

12

side effects of metoclopramide?

inc parkinsonian effects, tardive dyskinesia, restlessness, drowsiness, diarrhea

13

does metoclopramide affect the colon transportation time?

no

14

name 4 H2 blockers

cimetidine, ranitidine, famotidine, nizatidine

15

what is the mech of H2 blockers?

reversible block of histamine H2 receptors --> dec proton secretion by parietal cells

16

among H2 blockers, what is unique about cimetidine?

inhibitor of P450 and also has antiandrogenic effects (prolactin release, gynecomastia, impotence, dec libido in males)

17

what 2 H2 blockers dec renal excretion of creatinine?

cimetidine, ranitidine

18

4 clinical applications for octreotide

1. variceal bleeds
2. acromegaly
3. VIPoma
4. carcinoid tumors

19

what is the common side effect of all antacid?

hypokalemia

20

name 4 osmotic laxatives

1. magnesium hydroxide
2. magnesium citrate
3. polyethylene glycol (prep for colonoscopy)
4. lactulose

21

the mech of osmotic laxatives?

provide osmotic load to draw water into the GI lumen

22

what is sulfasalazine?

combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory)

23

sulfasalazine need to be activated by

colonic bacteria

24

3 clinical usage for sulfasalazine?

1. UC
2. Crohn (colitis component)
3. rheumatoid arthritis

25

name 3 antacids

1. aluminum hydroxide
2. calcium carbonate
3. magnesium hydroxide

26

which antacid can chelate and dec the effectiveness of drugs such as tetracycline, fluoroquinolones

calcium carbonate

27

what is the drug that ripens cervix?

misoprostol (PGE1 analog)

28

name two H2 blockers that reduce renal excretion of creatinine?

cimetidine, ranitidine

29

mech of proton pump inhibitor?

irreversible inhibition of Na+/K+ ATPase

30

3 side effects of PPI?

1. inc risk of C. difficle infection
2. pneumonia
3. dec serum Mg2+ with long term use

31

does PPI inhibit or induce P450?

inhibit

32

mech of bismuth, sucralfate?

bind to ulcer base providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer

33

which drug is a prodrug that requires acid to be activated?

sucralfate

34

bismuth is also used is what other path?

H. pylori (Quadruple tx: PPI, bismuth, metronidazole, tetracycline)

35

4 clinical applications for octreotide?

1. variceal bleeds
2. acromegaly
3. VIPoma
4. carcinoid tumors

36

what path is associated with "disorganized glandular structure with cellular infiltration?"

pancreatic adenocarcinoma

37

where does pancreatic adenocarcinoma usually arise from?

pancreatic duct

38

what is the most common location of pancreatic adenocarcinoma?

pancreatic head

39

what are the clinical symptoms from obstructive jaundice due to pancreatic adenocarcinoma?

1. painless jaundice
2. puritis
3. dark urine
4. pale stool

40

what are the 2 tumor markers for pancreatic adenocarcinoma?

CA 19-9, CEA

41

name 5 risk factors for pancreatic adenocarcinoma

1. tobacco use
2. chronic pancreatitis
3. diabetes
4. age > 50 yrs
5. Jewish and African American males

42

name 4 unique presentations of pancreatic adenocarcinoma

1. abdominal pain radiating to back
2. weight loss (due to malabsorption and anorexia)
3. migratory thrombophlebitis
4. obstructive jaundice with palpable nontender gallbladder

43

explain the pathophysio of the migratory thrombophlebitis?

precoabulant effect of the circulating "mucin" released by tumor cells --> inc coagulation factors

44

what is another name for migratory thrombophlebitis?

Trousseau syndrome

45

what is Courvoisier sign?

obstructive jaundice with palpable nontender gallbladder

46

what path is associated with inc risk of gallbladder carcinoma?

porcelain gallbladder

47

what infectious agent is associated with cholangiocarcinoma?

clonorchis sinensis (Chinese liver fluke)

48

what is the treatment for porcelain gallbladder?

prophylactic cholecystectomy due to high rates of gallblader carcinoma

49

define porcelain gallbladder

calcified gallbladder due to chronic cholecystitis

50

what is the complication of acute pancreatitis?

pancreatic pseudocyst (lined by granulation tissue, not epithelium can rupture and hemorrhage)

51

3 clinical presentations for acute pancreatitis?

1. epigastric abdominal pain radiating to back
2. anorexia
3. nausea

52

what are the consequences of acute pancreatitis other than pseudocysts?

1. DIC
2. ARDS
3. diffuse fat necrosis
4. hypocalcemia (Ca2+ collects in pancreatic Ca2+ soap deposits)
5. infection
6. multiorgan failure

53

is amylase and lipase a good marker for confirming chronic pancreatitis?

no (amylase and lipase may or my not be elevated in chronic pancreatitis)

54

is amylase/lipase good makers for acute pancreatitis?

yes (amylase and lipase always elevate in acute pancreatitis)