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Pharmacology > GIT drugs > Flashcards

GIT drugs Flashcards

1
Q

These are the drugs for hyperacidity that interact with HCl by neutralizing it. They are to be given after meals. They are fast acting but have short DOA
ADR: increase of gastric pH

Antacids are generally not significantly absorbed in the GIT except these 2 drugs

A

Antacids
Sodium bicarbonate, calcium bicarbonate, aluminum hydroxide, magnesium hydroxide

Sodium and calcium bicarbonate

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2
Q

An antacid that has an AE of belching. worsening of HTN, and milk alkali syndrome (metabolic alkalosis)

An antacid that has an AE of belching and hypercalcemia

An antacid that has an AE of constipation

An antacid that has an AE of diarrhea

A

Sodium bicarbonate

Calcium bicarbonate

Aluminum hydroxide

Magnesium hydroxide

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3
Q

They are drugs for hyperacidity that inhibit basal acid production and prandial acid release. They are given twice a day orally. They are all rapidly absorbed and are not affected by food. They can cross the placenta but are not teratogenic. They also have rapid hepatic metabolism. The structures of the drugs are based on the modification of histamine
AE: Abdominal discomfort, NDV

A

H2 Antagonists
Cimetidine, famotidine, nizatidine, ranitidine

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4
Q

This is an H2 antagonist that is the first to be discovered
Histamine + imidazole
AE: alopecia, loss of libido, impotence, irregular mestruation

A

Cimetidine

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5
Q

They are H2 antagonists that are orally taken but can give almost 100% bioavailability
Histamine + thiazole

A

Nizatidine and Famotidine

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6
Q

This is an H2 antagonist that is the most commonly used among the other antagonists
Histamine + furan

A

Ranitidine

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7
Q

They are the drugs for hyperacidity that are the most effective. They irreversibly block the proton pump. They inhibit both fasting and meal stimulated secretion and are usually given once a day. They are fast acting and have long DOA and all of them are prodrugs. They are indicated for Zollinger syndrome and for active GI bleeding given as IV bolus. They are also used for the diagnosis of GERD.
AE: Abdominal discomfort, NDV

A

Proton pump inhibitors
Omeprazole, lansoparazole, esomeprazole, pantoprazole, rabeprazole

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8
Q

The only PPI excreted through feces (as all PPI are excreted through the urine)

The PPI that has the least biovailability but is the most prescribed since it is cheap

The PPI that has an interaction with clopidogrel. This PPI is a CYP inhibitory while clopidogrel is activated by CYP

A

Pantoprazole

Omeprazole

Omeprazole

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9
Q

They are drugs for hyperacidity that aims to protect the gastric mucosa and is given in cases of GIT ulcerations

A

Mucosal protectants
Misoprostol, Sucralfate, Bismuth salts

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10
Q

This is a mucosal protectant that is an analogue of prostaglandin E. It increases mucosal protection and inhibits acid secretion. They are orally administered
AE: Abdominal discomfort, diarrhea
C/I: Pregnant women (previous abortifacient, FDA category X)

A

Misoprostol

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11
Q

This is a mucosal protectant that is a sucrose complex with sulfated aluminum hydroxide. This drug has small poorly soluble molecules that polymerizes in the acid environment of the stomach, which can accelerate the healing of the ulcers
AE: Constipation

A

Sucralfate

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12
Q

This is a mucosal protectant that is prepared as a slurry and coats the mucosa. It can stimulate mucosal protective mechanisms and can be an antibacterial as well. They can be in the form of salicylates, citrates, and subcitrates
AE: Black stool, black gums

What form of this drug should be used with caution due to ASA hypersensitivity?

A

Bismuth salts

Bismuth salicylate

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13
Q

They are drugs that increase gastric motility as they increase acetylcholine, which is one of the factors that increase gastric motility
AE: DUMBELLS

All of the drugs under this class are direct acting, except for one that is indirect acting

A

Cholinergic agonists
Pilocarpine, Betanechol, Neostigmine

Neostigmine

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14
Q

They are drugs that increase gastric motility as they inhibit dopamine, as dopamine inhibits motility

A

Dopamine 2 antagonists
Domperidone, Metoclopramide, Erythromycin

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15
Q

This is a dopamine 2 antagonist to increase gastric motility that crosses the BBB and causes EPS or extrapyramidal symptoms. This drug is also an antiemetic and is used for gastroparesis
AE: Endocrine side effects (hyperprolactinemia and galactorrhea)
Tx for galactorrhea: bromocriptine or cabergoline

