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GI Drugs Flashcards

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0
Q

Proton pump inhibitors
H2-receptor blockers
Sucralfate
Antacids

A

Drugs used in acid-peptic diseases

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1
Q

Drugs used in acid-peptic diseases

A

Proton pump inhibitors
H2-receptor blockers
Sucralfate
Antacids

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2
Q

Proton pump inhibitors

A

Omeprazole
Lansoprazol
Etc

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3
Q

Omeprazole

A

Proton pump inhibitor

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4
Q

Lansoprazol

A

Proton pump inhibitor

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5
Q

Proton pump inhibitors

Mechanism of action

A

Irreversible blockade of H+/K+ATPase pump in active parietal cells of stomach

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6
Q

Irreversible blockade of H+/K+ATPase pump in active parietal cells of stomach

A

Proton pump inhibitors

Mechanism of action

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7
Q

Proton pump inhibitors

Effects

A

Long-lasting reduction of stimulating and nocturnal acid secretion

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8
Q

Long-lasting reduction of stimulating and nocturnal acid secretion

A

Proton pump inhibitors

Effects

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9
Q

Proton pump inhibitors

Clinical applications

A

Peptic ulcer
Gastroesophageal reflux disease
Erosive gastritis

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10
Q

Peptic ulcer
Gastroesophageal reflux disease
Erosive gastritis

A

Proton pump inhibitors

Clinical applications

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11
Q

Proton pump inhibitors

Toxicities

A

Reduction of stomach acid may reduce absorbtion of some drugs and increase that of others

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12
Q

Reduction of stomach acid may reduce absorbtion of some drugs and increase that of others

A

Proton pump inhibitors

Toxicities

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13
Q

H2-receptors blockers

A

Cimetidine

Etc

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14
Q

H2-receptors blockers

A

Cimetidine

Etc

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15
Q

H2-receptors blockers

Effects

A

Effective reduction of nocturnal acid but less effective against stimulated secretion, very safe.

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16
Q

Effective reduction of nocturnal acid but less effective against stimulated secretion, very safe.

A

H2-receptors blockers

Effects

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17
Q

Sucralfate

Effects

A

Polymerizes at site of tissue damage (ulcer bed) and protectsagainst further damage; very insoluble with no systemic effects; must be given 4 times daily

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18
Q

Polymerizes at site of tissue damage (ulcer bed) and protectsagainst further damage; very insoluble with no systemic effects; must be given 4 times daily

A

Sucralfate

Effects

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19
Q

Antacids

Effects

A

Popular OTC medication for symtomatic relief of heartburn; not as usful as PPI and H2 blockers in peptic diseases

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20
Q

Popular OTC medication for symtomatic relief of heartburn; not as usful as PPI and H2 blockers in peptic diseases

