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Pharmacology III > GI Drugs > Flashcards

GI Drugs Flashcards

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1
Q

Histamine binds H2 receptors on the _____ cell which increases the intracellular concentration of ________ to stimulate the _______

A

parietal cell

cAMP

stimulates proton pump (H+/K+ ATPasae)

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2
Q

What substance decreases cAMP production and therefore reduces proton pump activity? It also increases mucous and bicarb production…

A

PGE3

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3
Q

What drug can be used with NSAID administration to protect against ulcers?

A

misoprostol (PG analog)

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4
Q

Tritec is the h. pylori triple therapy that includes…

A

ranitidine, bismuth citrate + clarithromycin

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5
Q

Helidec is the h. pylori quadruple therapy that includes…

A

metro, amoxicillin, tetracycline, clarithromycin

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6
Q

_______ increases gastric motility and may cause diarrhea…

A

magnesium

antacid

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7
Q

________ relaxes smooth muscle and may cause constipation…

A

alumininium

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8
Q

These drugs neutralize HCl to form salts and water.

A

antacids

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9
Q

Antacids are commonly hydroxides of what 4 compounds?

A

aluminium
magnesium
sodium bicarb
calcium

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10
Q

Mg antacids are well tolerated, but can be a problem/toxicity in the presence of what condition?

A

renal impairment

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11
Q

Two main uses for antacids…

A

Sx relief

GERD Adjunct

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12
Q

sodium bicarb should be avoided with what condition?

A

CHF

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13
Q

How do antacids cause drug interactions?

A

alter rate of dissolution/absorption

complex formation

delayed gastric emptying

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14
Q

When are H2 receptor blockers most effective?

A

overnight

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15
Q

H2 receptor blockers are effective at treating which condition?

A

PUD

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16
Q

H2 receptor blockers can be considered an adjunct in what 2 conditions?

A

GERD

Zollinger-Ellison

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17
Q

Which GI drug is given pre-op to reduce stomach acidity in case of aspiration?

A

H2 receptor blockers

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18
Q

Why are H2 receptor blockers given in allergic rxns?

A

reduce vasodilation

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19
Q

Duration of H2 blockers

A

12 hours

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20
Q

H2 blockers have low S/E profile… but which one has an anti-androgen effect?

A

cimetidine

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21
Q

cimetidine inhibits…

A

CYP3A4

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22
Q

DOC for GERD.

A

PPIs

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23
Q

PPIs cause reversible or irreversible inhibition at the parietal cell?

A

irreversible (covalent bonding)

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24
Q

how long before 80% inhibition of acid secretion with PPIs?

