GI tract

Question 1

Emesis

Answer 1

Complex reflex due to activation of the vomiting center in the medulla oblongata.

Question 2

Direct Acting Stimuli

Answer 2

Cerebral cortex (fear)
Senosory Organs (odors, pain)
vestibular apparatus inner ear

Question 3

indirect acting stimuli

Answer 3

Activation of chemoreceptor trigger zome CTZ
- signals from stomach/small intestine
- emetogenic compounds carried to CTZ via blood

Question 4

Antiemetics

Answer 4

Serotonin Receptor Antagonists- Ondansetron

Substance P/NK1 Antagonist- Aprepitant

Dopamine Antagonists- Phenothiazines

Chemotherapy Induced

Pregnancy- Doxylamine and vit B6

Question 5

Ondansetron mech

Answer 5

blocks 5-HT3 receptors in CTZ

Question 6

Ondansetron TU

Answer 6

**Anticancer drugs
- radiation
- anesthesia
- pregnace

Question 7

Ondansetron AE

Answer 7

diarrhea, dizziness
PROLONGED QT

Question 8

Ondansetron DI

Answer 8

pt with long QT syndrome or taking QT drugs

Question 9

Substance P/ NK1 Antagonist mech

Answer 9

blocks NK1 receptors in CTZ

Question 10

Substance P/ NK1 Antagonist drug

Answer 10

Aprepitant

Question 11

Substance P/ NK1 Antagonist TU

Answer 11

postoperative vomiting and CINV

Question 12

Substance P/ NK1 Antagonist Pharm

Answer 12

well-absorbed
peak 4 hours
1/2 life 11 hours

Question 13

Substance P/ NK1 Antagonist DI

Answer 13

complex- multiple DI
- can inhibit or induce P450

Question 14

Dopamine Antagonists drug

Answer 14

Phenothiazines

Question 15

Dopamine Antagonists mech

Answer 15

blocks dopamine (DA2) receptors in CTZ

Question 16

Dopamine Antagonists TU

Answer 16

chemo
surgery
toxins

Question 17

Dopamine Antagonists AE

Answer 17

respiratory depression

NOT FOR UNDER 2 YEARS

Question 18

Chemotherapy Induced Types

Answer 18

1) Anticipatory
2) Acute
3) Delayed

Question 19

Antiemetics are more effective at

Answer 19

preventing CINV than suppressing CINV

Question 20

Drug for treating pregnancy emesis

Answer 20

Doxylamine and vitamin 6
- first line
- Diclegis- delayed 10 mg tab

Question 21

Antidiarrheal drug groups

Answer 21

Nonspecific- provide symptomatic relief- dont influence underlying cause

Specific- treat underlying cause

Question 22

What is most effective at treating diarrhea?

Answer 22

Opiods
“Diphenoylate”

• CNS effects dont occur

Question 23

Infectious diarrhea

Answer 23

bacteria / protozoa

self limited

limit antibiotics

Question 24

travelers diarrhea

Answer 24

E.Coli

Self-limited

Severe: ciprofloxacin
- children and pregnant: azithromyacin

Question 25

IBS treatments

Answer 25

Two Acid Suppressants 1) Proton pump Inhibitor (soprazole or omeprazole) 2) Histamine2 receptor blockers (famotidine or ranitidine)

Question 26

IBD forms

Answer 26

1) Crohns disease - transmural inflammation 2) Ulcerative colitis - inflammation of mucosa and submucosa of colon and rectum

Question 27

Drugs for IBD

Answer 27

1) 5-aminosalixylates - sulfasalazine 2) Glucocorticoids - hydrocorticoids 3) Immunosuppressant - azathioprine/ mercaptopurine - cyclosporine 4) Immunomomdulators - infliximab NONE ARE CURATIVE

Question 28

Sulfasalzine mech

Answer 28

metabolized into to compounds 1) 5-ASA Reduce inflammation - supresses prostaglandins synthesis and migration of inflamm cells into affected region 2) Sulfapyridine: responsible for adverse effects

Question 29

Sulfasalazine TU

Answer 29

mild - moderate colitis of crohns

Question 30

Sulfasalazine AE

Answer 30

fever, rash, arthralgia, anemia - blood counts should be done

Question 31

Glucocorticoids PH

Answer 31

IV or PO PO- Budesonide- release in ilium and ascending colon

Question 32

TU Glucocorticoids

Answer 32

mild- moderate crohns in ilium or ascending colon - mild - moderate colitis

Question 33

Immunosuppressants drug

Answer 33

Azathioprine/ Mercaptopurine Cyclosporin

Question 34

Azathiospring/Mercaaptopurine

Answer 34

A is prodrug M is active - pt not responding to traditional therapy

Question 35

Azathiospring/Mercaaptopurine AE

Answer 35

pancreatitis, neutropenia

Question 36

Cyclosporin

Answer 36

Stronger immunosuppressant / faster acting acute, severe colitis / Crohns that has not responded to glucocorticoids IV- rapidly induce remission GENERAL SUPPRESSION OF IMMUNE SYSTEM

Question 37

Immunomodulators

Answer 37

Infliximab IV infusion

Question 38

Infliximab mech

Answer 38

Monoclonal antibody designed to neutralize TNF-alpha (a key immunoinflammatory modulator

Question 39

Infliximab TU

Answer 39

moderate to sever Crohns and Colitis - reduces symptoms 65% in Crohn and 33% in Colitis

Question 40

Infliximab AE

Answer 40

infections (tuberculosis) and infusion reactions