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PMCOL 200 - Introduction to Pharmacology > Lecture 13- Over the counter drugs- Digestive Problems > Flashcards

Lecture 13- Over the counter drugs- Digestive Problems Flashcards

1
Q

What are some problems that affect the Gastrointestinal tract?

A
  • peptice ulcers
  • gastroesophageal reflux disease (heartburn)
  • nausea and vomitting
  • Motility problems; constipation adn diarrhea
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2
Q

Acid-peptic disease is a group of disorder involving either ____ acid secretion or erosion of the ____ ____ of the gastrointestinal tract.

A

excessive; mucosal lining.

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3
Q

Acid-peptice disease includes ____, ____, and ____ ____ ____

A

heartburn, peptic-ulcers, stress-related gastritis

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4
Q

The stomach is divided into 2 sections, what are they and which one is the top layer?

A

Fundus and the antrum; top layer is fundus

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5
Q

Which cells in the fundus are responsible for secretion of acid in the stomach?

A

parietal cells.

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6
Q

Which protom pump moves acid from the parietal cells into the gastric lumen?

A

H+/K+ ATPase

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7
Q

Which cells in the antrum respond to intraluminal dietary peptides to release gastrin which binds to ____ receptors on parietal cells?

A

G-cells and CCK

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8
Q

Gastrin also stimulates ____ cells (H-cells) to release histamine which binds to H ____ receptors on parietal cells.

A

enterochromaffin; H2

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9
Q

Which nerve stimulates postganglionic neurons of the enteric nervous sytem to release ____ which binds to muscarinic receptors (M3) on parietal cells?

A

vagus nerve; ACh

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10
Q

Is the vagus nerve part of the parasympathetic nervous system or the symphathetic nervous system?

A

parasympathetic

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11
Q

An increase in acid secretion causes ____ cells to release ____ and inhibit gastrin release from G-cells (____ feedback loop)

A

D cells; somatostain; negative

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12
Q

Fill in the blanks:
* G cells —> ____ —–> ____
* ____ —-> H cells —-> ____ —> H____ receptors
* ____ —> Acetylcholine —-> M3 receptors
* Increased Acid secretion —-> ____ —-> ____ —-> ____

A
  • G-cells - gastrin - CCK
  • Gastrin - H cells - Histamine - H2 receptors
  • Vagus Nerve - ACh - M3 receptors
  • Increased acid secretion - D cells - somatostain - gastrin inhibition
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13
Q

Antacids are ____ bases that neutralize stomach acid by reacting with protons in the lumen of the gut. When used regularly, in the large doses needed to raise stomach pH, antacids reduce the recurrence rate of ____ ____.

A

weak bases; peptice ulcers

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14
Q

The most common antacids include ____ hydroxide and ____ hydroxide.

A

Magesium (MgOH2) and aluminum (AlOH3)

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15
Q

Which antacid has a strong laxative effect and which one has a constipating acting?

A

Magnesium is a laxative
Aluminum has a constipating action

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16
Q

What is an example of a proton pump inhibitor which are lipophilic weak bases that diffuse into the parietal cell and inactivate the ____ ____ transporter?

A

Omeprazole ; H+/K+ ATPase

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17
Q

Prolonged use of omeprazole can lead to ____ because acid secretion inhibits gastrin release that may increase cancer risk.

A

hypergastrinemia

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18
Q

What is hypergastrinemia?

A

elevated levels of gastrin secreted in the stomach.

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19
Q

OTC anti- ____ can help when dealing with nausea and vomitting caused by motion sickness and other conditions.

A

emetics

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20
Q

Proton pump inhibitors will decrease the bioavailability of vitamin ____ and certain drugs that require acidity for their absorption.

A

B12

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21
Q

____ ____, which is an active ingredient in Peptobismol, can be used to treat ulcers.

A

Bismuth Subsalicylate

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22
Q

Bismuth Subsalicylate hydrolyzes in the gut to Bismuth ____ and ____ ____.

A

Bismuth oxychloride; salicylic acid

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23
Q

Salicyclic acid is absorbed in the gut and inhibits ____ synthesis (anti-inflammatory properties)

A

prostaglandin

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24
Q

____ is a theoclate salt, composed of diphenhydramine and 8-chlorotheophylline.

A

Dimenhydrinate

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25
Q

Dimenhydrinate acts as a ____ ____ but is an inverse agonist at the H1 receptor, driven by diphenhydramine.

