Flashcards in Upper GI Pharmacology Deck (20):
Octreotide is a _________________.
longer-acting analogue of somatostatin
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
Inhibitors: AAA racks in GQ magazines
- acute alcohol abuse
- grapefruit juice
- macrolides (except azithromycin)
The mechanism of this drug is blocking H2 receptors to block the production of gastric acid.
Cimetidine, famotidine, and ranitidine
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.
Which drug works faster in PUD, PPIs or H2 antagonists?
PPIs; H2 antagonists work faster in acute gastritis, however.
The H2 receptors are on the ____________ membrane of parietal cells.
basolateral (meaning the side that faces the blood)
How does sucralfate work?
It is a sulfated disaccharide aluminum that binds to necrotic stomach tissue and forms a protective barrier.
Why is sodium bicarbonate often avoided?
Because it is readily absorbed and can cause volume overload.
Antacids must be taken _____________.
every two hours to be effective
Antacids only need to raise the gastric pH to above ____ to be effective.
What are the triple and quadruple therapies?
Triple: clarithromycin, amoxicillin, and PPI/H2ant
Quadruple: tetracycline, metronidazole, bismuth, and PPI/H2ant
Consider dosage adjustment of __________ in patients with hepatic failure.
Which drug can produce a hyper-gastrin state?
PPIs – leading to rebound acidity if stopped abruptly
Which drug is better at blocking nocturnal acid secretion?
H2 antagonists – this is crucial for duodenal ulcer healing
What other drug's absorption can be impacted by increased gastric pH?
Ketoconazole (it requires a low pH to be absorbed)
What drug stimulates the release of acetylcholine by PNS neurons onto smooth muscle by antagonizing dopamine, thus acting as an pro-kinetic agent?
True or false: stimulation of M3 receptors leads to peristalsis.
False. Stimulating the muscarinic receptors (say, with bethanechol) leads to uncoordinated contraction.
The best treatment for NSAID-induced ulcers is ________________.
(1) stop taking the NSAID
Adjust the dosage of H2 inhibitors in _________________.
the elderly with renal impairments