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Gastrointes > 010815 upper GI pharm > Flashcards

010815 upper GI pharm Flashcards

1
Q

what role do prostaglandins play in upper GI?

A

PGI2 and PGE2 are protective:
decrease gastric acid production
increase mucus production

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2
Q

H+/K+ ATPase pump inhibitors are used for

A

gastric and duodenal ulcers
GERD
pathological hypersecretory conditions like Zollinger Ellison syndrome

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3
Q

list types of H+/K+ ATP ase pump inhibitors

A

the zoles

omeprazole
esomeprazole
lansoprazole

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4
Q

how do the H+/K+ ATPase pump inhibitors get targeted to their site of action?

A

they are prodrugs and only in the acidic gastric secretory canaliculi are they catalyzed to a sulfonamide

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5
Q

MOA of H+/K+ ATPase pump inhibitors

A

irreversibly inactivate the H+/K+ ATPase pump, so only way for the stomach to overcome it is to make new proton pumps!

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6
Q

metabolism of H+/K+ ATPase pump inhibitors

A

hepatic P450

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7
Q

side effects of H+/K+ ATPase pump inhibitors

A

few

chronic use-increased risk of bone fracture, increased risk of infection

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8
Q

MOA of H2 receptor antagonists

A

competitively bind to histamine H2 receptors on parietal cells. reversible binding.

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9
Q

list H2 receptor antagonists

A

cimetidine (inhibits P450)
ranitidine

the -dines

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10
Q

can develop tolerance to H2 receptor antagonists: true or false?

A

true

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11
Q

two main drug mechanisms for decreasing acid

A

H2 antagonist on parietal cell

proton pump inhibitors on parietal cell

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12
Q

in treating ulcers, what are the possible approaches?

A

decrease acid

increase protective mechanisms

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13
Q

sucralfate

A

sucrose sulfate and Al(OH)3

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14
Q

MOA of sucralfate

A

in stomach acid, forms a polymer gel in the acid environment. adheres to epithelial cells and ulcer craters to protect the ulcer by coating it from pepsin hydrolysis

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15
Q

antacids-list them

A

Al(OH)3
Mg(OH)2
CaCO3

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16
Q

which antacid produces CO2 as side effect?

A

CaCO3

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17
Q

which antacid has constipation as side effect? diarrhea?

A

constipation: Al(OH)3
diarrhea: Mg(OH)2

so Mg and Al are combined in many antacid preps to offset each other

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18
Q

cautions for antacids

A

avoid concurrent administration of antacids and drugs intended for systemic absorprtion (antacids can change drug absoprtion and elimination because they alter gastric and urinary pH)

19
Q

bismuth subsalicylate

A

trivlanet bismuth and salicylate suspended in mix of magnesium aluminum silicate clay

called Pepto bismol

20
Q

use of bismuth subsalicylate

A

ulcer

21
Q

black stools, black tongue side effect comes from?

A

bismuth subsalicylate

22
Q

antibiotic for H pylori consists of

A

multi agent antibiotic therapy (single one is ineffective)

23
Q

tx strategy for NSAID related mucosal injury

A

if can’t stop using NSAID:
reduce acid
replace prostaglandins (not used much)

24
Q

treatment for active ulcers that are non-H pylori and non-NSAID

A

reduce acid

25
Q

MOA of bismuth subsalicylate

A

unknown exactly

26
Q

scopolamine most acts through

A

Ach (muscarinic) receptor–antagonist

27
Q

dimenhydrinate mostly acts through

A

histamine H1 receptor–antagonist

28
Q

granisetron and ondansetron mainly act through

A

serotonin receptor

29
Q

metoclopramide mainly acts through

A

dopamine receptor

30
Q

prochlorperazine mainly acts through

A

dopamine receptor

31
Q

dexamethasone

A

steroid

32
Q

use of scopolamine

A

motion sickness , post op nausea

33
Q

use of dimenhydrinate

A

motion sickness

post op nausea

34
Q

serotonin receptor antagonists–list them

A

ondansetron

granisetron

35
Q

use of serotonin receptor antagonists

A

chemotherapy, irradiation related nausea

36
Q

use of prochlorperazine

A

general use, not chemo nausea

37
Q

dronabinol MOA

A

CB1 receptor agonist

38
Q

use of dronabinol

A

prophylaxis of refractory, chemo induced vomiting

39
Q

dexamethasone used for

A

in conjunction with other anti-emetics for chemo

40
Q

aprepitant MOA

A

substance P and NK1 receptor antagnoist

41
Q

use of aprepitant

A

combo therapy-usally given with serotonin antagonist and corticosteroid

42
Q

metoclopramide

A

prokinetic agent
D2 antagonist

enhances gastric emptying by enhancing Ach release in myenteric plexus

43
Q

use of metoclopramide

A

diabetic gastroparesis and GERD

44
Q

erythromycin

A

acts similar to motilin

tx for diabetic gastroparesis (off label)

Gastrointes (11 decks)

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