GI Flashcards by Claire Davis

What cell secretes acid into the stomach lumen

Parietal

How well did you know this?

Not at all

Perfectly

What 3 things stimulate the parietal cell

Histamine, Ach, and Gastrin

How well did you know this?

Not at all

Perfectly

What is the parietal cell negatively regulated by

Somatostatin

How well did you know this?

Not at all

Perfectly

Chief cells produce

Pepsinogen, which is cleaved to make pepsin

How well did you know this?

Not at all

Perfectly

What does pepsin do

Digests peptide bonds

How well did you know this?

Not at all

Perfectly

What is a concern that GERD can lead to in some patients

Barrett’s esophagus (precancerous)

How well did you know this?

Not at all

Perfectly

In this type of peptic ulcer, the amount of acid production is normal, but the mucosal barrier is weak

Benign Peptic Ulcer Disease

How well did you know this?

Not at all

Perfectly

In this type of peptic ulcer, there is excessive secretion of gastric acid that overwhelms the mucosal barrier

Malignant Peptic Ulcer Disease

How well did you know this?

Not at all

Perfectly

What are the 2 main causes for peptic ulcers

NSAIDs and H. Pylori

How well did you know this?

Not at all

Perfectly

What are the two types of antacids

Systemic and Nonsystemic

How well did you know this?

Not at all

Perfectly

This is the systemic antacid

Sodium Bicarbonate

How well did you know this?

Not at all

Perfectly

These two drugs are the nonsystematic antacids

Aluminum Hydroxide + Magnesium Hydroxide combinations and Calcium Carbonate

How well did you know this?

Not at all

Perfectly

In what type of patients is Aluminum+Magnesium Hydroxide combinations contraindicated

Patient with impaired renal function

How well did you know this?

Not at all

Perfectly

Magnesium may cause what symptom

Diarrhea

How well did you know this?

Not at all

Perfectly

Calcium may cause what symptom

Constipation

How well did you know this?

Not at all

Perfectly

What common suffix do Histamine Receptor Blockers have

Tidine

How well did you know this?

Not at all

Perfectly

What are the 4 Histamine Receptor blockers

Cimetidine, Famotidine, Ranitidine, and Nizatidine

How well did you know this?

Not at all

Perfectly

What do Histamine Receptor Blockers do

Inhibit the histamine on the parietal cells, which decreases the amount of acid being produced

How well did you know this?

Not at all

Perfectly

What is a side effect of cimetidine

Inhibits the metabolism of estrogen, therefore en will have feminization due to excess estrogen

How well did you know this?

Not at all

Perfectly

How do proton pump inhibitors work

They prevent any release of protons (acid)

How well did you know this?

Not at all

Perfectly

How long is the course of treatment for proton pump inhibitors

4-8 weeks

How well did you know this?

Not at all

Perfectly

What kind of patients are proton pump inhibitors contraindicated

patients taking clipidogel (Plavix); it can reduce the effectiveness of Plavix

How well did you know this?

Not at all

Perfectly

What is a problem with proton pump inhibitors

It is overprescribed especially in hospital settings and can significantly increase mortality rate compared to no PPI or even H2 blocker

How well did you know this?

Not at all

Perfectly

What are the 5 Proton pump inhibitors

Omeprazole, Esomeprazole, Rebeprazole, Lansoprazole, Pantoprazole

How well did you know this?

Not at all

Perfectly

This drug is a prostaglandin

Misoprostol

You do not want to give this drug to women of childbearing years unless a reliable method of birth control can be DOCUMENTED

Misoprostol

Why don't you want to give misoprostol to women of childbearing years

it can cause birth defects and premature birth

You typically use this drug for elderly patients or postmenopausal women when the ulcer is due to NSAIDs bc it helps boost the production of the mucosal barrier

Misoprostol

This drug blocks the Ach input on the parietal cells and is a muscarinic acetylcholine receptor antagonist

Pirenzipine

What are the side effects of pirenzipine

Anticholinergic side effects; at therapeutic levels, it can have antimuscarinic effects in the CNS (blurry vision, constipation, dry mouth, sedation

Name the two mucosal protective agents

Sucralfate and Chelated Bismuth

This drug forms a sticky polymer in acidic environment and adheres to the ulcer site

Sucralfate

Why should you take sucralfate 2 hours before or after other drugs

because it may bind with other drugs and interfere with absorption

This drug protects the ulcer crater and allows healing with some activity against H. pylori

Chelated bismuth

This drug shouldn't be used repeatedly or for more than 2 months at a time; it can also cause black stools and constipation

