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Flashcards in GI Pharm Deck (79):
1

What are the acid secreting cells within the stomach?

Parietal cells

2

What are the pepsin secreting cells within the stomach?

Chief cells

3

What are the two major "aggressive factors" that the stomach secretes?

Pepsinogen
HCl

4

What is the major "protective factor" that the stomach secretes?

bicarb

5

What are the transporters in parietal cells that secrete H+ ions?

H/K ATPase

6

What cells in the stomach secrete intrinsic factor? What is the role of intrinsic factor?

Parietal cells
Vitamin B12 absorption

7

What are the cells in the stomach that secrete mucus/bicarb?

Superficial epithelial cells

8

What are the cells in the stomach that secrete histamine?

ECL cells

9

What are the cells in the stomach that secrete gastrin?

G cells

10

What are the cells in the stomach that secrete ACh?

NErve cells

11

What is the role that ACh plays in the stomach?

Promotes mucus, bicarb, and HCl secretion

12

What are the cells in the stomach that serete somatostatin? What is the role of somatostatin?

D cells
Suppressses HCl secretion

13

What is the role of gastrin?

Increases HCl output from parietal cells

14

What is the effect of PGE2 in the stomach?

Decreases the output of H/K ATPases

15

What is the neuronal input to gatric acid secretion? Does this facilitate or impair secretion?

ACh
Facilitates

16

What is the paracrine input to gatric acid secretion? Does this facilitate or impair secretion?

Histamine
Facilitates

17

What is the endocrine input to gatric acid secretion? Does this facilitate or impair secretion?

Gastrin
Facilitates

18

What is the role of pepsinogen?

Protein digestion

19

What do enterochromaffin cells secrete?

Histamine

20

Besides their direct effect on parietal cells, how else do ACh and gastrin increase HCl secretion?

Induce histamine release

21

What are the two substances that increase protective factor secretion?

ACh
Prostaglandins

22

Do prostraglandin exert their effects on gastric cells via that endocrine, or paracrine pathway

Paracrine

23

What are the three major effects of prostagladins?

1. Increase mucus/bicarb
2. Suppress HCl
3. Increase gastric blood flow

24

What are peptic ulcers?

Break i nthe protective mucosal lining of the lower esophagus, stomach, or duodenum

25

What are duodenal ulcers?

Ulcers of the duodenum

26

Which occur more frequently: peptic, duodenal, or gatric ulcers?

Duodenal

27

What are gastric ulcers?

Ulcers of the stomach

28

What is a cushing ulcer?

Stress ulcers associated with head trauma of brain surgery

29

What are ischemic ulcers?

Ulcers caused by hemorrhage, severe burns

30

What are the two most common causes of ulcers in the US?

NSAIDs
H. Pylori infx

31

True or false: rapid gastric empyting may cause ulcers?

True

32

ASA inhibits what enzyme?

COX1/2

33

True or false: melena or BRBPR are symptoms of an ulcer

True

34

The goal of antacids is to raise the pH of the stomach above what level?

4

35

What are the two MOA of antacids?

neutralize acid
Stimulate prostaglandin secretion

36

What is the duration of action for the simple antacids?

1-2 hours

37

What is the specific, adverse effect of using NaHCO3? (3)

metabolic alkalosis
Excessive NaCl absorption
Gas/bloating

38

What is the specific adverse effect of using CaCO3?

acid rebound
gas/bloating

39

What is the specific, adverse effect of using Mg(OH)2?

Osmotic diarrhea
Hypermagnesemia

40

What is the specific, adverse effect of using Al(OH)2?

Constipation

41

What is the major drawback of using simple antacids for treating ulcers?

Have to dose often

42

What is the acid rebound effect of CaCO3?

Increase the output of acid when neutralized

43

What disease increases the liklihood of having hypermagnesemia, hypercalcemia etc when taking simple antacids?

Renal insufficiency

44

True or false: simple antacids are usually used in combination with other therapies

True

45

True or false: simple antacids are equally efficacious as H2 receptor antagonists

True

46

What is the GERD heal rate of simple antacids?

50%

47

What is the peptic ulcer rate heal rate of simple antacids?

80%

48

Milk of magnesia is what chemcial?

Mg(OH)2

49

Alka-seltzer is what chemial?

NaHCO3

50

Histamine receptors use what type of receptor (Na gates or G protein)?

G protein coupled

51

Histamine inhibition of H2 receptors in competitive, or non-competitive?

Competitive

52

What don't H2 receptor antagonists decrease acid secretion by 100%?

Only affect the direct pathway; ACh and gastrin can still increase hitsmine secretion

53

What are the H2 receptor antagonists suffix?

tidine

54

What type of drug is cimetidine?

H2 receptor antagonist

55

What type of drug is ranitidine?

H2 receptor antagonist

56

What type of drug is nizatidine?

H2 receptor antagonist

57

What type of drug is famotidine?

H2 receptor antagonist

58

What is the most common effect of H2 receptor antagonists?

Headaches

59

What are the uncommon, but severe effects that H2 receptor antagonists cause?

CNS effects (hallucination, agitation etc)

Endocrine distruption

60

How long do H2 receptors antagonists last?

10 hours

61

Which H2 receptor antagonist specifically has higher chances of adverse effects?

Cimetidine (tagemet)

62

True or false: H2 receptor antagonists work directly in the stomach to antagonize H2 receptors?

False--have to absorb through the GI tract first. Too difficult to act in the stomach w/ mucus and all that

63

What is the MOA of PPIs?

Inhibition of the K/H ATPase

64

What activates PPIs?

Low pH

65

PPIs reversibly, or irreversibly bind the proton pumps?

Irreversibly

66

What is the suffix that denotes a PPI?

-prazole

67

What type of drug is omeprazole?

PPI

68

What type of drug is Lansoprazole?

PPI

69

What type of drug is Rabeazole?

PPI

70

What type of drug is Esomeprazole?

PPI

71

What type of drug is Pantoprazole?

PPI

72

What is the duration of action for PPIs?

24 hours, but 3-4 days to reach maximum effect

73

What is the major concern with using PPIs?

B12 deficiency

74

Why does it take 3-4 days for PPI to take maximal effect?

Vesicular network of stored proton pumps has to be depleted

75

What is the GERD heal rate, and puptic ulcer heal rate of PPIs?

90%

76

What is the MOA of sucralfate?

Adheres to ulcer and creates a physical barrier

Stimulates mucus secretion

77

What is the chemical in sucralfate?

sucrose + octasulfate + Al(OH)3

78

What is the active ingredient in peptobismol?

Bismuth subsalicylate

79

What is the MOA of bismuth (peptobismol)?

Adheres fo ulcer and creates a physical barrier

Stimulates mucus secretion