A

competitive antagonist

26
Q

Dimenhydrinate blocks ____ activity in the vestibular system, but less sedation than diphenhydramine as it is less potent.

A

histamine

27
Q

Which one is less potent, dimenhydrinate or diphenhydramine?

A

dimenhydrinate

28
Q

Gastrointestinal motility is controlled by ____ ____ ____ (enteric nervous system), neurons which are only present in the GIT.

A

intrinsic neural plexus

29
Q

Removing ____ automatic control results in disorganized gastric activity (nausea or vomitting).

A

extrinsic

30
Q

What is known as the second brain in our body?

A

Enteric nervous system

31
Q

____ plexus provides motor innervation to the muscular layer of the gut which mediates peristalsis, outer layer

A

myenteric

32
Q

____ plexus provides secretomotor (induce a gland to secret a substance) innervation to the mucosa, inner layer.

A

submucosal

33
Q

Enteric neurons are predominantly ____ but release a lot of other neurotransmitter such as serotonin and dopamine.

A

cholinergic

34
Q

The autonomic nervous sytem is divded into ____ and ____ system.

A

parasympathetic; sympathetic

35
Q

All ____ganglionic neurons are cholinergic; they release acetylcholine.

A

pre

36
Q

Postganglionic parasympathetic neurons are ____, whereas postganglionic sympathetic neurons are ____, they release noradrenaline

A

cholinergic; adrenergic

37
Q

Acetylcholine binds to ____ receptors (M2) on GI smooth muscle leading to ____ (stimulates motility)

A

muscarinic; contraction

38
Q

M2 receptors are G____ - coupled receptors

A

Gi

39
Q

Postganglionic parasympathetic = ____ –> myenteric

A

cholinergic

40
Q

Postganglionic sympathetic = ____ —> enteric

A

adrenergic.

41
Q

____ are substances that loosen stool or stimulate bowel movement.

A

laxatives

42
Q

What are the 4 types of laxatives?

A
  1. Bulk forming
  2. osmotic
  3. lubricant
  4. stimulant
43
Q

Which laxatives contain naturally occuring plant fiber like psyllium and methyl cellulose that draw water into the stool to make them larger and easier to pass?

A

Bulk forming laxatives

44
Q

Which laxatives contains ingredients like polyethylene glycol or magnesium that draw fluid into the bowel from nearby tissue?

A

osmotic laxatives

45
Q

Which kind of laxative has glycerin suppositories that coat the surface of stools or anus to make it easier for stool to pass?

A

Lubricant laxatives

46
Q

Which kind of laxative contains ingredients like senna and bisacodyl that causes the bowels to squeeze the stools out?

A

stimulant laxatives

47
Q

What are the 2 types of bulk forming laxatives and what do they do?

A

Psyllium and methyl cellulose; they draw water into the stoll; they are plant fibers

48
Q

What are the 2 types of osmotic laxatives and what do they do?

A

Polyethylene glycol and magnesium; they draw water into stoll from nearby tissues.

49
Q

What are the 2 types of stimulant laxatives and what do they do?

A

Senna and bisacodyl; they stimulate the bowels to squeeze the stool out.

50
Q

____ is a loose, watery stool that occurs when colon is unable to adequately absorb the liquid from the food and fluids you ingest.

A

Diarrhea

51
Q

What are the 2 most common OTC treatment for diarrhea?

A
  • Loperamide
  • Bismuth subsalicylate
52
Q

Like codeine, what else is a mu opioid agonist?

A

loperamide

53
Q

mu opioid receptors are located on the ____ plexus which provides motor innervation of the gut, controls peristalsis

A

myenteric

54
Q

Loperamide has ____ (strong/weak) analgesic activity but effectively slows gut motility.

A

weak.

55
Q

How is loperamide different from codeine?

A
  • less analgesic
  • less respiratory depression
  • no effect on cough
56
Q

Loperamide is a ____ agonist but has weak analgesic activity.

A

full

57
Q

Loperamide is a substrate for ____ (aka P-gp). P-gp is located on endothelial cells at the ____ ____ ____ and actively pumps drugs out of the brain.

A

P-glycoportein; blood brain barrier

58
Q

Loperamide brain levels are kept ____ (high/low) due to active extrusion by P-gp.

A

low

59
Q

P-gp is inhibited by tricyclic antidepressents such as ____.

A

amitriptyline.

60
Q

Blocking P-gp will ____ (increase/decrease) brain concentration of loperamide.

A

increase

PMCOL 200 - Introduction to Pharmacology (12 decks)

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