Upper GI Pharmacology Flashcards Preview

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Flashcards in Upper GI Pharmacology Deck (20):
1

Octreotide is a _________________.

longer-acting analogue of somatostatin

2

Give the mnemonics for CYP inducers and inhibitors.

Inducers: chronic alcoholics steal phen phen and never refuse greasy carbs
- chronic alcoholism
- St. John's wort
- Phenytoin
- Phenobarbital
- Nevirapine
- Rifampin
- Griseofulvin
- Carbamazepine

Inhibitors: AAA racks in GQ magazines
- acute alcohol abuse
- ritonaivr
- amiodarone
- cimetidine
- ketoconazole
- sulfonamides
- isoniazide
- grapefruit juice
- quinolones
- macrolides (except azithromycin)

3

The mechanism of this drug is blocking H2 receptors to block the production of gastric acid.

Cimetidine, famotidine, and ranitidine

4

How do proton-pump inhibitors work?

They get molecularly trapped inside the canaliculi of parietal cells and irreversibly inhibit the H+/K+-ATPase exchanger. Importantly, they only inhibit active pumps.

5

Which drug works faster in PUD, PPIs or H2 antagonists?

PPIs; H2 antagonists work faster in acute gastritis, however.

6

The H2 receptors are on the ____________ membrane of parietal cells.

basolateral (meaning the side that faces the blood)

7

How does sucralfate work?

It is a sulfated disaccharide aluminum that binds to necrotic stomach tissue and forms a protective barrier.

8

Why is sodium bicarbonate often avoided?

Because it is readily absorbed and can cause volume overload.

9

Antacids must be taken _____________.

every two hours to be effective

10

Antacids only need to raise the gastric pH to above ____ to be effective.

4

11

What are the triple and quadruple therapies?

Triple: clarithromycin, amoxicillin, and PPI/H2ant

Quadruple: tetracycline, metronidazole, bismuth, and PPI/H2ant

12

Consider dosage adjustment of __________ in patients with hepatic failure.

PPIs

13

Which drug can produce a hyper-gastrin state?

PPIs – leading to rebound acidity if stopped abruptly

14

Which drug is better at blocking nocturnal acid secretion?

H2 antagonists – this is crucial for duodenal ulcer healing

15

What other drug's absorption can be impacted by increased gastric pH?

Ketoconazole (it requires a low pH to be absorbed)

16

What drug stimulates the release of acetylcholine by PNS neurons onto smooth muscle by antagonizing dopamine, thus acting as an pro-kinetic agent?

Metoclopramide

17

True or false: stimulation of M3 receptors leads to peristalsis.

False. Stimulating the muscarinic receptors (say, with bethanechol) leads to uncoordinated contraction.

18

The best treatment for NSAID-induced ulcers is ________________.

(1) stop taking the NSAID
(2) PPI

19

Adjust the dosage of H2 inhibitors in _________________.

the elderly with renal impairments

20

What side effect do the drugs that directly stimulate acetylcholine release have?

Prolonged QT (this is tegaserod and cisapride)

Decks in Digestive, Endocrine, and Metabolic Systems Class (133):