Lecture 16: GI Pharm Flashcards Preview

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Flashcards in Lecture 16: GI Pharm Deck (20):
1

Neural influences that lower LESp (4)

Cholinergic antagonists, alpha blockers, beta agonists, NO

2

Drugs that lower LESp (4)

Theophylline, Ca2+-channel blockers, morphine/diazepam, serotonin

3

Final common denominator for gastric acid secretion

H/K ATPase

4

Prostaglandins cause what in the stomach (4)

Stimulate mucus production, epithelial cell repair, bicarbonate, mucosal blood flow

5

Drugs for control of gastric acidity (4)

Antacids, cytoprotectants, H2 receptor antagonists, PPIs

6

Antacids: mechanisms and types

Local neutralization of acid; aluminum and magnesium OH, calcium carbonate, sodium bicarbonate

7

Cytoprotectants (3)

Sucralfate, misoprostol, bismuth compounds

8

Bismuth: mechanism (3)

Binds to base of ulcer, promotes mucin and bicarbonate production, antibacterial effects

9

Misoprostol: mechanism

Prostaglandin E analog, stimulates secretin of mucin/bicarb, increases mucosal blood flow; NOT AVAILABLE IN US

10

Misoprostol: AEs

SM contraction --> cramps, diarrhea, contraindicated in pregnancy (chemical abortion)

11

H2 Receptor antagonists: mechanism and examples

Competes with histamine for parietal cell receptors; cimetidine, ranitidine, famotidine, nizatidine

12

H2 Receptor antagonists: use

Gastric/duodenal ulcers, uncomplicated GERD, stress ulcer prophylaxis

13

H2 Receptor antagonists: drug interactions

Interferes w/ absorption of drugs that require an acidic environment; cimetidine is CYP-450 inhibitor, interfering with Phenytoin, theophylline, wararin

14

Proton pump inhibitors: examples

-Prazoles

15

Proton pump inhibitors: mechanism

Produg requires protonation in acidic environment AND enteric coating, absorbed in small intestine, IRREVERSIBLY binds to and inactivates H/K ATPase in parietal cell

16

Proton pump inhibitors: uses

Gastric and duodenal ulcers, GERD, ZE syndrome, IV use for upper GI bleeding

17

Proton pump inhibitors: AEs

Hypergastrinemia, potential increase in C difficile, potential increased risk of osteopenia

18

Agents for increasing gastric motility

Cholinergics (bethanechol), metoclopramide (D2 antagonist and serotonin agonist), cisapride/tegaserod (serotonin agonists), domperiodone (block D2 receptors), erthromycin (binds to motilin receptor agonists)

19

What serotonin receptor in the stomach is pro-motility?

5-HT4

20

Problem with metoclopramide and advantage of domperidone

Also blocks D2 receptors in the brain, causing PD symptoms; domperidone does NOT cross the BB barrier