A

2-5 days

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25
How long do PPIs last? why?
24-48 hours requires synth of new pumps
26
T or F... all PPIs are prodrugs converted to active form (Sulfenamide) by acid...
true
27
Recommended dosing regimen for PPIs
take in morning on empty stomach 30 min before 1st meal
28
PPIs are generally well tolerated, but what are two SEs that may occur?
PNA | Abd. Colic/GI sxs
29
chronic PPI use can cause decreases in... (3)
Calcium Magnesium B12
30
long term PPI use can cause what 2 diseases?
CKD | osteoporosis
31
________ inhibits CYP2C19, decreasing metabolism of phenytoin, diazepam, warfarin and conversion of clopidogrel to active compound.
omeprazole
32
C/I for misoprostol...
pregnancy, or could become pregnant
33
What is a cytoprotective agent used to protect the gastric mucosa?
misoprostol
34
This is a D2 receptor antagonist, which enhances ACh release on M3 receptors in the GI tract
metoclopramide
35
What effect does metoclopramide have?
enhances motility and SM tone
36
Metoclopramide can have anti-emetic properties by acting on...
chemoreceptor trigger zone in CNS
37
MC use of metoclopramide...
post-op hypomotility
38
what serious S/Es can accompany metoclopramide? Why?
EPS, due to D2 receptor blockade
39
Can metoclopramide be used in pregnancy?
no
40
Which muscarinic agonist can be used to increase GI tone and motility?
Bethanechol
41
This drug stimulates motilin receptors, which causes potent contraction of the GI tract...
erythromycin
42
When can erythromycin be considered as a prokinetic agent?
last line
43
this is a muscarinic antagonist that decreases intestinal overactivity
Dicycloamine
44
this IBS drug blocks muscarinic receptors and increase NE release. NE then stimulates alpha 2 receptors to reduce pain.
Amitriptyline
45
Which antispasmodic is a mu and kappa opioid AGONIST and a delta opioid ANTAGONIST?
Eluxadoline
46
Eluxadoline is useful for...
IBS-D
47
The CTZ, which stimulates the brain's vomiting center, is rich in what 3 receptor types?
5HT3, D2, NK1
48
Ondansetron selectively blocks what receptors and where?
5HT3 in CTZ and GI
49
2 uses for ondansetron?
chemo N/V and vagal stimulation
50
Is ondansetron useful in motion sickness?
no
51
Which two anti-emetics block D2 and H1 receptors?
Prochlorperazine | Promethazine
52
When are prochlorperazine and promethazine considered for use?
post-op N/V
53
major S/E of prochlorperazine and promethazine and why?
Significant sedation H1 and Muscarinic blockade
54
Arepitant blocks what receptor?
NK1
55
Arepitant should be combined w... (2)
5HT3 antagonist + CS
56
When can arepitant be considered?
severe chemo nausea and vomiting
57
3 absolute C/Is for laxatives
obstruction perf toxic megacolon
58
best way to prevent constipation and diverticulitis...
high fiber diet
59
2 fiber supplements...
methylcellulose | psyllium
60
Sodium salts should be used in the presence of what condition?
CHF
61
Which osmotic laxatives are also sweeteners?
sorbitol | mannitol
62
Which osmotic laxative ionizes ammonia to ammonium, trapping it in the colon?
Lactulose
63
Lactulose is used for...
decrease ammonia in cirrhosis
64
Describe the use of osmotic laxatives...
bowel prep
65
Which is the only osmotic laxative that can be used chronically, but not for constipation tx...?
lactulose
66
Which three laxatives can produce a semi-formed stool within 2-8 hours by irritating mucosa?
Biscodyl Senna Castor oil
67
Describe the effectiveness of senna...
mild
68
Castor oil shouldn't be used in the presence of... (2)
biliary obstruction, pregnancy
69
Which 3 laxatives are lubricating agents/stool softeners?
mineral oil docusate glycerin
70
Mineral oil can decrease absorption of...
ADEK
71
this laxative can cause lipoid PNA if inhaled into the lungs...
mineral oil
72
This laxative is an emulsifying agent
docusate
73
This laxative lubricates the distal end of the bowel via suppository
glycerin
74
what can cause the below?  laxative dependence  fluid and electrolyte imbalances  spastic colitis  increased risk of ulcerative colitis
laxative overuse
75
This is a PGE1 derivative activates the ClC-2 chloride channels.
lubiprostone
76
This laxative stimulates the CFTR to secrete Cl
linaclotide
77
Linaclotide is approved for...
IBS-C
78
Opioid antagonists that acts selectively in the GI tract, with no central effect used to antagonize opioid-induced constipation post-operatively (2)
Alvimopan, Methylnaltrexone
79
Can fiber compounds be used to treat diarrhea?
yes
80
opioid that decreases peristalsis, low abuse potential w. no CNS effects. Available OTC
loperamide
81
Opioid with atropide to inhibit cholinergic receptors. CNS effects w. abuse potiential, but reduced w. atropine
Diphenoxylate + Atropine
82
When should opioids not be used for diarrhea?
penetrative intestinal organisms UC
83
How does colloidal bismuth treat diarrhea?
absorbs extra water
84
2 S/Es of colloidal bismuth...
dark stools Reye's syndrome (via salicylate allergy)
85
in children with ASA allergy, what can be used instead of colloidal bismuth?
bismuth citrate
86
Which IBD drug is better for UC
Sulfasalazine
87
this drug coats and dissipates gas...
simethicone

Pharmacology III (15 decks)

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