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Gastrointestinal > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q

why is histamine released

A

in response to Ach

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2
Q

what does histamine do

A

activates adenylyl cyclase > inc cAMP > inc proton pumps > inc gastric secretion

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3
Q

why is Ach released?

A

parasympathetic cholinergic neurones

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4
Q

other than histamine release, what does Ach do?

A

binds to parietal cells activating PLC and causing inc Ca2+ which causes an inc in proton pump action

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5
Q

what is gastrin’s action?

A

binds to CCK2 Rs activating PLC causing inc Ca2+ > inc proton pump action > inc gastric secretions

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6
Q

what is the pathophysiology of vomiting

A

reverse peristalsis =
toxic material in gut > enterochromaffin cells in mucosa release mediators > sensory afferent nerves activated > AP discharged to brainstem > co-ordination by vomiting centre

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7
Q

causes of vomiting?

A

toxic material, mechanical stimuli, vestibular system, stimuli within CNS

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8
Q

what is the main zone for emetic stimuli?

A

chemoreceptor trigger zone

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9
Q

which receptors activate chemoreceptor trigger zone?

A

dopamine and Ach

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10
Q

what is big risk of NSAID abuse?

A

liver failure & GI ulcer

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11
Q

for patients with cirrhosis/ liver disease, what is the Moto for drug prescription?

A

start low, go slow

give renal excretion medicine

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12
Q

what are the 4 drugs that control gastric secretion?

A

PPIs, NSAIDs, Histamine H2 receptor antagonists, alginates and antacids

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13
Q

name 2 PPIs?

A

omeprazole and iansoprazole

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14
Q

which drug inhibits proton pump so reduces HCl secretion?

A

PPIs

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15
Q

how are PPIs given

A

oral or IV

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16
Q

what are PPIs given for?

A

peptic ulcers, GORD, helicobacter pylori

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17
Q

True/False…

PPIs inc chance of GI tract infection

A

True

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18
Q

named example of NSAID?

A

misoprostol

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19
Q

action of NSAIDs?

A

inhibits COX-1 so less prostaglandins to inc histamine promoting HCl secretion

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20
Q

what are NSAIDs used for?

A

inflammation e.g. IBD

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21
Q

common side effect of NSAIDs?

A

abdominal pain and ulcers

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22
Q

named example of histamine H2 receptor antagonist…?

A

ranitidine

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23
Q

action of histamine H2 receptor antagonist?

A

blocks H2 receptor dec HCl secretion

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24
Q

what is histamine H2 receptor antagonist given for?

A

gastric ulcers, NSAID associated ulcers

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25
what are named exampled of antacids and alginates?
gavsicon, peptac, mucogel
26
what is the action of antacids?
buffers HCl
27
what are antacids typically given for?
GORD
28
what are the 9 anti-motility drugs including antidiarrhoeals
``` antimuscarinic drugs anti motility drugs amino salicylic acid steroids anti-TNF therapy immunosuppressants laxatives - bulk forming laxatives- osmotic laxatives- stimulant ```
29
what is an example of antimuscarinic drugs?
buscopan and atropine
30
what do antimuscarinic drugs do?
blocks muscarinic Ach receptors
31
what are antimuscarinics given for?
relieve SM spasm, IBS
32
what is of note of antimuscarinic drugs?
should be given cautiously in patients with arrhythmias
33
what are antimotility drug examples?
loperamide, codeine phosphate
34
what do drugs like loperamide do?
electrolyte replacement
35
when are anti motility drugs given?
acute diarrhoea, IBS
36
what must be excluded before prescribing anti motility drugs?
c.diff infection
37
give named examples of amino salicylic acids?
mesalazine, balsalazide, sulphasalazine
38
what is amino salicylic acid given for?
UC, occasionally RA
39
give named examples of steroids?
Prednisolone, hydrocortisone
40
what are steroid's action?
anti-inflammatory
41
what are 5 side effects of steroids
osteoporosis, wt gain, thinning of skin, HT, cataracts, diabetes
42
how does anti-TNF alpha therapy act?
blocks pro-inflammatory cytokines and induces apoptosis of T cells
43
what are 2 examples of immunosuppressants?
methotrexate, azathioprine
44
what are 3 side effects of immunosuppressants?
pancreatitis, leucopaenia, hepatitis
45
what is an example of bulk forming laxatives?
ispagula husk
46
what are laxatives given for?
constipation, faecal impaction
47
what are examples of osmotic laxatives?
lactulose, phosphate enemas, senna
48
what are examples of stimulant laxatives?
Senna, glycerol suppository, sodium pico sulphate
49
which of the 3 types of laxatives is given for chronic diarrhoea due to diverticular disease/ IBS?
bulk forming laxatives
50
what are the 6 anti emetic drugs?
``` dopamine D2 receptor antagonists anti-muscarinics histamine H1 receptor antagonists phenothiazines 5-HT3 receptor antagonist neurokinin-1 R antagonist ```
51
give 3 named examples of dopamine D2 receptor antagonists?
domperidone, metoclopramide, chlorpromazine
52
what are dopamine D2 receptor antagonists tx for?
nausea and vomiting, GORD for pts who don't respond to PPIs
53
anti muscarinic named example as anti-emetic?
scopolamine
54
what are anti-muscarinics used for in anti-emetic terms?
motion sickness
55
what are 2 named examples of histamine H1 receptor antagonists
cyclizine, cinnarizine
56
what are histamine H1 receptor antagonists typically used for to treat?
vertigo
57
chlorpromazine is an example of which anti-emetic drug?
phenothiazines
58
what are phenothiazines used for?
nausea due to chemo
59
what are ondanesteron and palonesterone examples of?
5-HT3 receptor antagonist | - these must be given cautiously !
60
fossaprepitant and apreptant are examples of...?
NK-1 receptor antagonists

Gastrointestinal (24 decks)

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