A

Metoclopramide

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16
Q

This is a dopamine 2 antagonist to increase gastric motility that does not cross BBB, is not an anti-emetic, and is used for stimulation of postpartum lactation. It shall be given after meals. It is also used for the treatment of gastroparesis

A

Domperidone

17
Q

This is a dopamine 2 antagonist to increase gastric motility that is a macrolide antibiotic. It promotes motilin release, which is responsible for gastric motility. It is administered parenterally
AE: Diarrhea, pain in injection site

A

Erythromycin

18
Q

They are used in cases of constipation, especially for short term relief. They are used for the prevention of straining conditions like CHF, post-MI, post-partum, and post-op. They are used for preparation of diagnostic exams like colonoscopy, removal of poisons or toxins, and adjunct in anti-helminthic therapy
C/I: With acute abdominal disorders like appendicitis, diverticulitis, ulcerative colitis
AE: ND, cramping, fluid and electrolyte imbalance, sympathetic reactions, cathartic dependence

A

Laxatives

19
Q

They are a type of laxatives that absorb water, softens and enlarges stool, and the swells fecal matter to promote peristalsis

A

Bulk forming laxatives
Methylcellulose (Citrucel), Psyllium (Metamucil), Polycarbophil

20
Q

They are a type of laxatives that are poorly absorbed salts in the fecal matter and through osmosis, they will pull water into the lumen. They cause duodenal secretion of cholecystokinin, which increases fluid secretion and motility

A

Osmotic laxatives
magnesium hydroxide, Saccharides (Sorbitol, lactulose), Saline (Magnesium hydroxide/citrate/sulfate, Na and K (in SO4 and PO4), and Glycerin

21
Q

They are a type of laxatives that are also called stool softeners or emollient laxatives. They lower the surface tension as they facilitate water penetration in the stool

A

Surfactant laxatives
Docusate salts- surfactant which facilitates mixing of water and oily materials (Colace, Modane Soft)

22
Q

They are a type of laxatives that stimulate peristalsis and increase water and electrolyte secretion into intestinal lumen. They decrease water and electrolyte reabsorption and stimulate mucosal nerves in the colon

A

Stimulant laxatives
Diphenylmethane derivatives:
Phenolphthalein (Ex-Lax, Feen-a-Mint, Correctol), Bisacodyl (Dulcolax)
Anthraquinone derivatives:
Cascara sagrada, Sennosides, Casanthrol
Castor oil (Active: ricinoleic acid)

23
Q

They are a type of laxatives that makes the GIT slippery

A

Lubricant laxatives
Mineral oil (interferes with water and fat absorption)

24
Q

Antiflatulent drugs

A

Aluminum hydroxide- Magnesium hydroxide- Simethicone

25
Q

Bowel evacuant drugs or enema, wherein one of the drugs is an agent for whole bowel irritation

A

Polyethylene glycol
Sodium phosphate (fleet phospho-soda or fleet enema)

26
Q

They are drugs for IBD that are used for topical therapy (colonic mucosa or GIT mucosa). These are drugs that contain 5-aminosalicylic acid or mesalamine (or mesalazine). They inhibit the synthesis of prostaglandins and inflamatory leukotrienes and interfere with the production of inflammatory cytokines

3 drugs from this class contain 5-ASA bound by an azo (N=N) bond to an inert compound, another 5-ASA molecule, or sulfapyridine

One drug has high incidence of adverse effects (SJS)

A

5-ASA / 5-Aminosalicylates

27
Q

An IBD drug that delivers 5-ASA from jejunum to rectum (having the widest coverage)

A

Pentasa

28
Q

IBD drugs that deliver 5-ASA from ileum to rectum

A

Asacol
Lialda

29
Q

IBD drugs that deliver 5-ASA to the colon only (used mainly for ulcerative colitis)

A

Sulfasalazine
Balsalazide

30
Q

An IBD drug that delivers 5-ASA to sigmoid and rectum

A

Rowasa

31
Q

An IBD drug that delivers 5-ASA to rectum only

A

Canasa

32
Q

IBD drugs hierarchy:

Mild

Moderate

Severe

Last line

A

5-ASA, Antibiotics, Topical corticosteroids, Budesonide

DMARDS (Methotrexate, azathioprine/ 6-mercaptopurine), oral corticosteroids, TNF antagonists

TNF antagonists, natazilumab (monoclonal antibody), IV corticosteroids,cyclosporine

Surgery

Pharmacology (13 decks)

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