A

Antacids

Effects

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21
Q

Drugs stimulating motility

A

Metoclopramid
Domperidone
Cholibomimetics: Neostigmine
Macrolides: Eryhromycin

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22
Q

Metoclopramid
Domperidone
Cholibomimetics: Neostigmine
Macrolides: Eryhromycin

A

Drugs stimulating motility

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23
Q

Drugs stimulating motility
Metoclopramid
Domperidone

Mechanism of action

A

D2-receptor blocker

Removes inhibition of acetylcholine neurons in enteric nervous system

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D2-receptor blocker | Removes inhibition of acetylcholine neurons in enteric nervous system
Drugs stimulating motility Metoclopramid Domperidone Mechanism of action
25
Drugs stimulating motility Metoclopramid Domperidone Effects
Increases gastric emptying and intestinal mobility
26
Drugs stimulating motility Metoclopramid Domperidone Effects
Increases gastric emptying and intestinal mobility
27
Drugs stimulating motility Metoclopramid Domperidone Clinical applications
``` Gastric paresis (e.g, in diabetic) Antiemetic ```
28
``` Gastric paresis (e.g, in diabetic) Antiemetic ```
Drugs stimulating motility Metoclopramid Domperidone Clinical applications
29
Drugs stimulating motility Metoclopramid Domperidone Toxicities
Parkinsonian symtoms due to block of central nervous system (CNS) D2 receptors
30
Parkinsonian symtoms due to block of central nervous system (CNS) D2 receptors
Drugs stimulating motility Metoclopramid Domperidone Toxicities
31
Laxatives
``` Magnesium hydroxide, other nonabsorbable salts Bulk-forming laxatives Stimulants laxatives Stool surfactans Chlorid channal activator Opioid receptor antagonists 5-HT4 agonists ```
32
``` Magnesium hydroxide, other nonabsorbable salts Bulk-forming laxatives Stimulants laxatives Stool surfactans Chlorid channal activator Opioid receptor antagonists 5-HT4 agonists ```
Laxatives
33
Magnesium hydroxide, other nonabsorbable salts and sugars Mechanism of action
Osmotic agents increase water content of stool
34
Osmotic agents increase water content of stool
Magnesium hydroxide, other nonabsorbable salts and sugars Mechanism of action
35
Magnesium hydroxide, other nonabsorbable salts and sugars Effects
Usally cause evacuation within 4-6 h, sooner in large doses
36
Usally cause evacuation within 4-6 h, sooner in large doses
Magnesium hydroxide, other nonabsorbable salts and sugars Effects
37
Magnesium hydroxide, other nonabsorbable salts and sugars Clinical applications
Simple constipation Bowel prep for endoscopy (especially PGE solutions)
38
Simple constipation Bowel prep for endoscopy (especially PGE solutions)
Magnesium hydroxide, other nonabsorbable salts and sugars Clinical applications
39
Magnesium hydroxide, other nonabsorbable salts and sugars Toxicities
Magnesium may be absorbed and cause toxicity in renal imparment
40
Magnesium may be absorbed and cause toxicity in renal imparment
Magnesium hydroxide, other nonabsorbable salts and sugars Toxicities
41
Bulk-forming laxatives
Methylcellulose Psyllium Etc ( increase volume of colon, stimulat evacuation)
42
Methylcellulose Psyllium Etc ( increase volume of colon, stimulat evacuation)
Bulk-forming laxatives
43
Stimulants (laxatives)
Senna Cascara (Stimulate activity; may cause cramping)
44
Senna Cascara (Stimulate activity; may cause cramping)
Stimulants (laxatives)
45
Stool surfactants
Docusate Mineral oil (Lubricate stool, ease passage)
46
Docusate Mineral oil (Lubricate stool, ease passage)
Stool surfactants
47
Chloride channal activators (laxatives)
Lubiprostone Prostanoic acid derivate (Stimulates chloride secration into intestine, increasing fluid content)
48
Lubiprostone Prostanoic acid derivate (Stimulates chloride secration into intestine, increasing fluid content)
Chloride channal activators (laxatives)
49
Opioid receptor antagonists (laxatives)
Alvimopan Methylnaltrexone (Blocks intestinal U-opioid receptors but do not enter CNS, so analgesia is maintained)
50
Alvimopan Methylnaltrexone (Blocks intestinal U-opioid receptors but do not enter CNS, so analgesia is maintained)
