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GI III Flashcards

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1
Q

What is the MOA of tegaserod?

A

Partial agonist that simulates 5HT-4 receptors in the GI tract, to increase ACh, and thus gastric motility

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2
Q

What is the MOA of lubiprostone?

A

Prostaglandin derivative, the activates CIC2 Cl channels to increase Cl in the GI lumen

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3
Q

What is the MOA of methylnaltrexone?

A

Mu-opioid antagonist

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4
Q

What is the MOA of alvimopan?

A

Mu-opioid receptor antagonist

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5
Q

What are the adverse effects of lubiprostone?

A

n/v/d

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6
Q

What are the adverse effects of methylnaltrexone?

A

Abdominal pain

n/v/d

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7
Q

What are the adverse effects of alvimopan

A

abdominal pain

n/v/d

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8
Q

What are the two mu-opioid receptor antagonists?

A

Methylnaltrexone

Alvimopan

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9
Q

How do the opioid antidiarrheal agents work?

A

Agonists to opioid receptor cannot cross the blood/brain barrier, but will cause decreased GI motility

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10
Q

How are opioid antidiarrheal agents administered?

A

orally

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11
Q

What is the MOA of bismuth subsalicylate as an antidiarrheal agent? (2)

A

inhibition of prostaglandin synthesis in the intestines

Absorb bacterial toxins

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12
Q

What is the difference between bismuth subsalicylate’s action in the stomach, vs in the intestines?

A

Stomach = inhibit prostaglandin synthesis

Intestines = stimulate

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13
Q

What is the MOA of bile salt binding resins as an antidiarrheal?

A

Disrupt hydrostatic pressure that bile salts exert (these are used when there is too much bile salt secretion)

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14
Q

What is the MOA of octreotide?

A

Agonist to the somatostatin receptor which inhibits gut motility

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15
Q

What type of molecule is octreotide? What does this mean in terms of administration?

A

Polypeptide

Must be given IV or SQ

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16
Q

What type of drug is loperamide?

A

Opioid agonist (antidiarrheal)

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17
Q

What type of drug is Diphenoxylate?

A

Opioid agonist

antidiarrheal

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18
Q

What type of drug is cholestyramine?

A

Binds bile acids and bile salts (antidiarrheal)

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19
Q

What type of drug is octreotide?

A

Somatostatin receptor agonist (antidiarrheal)

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20
Q

What are the adverse effecs of loperamide?

A

Constipation

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21
Q

What are the adverse effects of diphenoxylate?

A

Atropine effects

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22
Q

What are the adverse effects of bismuth subsalicylate?

A

Salicylate toxicity

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23
Q

What are the adverse effects of cholestyramine?

A

Impaired fat absorption

Fecal impaction

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24
Q

What are the adverse effects of octreotide?

A

Impaired pancreatic secretion

Decreased gallbladder contraction

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25
What is the MOA of ondansetron?
5HT3 antagonist (antiemetic)
26
What is the MOA of scopolamine?
M1 antagonist (antiemetic)
27
What is the MOA of metoclopramide?
D2 antagonist (antiemetic)
28
What is the MOA of dimenhydrinate? Use?
``` H1 antagonist (antiemetic) Motion sickness ```
29
What is the MOA of aprepitant?
NK1 antagonist (antiemetic)
30
What is the MOA of prochlorperazine?
M1 D2 H1 antagonist (antiemetic)
31
What are the adverse effects of ondansetron?
HA Dizziness constipation
32
What are the adverse effects of scopolamine?
Antimuscarinic effects
33
What are the adverse effects with metoclopramide?
Parkinsonian symptoms
34
What are the adverse effects of dimenhydrinate?
Drowsiness
35
What are the adverse effects of aprepitant?
Fatigue Dizziness CYP3A4 interactions
36
What are the adverse effects of prochlorperazine?
Drowsiness | Anticholinergic
37
What is the role of GABA in the brain?
Inhibitory neurotransmitter
38
What is the MOA of lorazepam?
GABA agonist
39
What is the MOA of nabilon?
Cannabinoid agonist
40
What is the MOA of dexamethasone?
Glucocorticoid antagonist
41
What are the adverse effects of lorazepam?
Drowsiness
42
What are the adverse effects of nabilone?
Dysphoria | Sedation
43
What are the adverse effects of dexamethasone?
Weight gain/ water retention
44
What is IBS?
idiopathic chronic relapsing disorder, characterized by abdominal discomfort, with diarrhea, constipation, or both
45
What is the cause of IBS?
uncertain etiology
46
What is the drug of choice for treating diarrhea due to IBS?
Loperamide
47
What is the drug type of choice for treating constipation due to IBS?
osmotic laxatives
48
What are the drugs of choice for treating pain due to IBS?
antidepressants | Antimuscarinics
49
What is the MOA that tricyclic antidepressant relieve pain from IBS?
Block signalling from the GI neurons
50
What are the receptors on the neurons that control gastric motility?
5HT-4
51
What are the receptors on the neurons that transmit pain from the GI tract to the brain?
5HT-3
52
What is the MOA of alosetron?
Blocks 5HT-3 receptors on the gut wall to reduce pain
53
Would you want to stimulate or inhibit the 5HT-4 receptors to induce gastric motility
stimulate
54
Would you want to stimulate or inhibit the 5HT-3 receptors to reduce pain from the gut
inhibit
55
What are the very rare, but serious side effects of tegaserod?
MI
56
What are the side effects of alosetron?
ischemic colitis
57
Is tegaserod an antagonist, or agonist?
Partial agonist
58
Is alosetron an antagonist, or agonist?
antagonist
59
What is IBD? What are the two types?
Inflammatory bowel disease Crohn's disease Ulcerative colitis
60
What is crohn's disease?
Idiopathic inflammatory disorder that affects **any** part of the GI tract
61
What is ulcerative colitis?
a chronic inflammatory disease that causes ulceration of the colonic mucosa
62
Which can affect any part of the GI tract, and which is limited to the mucosa of the GI tract: crohn's disease, or ulcerative colitis?
Crohns = anywhere
63
What is the MOA of aminosalicylates (ASA)?
Inhibit COX production of prostaglandins, interleukin and NF-kappa B
64
What is the MOA of glucocorticoids?
Suppression of multiple inflammatory processes
65
What is the MOA of antimetabolites?
Inhibition of immune cell proliferation
66
What is the MOA of anti-TNFalpha therapy?
Inhibit TNF-alpha mediated immune response
67
True or false: aminosalicylates will not work if absorbed from the GI tract?
True--need to work topically
68
What type of drug is sulfasalzine?
ASA | IBD
69
What type of drug is mesalamine? What can it be used for?
ASA | IBD
70
What is the MOA of 6-mercaptopurine?
Inhibit purine synthesis (inhibit immune response for IBD)
71
What is methotrexate used for?
Inhibits DHFR resulting in impaired cellular proliferation | inhibit immune response for IBD
72
What is the MOA azathioprine?
Inhibits purine synthesis (inhibit immune response for IBD)
73
What is the MOA of infliximab?
TNFalpha monoclonal antibody Binds to TNF alpha, and inhibits immune reponse
74
When do you start to use antimetabolites in IBD?
When it is moderate or worse
75
When are steroids an option for IBD?
Active inflamation
76
What is scolpoamine used for? MOA?
Motion sickness by blocking M1 receptor

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