GI Tract Flashcards

1
Q

7 factors that decrease esophageal closure

A

Fats, chocolate, alcohol, peppermint, acidic beverages, red wine, carbonated drinks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 H2 receptor blockers

A

Cimetidine, ranitidine, famotidine, nizatidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cimetidine

A

Inhibits p450

Anti-androgenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 3 H2 receptor blockers are metabolized in the liver

A

Cimetidine, ranitidine, famotidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Side effects of H2 receptor blockers - 2

A

Bradycardia, confusion in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Inhibitors of H+ formation

A

PRAZOLES

Omeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mechanism of inhibitors of H+ formation

A

Inhibits ATPase required to drive proton pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are inhibitors of H+ formation activated by

A

Prodrugs activated by acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Are inhibitors of H+ formation acids or bases, strong or weak

A

Weak bases that stay in parietal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Side effects of inhibitors of H+ formation - 2

A

Hyperchlorhydria: lack of H+ production -> decreased Ca absorption -> osteoporosis
Decreased vitamin B12 absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mechanism of antacids

A

Neutralize the acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Systemic alkalinization

A

If cation is readily absorbed, then more anion can be absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Order of cation absorbability

A

Na»Ca>Mg>Al

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Na: form, speed, duration, neutralizing effect

A

NaHCO3, rapid, short, high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ca: form, speed, duration, neutralizing effect

A

CaCO3, rapid, medium, high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mg: form, speed, duration, neutralizing effect

A

Al(OH)3, slow, long, low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Al: form, speed, duration, neutralizing effect

A

Mg(OH)2, slow, medium, high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sucralfate mechanism

A

Complex that when exposed to H+ becomes very viscous and binds to damaged mucosa
Not systemically absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sucralfate side effect

A

Excess Al absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What shouldn’t sucralfate be taken with and why

A

H+ depleters because it won’t be activated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bismuth subsalicylate mechanism

A

Can increase mucous production in stomach and inhibit pylori growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Bismuth subsalicylate side effects - 2

A

Darkening of feces with extended use

Unpleasant taste/odor in mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Misoprostol mechanism

A

Replaces PG-E lost after use of NSAIDs and GCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Misoprostol side effect

A

Abortificient - increases uterine contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What combo of antibiotics are used for H pylori infections

A

Metronidazole, amoxicillin, clarithromycin, tetracycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Metoclopramide mechanism

A

DA, 5HT antagonist that increase motility without increasing gastric secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Metoclopramide side effects - 3

A

Sedation, depression, Parkinsons-like symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Erythromycin mechanism

A

Acts directly on motilin receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Erythromycin side effects - 4

A

Ototoxicity, pseudomembranous colitis, arrthymia, inhibits p450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Alvimopan mechanism

A

Blocks opiate receptor in gut

31
Q

2 stool softener cathartics

A

Dioctal sodium sulfosuccinate and mineral oil

32
Q

Dioctal sodium sulfosuccinate mechanism

A

Detergent that emulsifies colon contents

33
Q

3 reasons we don’t use mineral oil

A

Won’t absorb fat-soluble vitamins
Aspiration pneumonia
Carcinogens

34
Q

4 bulk-adding agent cathartics

A

Bran, methylcellulose, polybarbophil, psyllium

35
Q

4 gastric irritant cathartics

A

Cascara, senna, castor oil, bisocodyl

36
Q

Gastric irritant mechanism

A

Increases gastric motility and electrolyte secretion into gut

37
Q

Gastric irritant side effects - 2

A

Nephritis and liver damage

38
Q

3 osmotic agent cathartics

A

MgSO4, Mg(OH)2, polyethylene glycol

39
Q

2 secretion enhancer cathartics

A

Lubiprostone, linaclotide

40
Q

Lubiprostone mechanism

A

Acts on PG receptor to activate Cl channel in intestine - increases Cl and H20 secretion into gut

41
Q

Linaclotide mechanism

A

Activates guanylate cyclase - increases Cl secretion into gut

42
Q

Secretion enhancer side effect

A

Diarrhea

43
Q

4 adverse effects of cathartics

A

Fluid imbalances - K loss
Mucosal injury
Malabsorption of nutrients
Suppress normal reflex function

44
Q

4 antidiarrheal narcotic agents

A

Codeine, diphenoxylate, difenoxin, loperamide

45
Q

Where does diphenoxylate primarily act and what drug is it given with

A

Acts primarily in gut and given with atropine to decrease abuse

46
Q

Why doesn’t loperamide have opiate-like effect in CNS

A

Doesn’t cross BBB

47
Q

Antidiarrheal absorbing agent

A

Bismuth subsalicylate

48
Q

Bismuth subsalicylate mechanism

A

Binds bacterial toxins

49
Q

3 antidiarrheal anticholinergic agents

A

Atropine, scopolamine, crofelemer

50
Q

Why is there limited utility with anticholinergic agents

A

Multiple systemic side effects

51
Q

Crofelemer mechanism

A

Blocks Cl channels in gut

52
Q

2 miscellaneous antidiarrheals

A

Simethicone, alpha galactosidase

53
Q

Simethicone mechanism

A

Changes gas surface tension of gas pockets

54
Q

Alpha galactosidase mechansim

A

Increases metabolism of gas-producing oligosaccharides to digestible sugars

55
Q

4 salicylates used for inflammatory bowel disorders

A

Sulfasalazine, mesalamine, olsalazine, balsalazide

SALAs

56
Q

Salicylate mechanism

A

Decrease PG synthesis in gut

57
Q

Salicylate composition and mode of entry

A

All have 5 amino salicylate

Oral - not sytemic

58
Q

Salicylate side effect

A

Diarrhea

59
Q

2 GCs used for inflammatory bowel disorders

A

Prednisone, budesonide

60
Q

Infliximab use and mechanism

A

Used for inflammatory bowel disorders

Binds to TNF

61
Q

Infliximab side effects - 2

A

Infections, response to Ab

62
Q

2 other immunosuppressants used for inflammatory bowel disorders

A

Methotrexate, cyclosporine

63
Q

Ipecac

A

Reflex stimulant to induce vomiting

64
Q

Ipecac side effect

A

Cardiotoxic

65
Q

2 central stimulants emetics

A

Apomorphine, digoxin

66
Q

4 antihistamines anti emetics

A

diphenhydramine, dimenhydramine, meclizine, cyclizine

67
Q

Anticholinergic anti emetic

A

Scopolamine patch

68
Q

Scopolamine side effects - 3

A

Dry mouth, drowsiness, visual disturbances

69
Q

2 THC derivative anti emetics

A

Dronabinol, nabilone

70
Q

2 DA blocker anti emetics

A

Compazine, aphenothiazine

71
Q

Compazine side effect

A

Extrapyramidal

72
Q

5HT receptor blocker anti emetics

A

Ondansetron

SETRON Selective TeRminators Of Nausea

73
Q

2 uses for SETRONs

A

Irritable bowel syndrome - treats diarrhea

Chemotherapy

74
Q

SETRON side effect

A

Constipation