Opioid receptor antagonists (laxatives)
51
5-HT4 agonists (laxatives)
Tegaserod | Activates enteric 5-HT4 receptors and increase intestinal mobility
52
Tegaserod | Activates enteric 5-HT4 receptors and increase intestinal mobility
5-HT4 agonists (laxatives)
53
Antidiarrheal drugs
Loperamide Diphenoxylate Colloidal bismuth compounds Kaolin+pectin
54
Loperamide Diphenoxylate Colloidal bismuth compounds Kaolin+pectin
Antidiarrheal drugs
55
Loperamide | Mechanism of action
Activates U-opioid receptors in enteric nervous system
56
Activates U-opioid receptors in enteric nervous system
Loperamide | Mechanism of action
57
Loperamide | Effects
Slows mobility in gut with negliable CNS effects
58
Slows mobility in gut with negliable CNS effects
Loperamide | Effects
59
Loperamide | Clinical applications
Nonspecific, noninfectious diarrhea
60
Nonspecific, noninfectious diarrhea
Loperamide | Clinical applications
61
Loperamide | Toxicities
Mild cramping but little or no CNS toxicity
62
Mild cramping but little or no CNS toxicity
Loperamide | Toxicities
63
Diphenoxylate Effects
Similar to loperamid, but high doses can cause CNS opioid effects and toxicity
64
Similar to loperamid, but high doses can cause CNS opioid effects and toxicity
Diphenoxylate Effects
65
Colloidal bismuth compounds
Subsalicylate and citrate salts available | OTC preparations popular and have some value in travelers' diarrhea due to adsorption of toxins
66
Subsalicylate and citrate salts available | OTC preparations popular and have some value in travelers' diarrhea due to adsorption of toxins
Colloidal bismuth compounds
67
Kaolin+pectin
Adsorbent compounds available OTC in some contries
68
Adsorbent compounds available OTC in some contries
Kaolin+pectin
69
Drugs for irritable bowel syndrome (IBS)
Alosetron (5-HT3 antagonist) Anticholinergics Chloride channal activators
70
Alosetron (5-HT3 antagonist) Anticholinergics Chloride channal activators
Drugs for irritable bowel syndrome (IBS)
71
Alosetron | Mechanism of action
5-HT3 antagonist of high potency and duration of binding
72
5-HT3 antagonist of high potency and duration of binding
Alosetron | Mechanism of action
73
Alosetron | Effects
Reduces smooth muscle activity in gut
74
Reduces smooth muscle activity in gut
Alosetron | Effects
75
Alosetron | Clinical applications
Approved for severe diarrhea-predominant IBS in women
76
Approved for severe diarrhea-predominant IBS in women
Alosetron | Clinical applications
77
Alosetron | Toxicities
Rare but serious constipation Ischemic colitis Infarction
78
Rare but serious constipation Ischemic colitis Infarction
Alosetron | Toxicities
79
Antiemetic drugs
``` Ondasetron, other 5-HT3 antagonists Aprepitant Corticosteroids Antimuscarinic Antihistaminics Phenothizines Cannabinoids ```
80
``` Ondasetron, other 5-HT3 antagonists Aprepitant Corticosteroids Antimuscarinic Antihistaminics Phenothizines Cannabinoids ```
Antiemetic drugs
81
Ondasetron, other 5-HT3 antagonists Mechanism of action
5-HT3 blockade in gut and CNS with shorter duration of binding than alosetron
82
5-HT3 blockade in gut and CNS with shorter duration of binding than alosetron
Ondasetron, other 5-HT3 antagonists Mechanism of action
83
Ondasetron, other 5-HT3 antagonists Effects
Extremely effective in preventing chemotheraphy induced and postoperative nausea and vomiting
84
Extremely effective in preventing chemotheraphy induced and postoperative nausea and vomiting
Ondasetron, other 5-HT3 antagonists Effects
85
Ondasetron, other 5-HT3 antagonists Clinical applications
First-line agents in cancer chemotherapy; also useful for postop emesis
86
First-line agents in cancer chemotherapy; also useful for postop emesis
Ondasetron, other 5-HT3 antagonists Clinical applications
87
Aprepitant Mechanism of action
NK1-receptor blocker in CNS
88
NK1-receptor blocker in CNS
Aprepitant Mechanism of action
89
Aprepitant Effects
Interferes with vomiting reflex | No effect on 5-HT, dopamin or steroid receptors
90
Interferes with vomiting reflex | No effect on 5-HT, dopamin or steroid receptors
Aprepitant Effects
91
Aprepitant Clinical applications