Chelated bismuth

What kind of therapy can you use for H. pylori

triple therapy (proton pump inhibitor + a moderate and strong antibiotic) or quadruple therapy (same as triple but add bismuth)

What is included in the therapeutics for IBD

Anti-inflammatories and immunosuppressants (mild for mild symptoms and more effective immunosuppressants for chronic symptoms)

What are the side effects for IBD therapeutics

GI problems, Hepatotoxicity, pancreatitis, pulmonary fibrosis, risk for opportunistic infections; ~20% of patients discontinue treatment due to side effects

When should laxatives be used for constipation

only if dietary modification fails

what is the number one cause of constipation

laxatives

What do laxatives do to the intestinal lumen

it stretches it and turns on peristalsis

This type of laxative increases bowel content volume which triggers the stretch receptor and causes peristalsis that propels the bowel content forward

Bulk laxatives

Name the 3 bulk laxatives

Psylliun, bran, and methyl cellulose

what do bulk laxatives need to be taken with

lots of water

what is the most rapid acting laxative

Saline and osmotic laxatives

In this laxative, fluid is drawn into the bowel by osmotic force, increasing volume and triggering peristalsis

saline and osmotic laxatives

Name the two non digestible sugars and alcohols in saline and osmotic laxatives

Lactulose and prunes (sorbitol)

Name the 5 salts that are saline and osmotic laxatives

Milk of magnesia, epsom salt, glauber's salt, sodium phosphates, and sodium citrate

This saline and osmotic laxative is used in children

polyethylene glycol

Name the 3 stool softeners - Emollients

Docusate sodium (surfactant and stimulant), Liquid paraffin (oral solo), and glycerin suppositories

What are stool softeners used for

impacted stool or megacolon; helps lubricate for the stool to come out

This type of laxative increases intestinal motility by irritating the GI mucosal and pulling water into the lumen

Irratant/stimulant laxative- cathartics

This laxative works in 6-8 hours; its a gentle overnight laxative

irritant/ stimulant laxative-cathartics

Name the 4 irritant/stimlant laxatives

castor oil, senna, bisacodyl, and lubiprostone

How do anti-diarrheal agents work

reduce peristalsis by stimulating opioid receptors in the bowel and allow time for more water to be absorbedly the gut

Name the 4 anti-diarrheal agents

Morphine, codeine, diphenoxylate, loperamide

What does diphenoxylate combine with

atropine

This anti-diarrheal is 40-50x more potent than morphine and doesn't cross the BBB

Looperamide

What are the contraindications for antidiarrheals

Toxic materials, microorganisms, or antibiotic associated

This is a major cause of diarrhea and colitis in patients exposed to antibiotics (~20%)

C. Diff

What is the route of transmission for C. diff

Fecal-oral

What is the most preventative way for C. diff

washing the hands

What are the 3 pharmacological treatments for C. diff

discontinue offending antibiotic, metronidazole (not for liver or renal impairment), and vancomyocin (not for renal impairment)

This antiflatulant alters elasticity of mucus-coated bubbles, causing them to pass easier; but has limited data regarding effectiveness

Simethicone

Which part of the brain senses motion sickness

vestibular apparatus in the ear

Which part of the brain promotes emesis after seeing something repulsive

cortex

This syrup induces emesis and is good to have if you live in a rural area and can't get to the ER within an hour

Syrup of ipecac emetic

This muscararinic receptor antagonist is an antiemetic therapeutic and is given as patches

scopolamine

This histamine and dopamine receptor antagonist is an antiemetic therapeutic that is widely used today

Phenothiazine

what is the side effect of phenothiazines

blurred vision, dry mouth, seizures, extrapyramidal effects (tar dive dyskinesia)

These two antiemetic therapeutics are serotonin receptor antagonists that are excellent for chemotherapy induced N/V

Ondansetron and granisetron

where do the serotonin receptor antagonists for antiemetic therapeutics work

in the vomiting center, CTZ, and GI

This is the first antiemetic derived from marijuana

Dronabinol

In what type of patients is dronabinol used in

cancer/aids patients

What is the current theory for dronabinol

activation of the presynaptic CB1 receptors inhibits serotonin release onto the 5-HT3 receptors on the brainstem

This drug is also called substance P antagonist or SPA is the only NK1 antagonist for post-operative N/V and is approved in combo with 5-HT3 antagonist for highly emetic chemotherapy

Aprepitant

What is the side effect of aprepitant

headache, elevated liver enzymes, hypotension