GI Flashcards

Question

Cholestryramine, Colestipol

Answer 1

Anti-diarrhea Bile acid binding resins Action: - form non-absorbable complex with bile acids - bile acids stimulate colonic secretion, causing secretory diarrhea - bile acids absorbed in terminal ileum Caution: - seperate from other meds by 2 hrs cuz binds them

Answer 2

Anti-diarrhea Antisecretory agent Action: - reduces fluid and electrolyte secretion by stomach and pancreas - mild antimolity effect - promotes intestinal electrolyte absorption - suppresses neuroendocrine tumor release of peptides that cause intestinal hypersecretion of electrolytes and water

Answer 3

``` Anticholinergic - scopolamine Antihistamine - meclizine, dimenhydrinate DA antagonist - prochlorperazine, promethazine 5HT antagonist - ondansetron, dolasetron, granisetron Cannabinoid - dronabinol Neurokinin antagonist - aprepitant ```

Answer 4

``` Antiemetic Anticholinergic Action: - blocks Ach at M1 receptor Use: - prevents motion sickness - prevents chemo induced nausea Side effects: - anticholinergic: dry mouth, sedation, blurred vision, confusion, urinary retention ```

Answer 5

Antiemetic Antihistamine Action: - block H1 and has anticholinergic effects Use: - tx motion sickness - hyperemesis gravidarum Side effects: - sedating; meclizine less than dimenhydrinate - anticholinergic: dry mouth, sedation, blurred vision, confusion, urinary retention

Answer 6

``` Antiemetic DA antagonist Action: - D2 receptor blocker, some anticholinergic effects Use: - prophylaxis preop; postop - motion sickness - toxic and metabolic induced nausea - migraine related nausea - hyperemesis gravidarum Side effects: - anticholinergic: dry mouth, sedation, blurred vision, confusion, urinary retention - sedation - extrapyramidal - tardive dyskinesia, pseudo-parkinsonism, acute dystonia - QT prolongation ```

Answer 7

``` Antiemetic 5HT antagonist Action: - act on vagal nerve terminals and chemoreceptor trigger zone, antagonize serotonin receptors Use: - multiple settings for antiemesis - chemotherapy induced nausea/vomit - migraine related nausea - postop nausea/vomit - hyperemesis gravidarum Side effects: - QT prolongation ```

Answer 8

``` Antiemetic Cannabinoid Action: - agonize CB1 receptor Use: - chemo induced nausea vomit - appetite stimulant in AIDS/HIV Side effects: - euphoria, paranoia, CNS depression, abuse potential ```

Answer 9

``` Antiemtic NK antagonist Action: - substance P/neurokinin I receptor antagonist Use: - prevention of acute and delayed chemo induced and post-op nausea/vomit - give before chemo or anesthesia Adverse events: - hiccups - fatigue - increased risk of infxn ```

Answer 10

Aminosalicylates - sulfasalazine, mesalamine, balsalazide, olsalazine Glucocorticoids - prednisone, methylprednisolone, budesonide Immunomodulators - methotrexate, 6MP/azathioprine Biologics - infliximab, adalimumab, certolizumab, natalizumab

Answer 11

``` 5-Aminosalicylates Anti-inflammatory Active in colon 5-ASA is active component Use: UC and Crohn's Adverse events: - mild GI and headache occasionally - hypersensitivity rxns - pancreatitis, pneumonitis - paradoxical worsening of disease - chronic interstitial nephritis ```

Answer 12

``` Aminosalicylate Anti-inflammatory Prodrug release in colon Use: UC and Crohn's Adverse events: - frequent GI (N/V), CNS and hematologic side effects - megaloblastic anemia, leukopenia - agranulocytosis - monitor for this - decreased folic acid absorption - treat with folic acid ```

Answer 13

``` Glucocorticoid Use: - induce remission in both UC and Crohn's - not maintenance - must be tapered off Adverse events: - muscle wasting - lipodystrophy - buffalo hump, abdominal fat - thinning of skin - moon facies - HTN - poor wound healing - osteoporosis - hyperglycemia - increased suspectibility to infxn ```

Answer 14

``` Non-systemic glucocorticoid - controlled ileal or colonic release High first pass metabolism in liver Use: - induction for Crohn's and UC - requires taper Smaller pts get more systemic effects Adverse events: - muscle wasting - lipodystrophy - buffalo hump, abdominal fat - thinning of skin - moon facies - HTN - poor wound healing - osteoporosis - hyperglycemia - increased suspectibility to infxn ```

Answer 15

Purine antimetabolites - 6MP metabolized by TPMT, HPRT, and xanthine oxidase - HPRT to 6TGN - active metabolite - TPMT to 6-MMP - inactive metabolite Action: - inhibits nucleotide synthesis, decreases lymphocytes, decreases pro-inflammatory cytokine production Use: - maintenance of remssion in UC and Crohn's; 3 mo to reach therapeutic levels Adverse events: - leukopenia, thrombocytopenia from 6-TGN - hepatotoxicity from 6-MMP - infxn risk increased - increased risk of malignancy - avoid use with allopurinol

Answer 16

``` Immunomodulator - folate anti-metabolite - inhibits dihydrofolate reductase - results in apoptosis of T cells Use: - maintenance of remission in Crohn's Adverse events: - hepatotoxicity - myelosuppression - interstitial lung disease - mucositis - teratogenic Give folic acid to all pts ```

Answer 17

``` mAb against TNF-a Use: - induction and maintenance of remission in Crohn's and UC Infliximab - UC and CD Adalimumab - UC and CD Certolizumab - CD only Adverse events: - infxn - screen for latent TB and hepatitis B - myelosuppression - increased risk of malignancy - psoriasis - drug induced lupus - dymyelination syndrome ```

Answer 18

Anti-integrin - blocks leukocyte migration from blood vessels to sites of inflammation Adverse events: - Progressive multifocal leukoencephalopathy

Answer 19

Anti-integrin - gut specific - blocks leukocyte migration from blood vessels to sites of inflammation

GI Flashcards

(43 cards)