Effective in reducing both early and delayed emesis in cancer chemotherapy
92
Effective in reducing both early and delayed emesis in cancer chemotherapy
Aprepitant Clinical applications
93
Aprepitant Toxicities
Fatigue Dizziness Diarrhea CYP interactions
94
Fatigue Dizziness Diarrhea CYP interactions
Aprepitant Toxicities
95
Antimuscarinic (scopolamine)
Effective in emesis due to motion sickness; not other types
96
Effective in emesis due to motion sickness; not other types
Antimuscarinic (scopolamine)
97
Antihistaminics ( antiemetic )
Moderate efficacy in motion sickness and chemotherapy-induced emesis
98
Moderate efficacy in motion sickness and chemotherapy-induced emesis
Antihistaminics ( antiemetic )
99
Phenothiazines ( antiemetic )
Act primary through block of D2 and muscarinic receptors
100
Act primary through block of D2 and muscarinic receptors
Phenothiazines ( antiemetic )
101
Cannabinoids
Dronabinol is available for use in chemotherapy- induced nausea and vomiting, but associated with CNS marijuana effects
102
Dronabinol is available for use in chemotherapy- induced nausea and vomiting, but associated with CNS marijuana effects
Cannabinoids
103
Drugs used in inflammatory bowel disease (IBD)
5-Aminosalicylates, eg mesalamine Sulfasalazine Purine analogs, eg, 6-mercaptopurine, methtrexate Anti-TNF antibodies, eg infliximab, others Corticosteroids
104
5-Aminosalicylates, eg mesalamine Sulfasalazine Purine analogs, eg, 6-mercaptopurine, methtrexate Anti-TNF antibodies, eg infliximab, others Corticosteroids
Drugs used in inflammatory bowel disease (IBD)
105
5-Aminosalicylates
Mesalamine
106
Mesalamine
5-Aminosalicylates
107
Mesalamine Mechanism of action
Mechanism uncertain | May be inhibition of eicosanoid inflammatory mediators
108
Mechanism uncertain | May be inhibition of eicosanoid inflammatory mediators
Mesalamine Mechanism of action
109
Mesalamine Clinical applications
Mild to moderately severe Crohn's disease and ulcerative colitis
110
Mild to moderately severe Crohn's disease and ulcerative colitis
Mesalamine Clinical applications
111
Anti-TNF antibodies
Infliximab | Others
112
Infliximab | Others
Anti-TNF antibodies
113
Infliximab Mechanism of action
Bind tumor necrosis factor and prevents it from binding to its receptors
114
Bind tumor necrosis factor and prevents it from binding to its receptors
Infliximab Mechanism of action
115
Infliximab Effects
Suppression of several aspects of immune function, especially TH1 lymphocytes
116
Suppression of several aspects of immune function, especially TH1 lymphocytes
Infliximab Effects
117
Infliximab Clinical applications
Moderately severe to severe Crohn's disease and ulcerative colitis
118
Moderately severe to severe Crohn's disease and ulcerative colitis
Infliximab Clinical applications
119
Pancreatic supplements
Pancrelipase | Pancreatin
120
Pancrelipase
Pancreatic supplements
121
Pancrelipase Mechanism of actions
Replacement enzymes from animal pancreatic extracts
122
Replacement enzymes from animal pancreatic extracts
Pancrelipase Mechanism of actions
123
Pancrelipase Effects
Improves digestion of dietary fat, protein, and carbohydrate
124
Pancrelipase Effects
Improves digestion of dietary fat, protein, and carbohydrate
125
Pancrelipase Clinical applications
Pancreatic insufficiency due to cystic fibrosis, pancreatitis, pancreatectomy
126
Pancreatic insufficiency due to cystic fibrosis, pancreatitis, pancreatectomy
Pancrelipase Clinical applications
127
Bile acid therapy for gallstones
Ursodiol
128
Ursodiol
Bile acid therapy for gallstones
129
Ursodiol Mechanism of action
Reduces cholesterol secretion into bile
130
Reduces cholesterol secretion into bile
Ursodiol Mechanism of action
131
Ursodiol Effects
Dissolves gallstones
132
Dissolves gallstones
Ursodiol Effects
133
Ursodiol Clinical applications
Gallstones in patients refusing or not eligible for surgery
134
Gallstones in patients refusing or not eligible for surgery
Ursodiol Clinical applications
135
Orlistat
Non-amphetamine drug for treatment of obesity
136
Non-amphetamine drug for treatment of obesity
Orlistat

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