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Flashcards in GI Drugs II Deck (40):
1

what are neostigmine and bethanechol used for

neostigmine: colonic pseudo obstruction in hospitalized patient

bethanechol: bowel and bladder retention post op

2

mechanism and use of erythromycin

acts on motilin receptors of GIT --> used for GI emptying before upper GI procedure

3

major categories of anti emetics

5 ABCCD HN

5HT3 antagonists
Antimuscarinics
Benzodiazepines
Corticosteroids
Cannabinoids
D2 antagonists
H1 antagonists
NK1 antagonist

4

what are the 5-HT3 blockers used as anti emetics

Ondansetron
Granisetron

5

when are 5 HT3 blockers anti emetics used?

chemo induced emesis
post op nausea and vomiting

6

what are the H1 blockers and Antimuscarinic anti emetics used and when used?

H1 blocker: Diphenhydramine, Meclizine, Cyclizine for motion sickness and chemo

Antimuscarinics: scopolamine for motion sickness

7

what are the NK1 blockers used for anti emetics

Aprepitant
Fosaprepitant

8

adverse effects of NK1 antagonists (name them again)

aprepitant and fosaprepitant

dizziness, fatigue, diarrhea, CYP inhibition

9

corticosteroids anti emetics

Dexamethasone
Methylprednisolone

10

D2 receptor antagonist anti emetics

PPD

Prochlorperazine
Promethazine
Droperidol

11

adverse effects of prochlorperazine

extrapyramidal symptoms, hypotension, sedation

12

benzodiazepines anti emetics

LAD
Lorazepam
Alprazolam
Diazepam

13

benzos do not work too well as anti emetics so what then is their significant uses

sedative, anxiolytic, and amnesic properties

14

cannabinoid anti emetic and what it works on

Dronabinol - CB1 receptor agonist

15

what are the antidiarrheal drugs

SOB i shit my pants

Somatostatin analogs - Octreotide
Opioid agonist - Loperamide and Diphenoxylate
Bismuth compounds - Bismuth Subsalicylate

16

how do the opioid agonist anti diarrheals work (name them)

Loperamide and Diphenoxylate

-slow down gut motility by acting on GI mu-opioid receptor --> inhibition of acetylcholine release and decreased peristalsis

17

adverse effect of opioid agonists antidiarrheals (name them)

Loperamide and Diphenoxylate

-toxic megacolon in those with severe colitis
-Diphenoxylate is formulated with atropine to reduce abuse potential but high doses can cause CNS effects

18

mechanism of the somatostain antidiarrheal (name it) and types of pts that use it

Octreotide

potent inhibitor of GH, glucagon, and insulin

diarrhea and flushing in carcinoid syndrome and diarrhea in VIPoma

19

what is bismuth subsalicylate used for

-mucosal lining protectant (antacid)
-antidiarrheal
-decrease inflammation binds to toxins (E coli)

20

classify the laxatives by their mechanisms of action

-BOSCOS
Bulk forming
Osmotic
Stimulants
Chloride channel activator
Opioid antagonist
Softeners

21

what are the stimulant laxatives and their adverse effects

CBS
Castor oil, Bisacodyl, Senna

cause cramping and chronic use leads to perceived need for laxative

22

what are the bulk forming laxatives and their mechanism

BPM
Bran, Psyllium, Methylcellulose

non soluble compounds that increase water retention leading to bulky stool --> distention of the bowel --> peristaltic stimulation of gut

23

What are the osmotic laxatives

PLOMM

Polyethylene Glycol
Lactulose
Osmotic
Magnesium Hydroxide
Magnesium Salts

24

how do the osmotic laxatives work

they pull water into lumen of GIT --> stimulates motility

25

uses of Lactulose

-as an osmotic laxative by forming lactic acid and acetic acid which increases osmotic effect

-treatment of hepatic encephalopathy --> converts ammonia to ammonium so it can be excreted from body and prevent hyperammonia

26

when is polyethylene glycol used

endoscopic and radiological procedures

27

what are the softener laxatives

DoMGS

Docusate
Mineral oil
Glycerine
Softeners

28

use of glycerine and side effect

used for enema and can cause irritate anal mucosa

29

how do you treat opioid induced constipation

Senna and decusate

30

chloride channel activator laxative and mechanism

Lubiprostone --> increases secretion into GI --> increases fluid content

31

opioid receptor antagonist laxative

Alvimopan
Methylnaltrexone

32

drugs used in Inflammatory Bowel Disease (Ulcerative Colitis and Crohns)

AAGI

Anti TNFalpha drugs
Anti Integrins
Aminosalicylates
Glucocorticoids
Immunosuppressants

33

what are the aminosalicylates and their mechanism

BAMS

Balsalazide
Aminosalicylates
Mesalamaine
Sulfasalazine

inhibit pro inflammatory mediators IL-1 and TNFalpha

34

in the GIT, what is released by sulfasalazine by colonic bacteria

-sulfapyridine (antibacterial)
-5 aminosalicyclic acid (5 ASA) (anti-inflamm)

35

adverse effects of sulfasalazine

HeRS

Hypersensitivity to sulfa
Reversible Oligospermia
Suppression of bone marrow (related to the sulfapyridine)

36

mechanism of balsalazide

releases mesalamine (5 ASA) in large intestine at site of ulcerative colitis

37

glucocorticoids used in IBD and mechanism

Hydrocortisone
Prednisolone
Prednisone
Budesonide

inhibit IL-1, IL-8, and TNFalpha

38

immunosuppressant used in IBD and mechanism

Methotrexate (MTX)
Azathioprine (prodrug of 6-MP)
Mercaptopurine (6-MP)

39

mechanism of immunosuppressant used in IBD (name them)

MTX, Azathioprine, 6-MP

6-MP promotes apoptosis of immune response
MTX blocks dihydrofolate reductase (DHFR)

40

adverse effects of immunosuppressants of IBD (name them)

MTX, Azathioprine, 6-MP

GI mucositis, myelosuppression, hepatotoxicity (6-MP)

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