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GEM > 4.01 GI Pharm: IBD, IBS, Antiemetics, Etc. > Flashcards

4.01 GI Pharm: IBD, IBS, Antiemetics, Etc. Flashcards

1
Q

Anionic surfactant that may block water reabsorption

A

Docusate MOA

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2
Q

Docusate ADSE?

A

Diarrhea, stomach pain, cramping

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3
Q

How long does it take for Docusate to kick in? ADME considerations?

A

24-72 hours Oral
10-20 min Suppository

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4
Q

Generally mild way to treat patients for constipation? Not strong enough for patients on opioids

A

Docusate

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5
Q

Stimulates the peristalsis by directly irritating the smooth muscle of intestine (intramural plexus) alters water and electrolyte secretion producing net intestinal fluid accumulation and laxation?

A

Bisacodyl

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6
Q

Stimulates the peristalsis by directly irritating the smooth muscle of intestine (intramural plexus) alters water and electrolyte secretion producing net intestinal fluid accumulation and laxation?

A

Bisacodyl

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7
Q

Abdominal cramps, long term use = electrolyte disturbances, rectal irritation?

A

Bisacodyl

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8
Q

Used for acute constipation, bowel prep for procedures, opioid induced constipation?

A

Bisacodyl

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9
Q

What are the Bisacodyl contraindications?

A

Bowel obstruction, severe dehydration, acute surgical abdomen, rectal bleeding

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10
Q

Long term use could lead to lazy bowel syndrome, dependence, and electrolyte imbalances?

A

Bisacodyl

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11
Q

Bicycling fatty acid that acts locally on apical luminal portion of intestine as a chloride channel activated on CIC-2 increasing intestinal fluid secretion and intestinal motility

A

Lubiprostone

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12
Q

Laxative that is poorly absorbed and could have ADSE including diarrhea and comes CNS (Headache)?

A

Lubiprostone

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13
Q

What is used to treat chronic idiopathic constipation, opioid induced constipation, and IBS with constipation (women)?

A

Lubiprostone (W) and Linaclotide

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14
Q

Bind and agonize guanylate cyclase-c on luminal surface of intestinal epithelium resulting in chloride and bicarb secretion into intestinal lumen?

A

Linaclotide

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15
Q

What is the Linaclotide BBW?

A

Children under 2 years old due to dehydration concerns

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16
Q

Catalyzes hydrolysis of Gb-3 and other glycosphingolipids

A

A-galactosidase

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17
Q

Used to treat the X-linked lysosomal storage disorder Fabry Disease?

A

A - galactosidase

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18
Q

Numerous ADSE including peripheral edema, inclusion reactions, seroconversion, hypersensitivity reactions**

A

A galactosidase

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19
Q

A galactosidase ADME?

A

IV (parenteral)

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20
Q

Enzyme to break down lactose and taken orally with milk products?

A

Lactase

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21
Q

Isolated from porcine pancreatic glands, contains lipase, amylase and proteases?

A

Pancrelipase

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22
Q

Used to treat pancreatic insufficiencies?

A

Pancrelipase

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23
Q

How do you take Pancrelipase?

A

With food to aid digestion since coated in enteric capsule

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24
Q

What are some anti diarrheal options?

A

Loperamide or Diphenoxylate

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25
Q

Opioid agonist that minimally crosses BBB OTC?

A

Loperamide

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26
Q

Opioid agonist that will cross in higher doses and mixed with atropine?

A

Diphenoxylate

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27
Q

When shouldn’t you use opioids as anti diarrheal?

A

High fever, bloody diarrhea, septicemia

28
Q

Most common treatment for gallstones?

A

Laparoscopic cholecystectomy

29
Q

What should you be thinking as treatment for recurrent gallstones for patients?

A

Statins and ezetimibe

30
Q

What is an nonsurgical option to treat very Iill patients with gallstones or to prevent the formation in overweight people losing weight very quickly?

A

Ursodiol

31
Q

Decreases cholesterol content of bile by reducing the secretin of cholesterol from the liver?

A

Ursodiol

32
Q

Ursodiol is used for gallstones of what size?

A

< 20mm

33
Q

Ursodiol ADSE?

A

Headache, dizziness, diarrhea, constipation, nausea, back pain, upper respiratory tract infections

34
Q

When will gallstones be unresponsive to Ursodiol?

A

When they are calcified

35
Q

What is the Ursodiol effectiveness ?

A

50% when 10mg/kg/day for 12-24 months

36
Q

What are drugs that you can use to reduce portal pressure and treat variceal hemorrhages?

A

Octreotide or terlipressin

37
Q

Somatostatin agonist that inhibits secretion of CCK, gastrin, GH, insulin, VIP, 5-HT to reduce portal and splanchnic blood flow?

A

Octreotide

38
Q

Due to the impaired pancreatic secretions it may cause steatorrhea and fat soluble vitamin deficiencies alongside nausea, abdominal pain, flatulence, and gall stones?

A

octreotide

39
Q

How long would you use octreotide?

A

7 days or less, not long term

40
Q

What can you use to treat IBS?

A

Dietary Alterations*, then treat symptoms like diarrhea/constipation with normal drugs, can do low dose Anticholinergics or Alosetron (Severe diarrhea)

41
Q

selective 5-HT3 antagonist (direct channel)

A

Alosetron

42
Q

Approved for treatment for women with severe diarrhea predominant IBS who failed to conventional treatment?

A

Alosetron

43
Q

BBW for Alosetron?

A

Ischemic colitis and serious constipation complications

44
Q

Alosetron ADME?

A

Oral, extensive metabolism, urinary excretion

45
Q

Drugs to treat IBD generally?

A

Anti inflammatories

46
Q

Used to treat mild IBD?

A

5-ASA

47
Q

Used to treat severe IBD?

A

Natalizumab

48
Q

MOA uncertain with some COX inhibition, some NF-kB inhibition, mainly topical*

A

5-ASA (aminosalicylates)

49
Q

Anti-integrity therapy that blocks a4 integrity subunit on circulating inflammatory cells blocking ability for T cells to migrate/adhere in the gut area?

A

Natalizumab

50
Q

Used especially to treat Crohn’s disease?

A

Natalizumab

51
Q

Natalizumab ADSE?

A

Multifocal leukoencephalopathy (JC virus), Infusion reactions, opportunistic infections

52
Q

Why are 5-HT3 antagonists useful as antiemetic?

A

Blacks afferent vagal stimulation/signaling

53
Q

Why are benzos effective as an antiemetic?

A

It helps anticipatory vomiting from emesis responses to needles, IV bags, etc.

54
Q

Used to treat motion sickness like on a boat?

A

Scopolamine

55
Q

5-Ht3 Antagonist?

A

Ondansetron

56
Q

What is used for chemo/radiation or postoperative nausea/vomiting and much be continuously delivered as it has a short half like (3-4hrs)?

A

Ondansetron

57
Q

Ondansetron ADSE?

A

Headache, dizziness, constipation, small QT interval increase

58
Q

Neurokinin receptor antagonist, blockade of the NK1 receptor in postrema area

A

Aprepitant

59
Q

Neurokinin receptor antagonist

A

Aprepitant

60
Q

What is used in combination with 5-HT3 antagonists for acute and delayed nausea/vomiting from highly emetogenic chemo regimens?

A

Aprepitant

61
Q

Neurokinin receptor antagonist Aprepitant ADSE?

A

Drug-drug interactions (CYP3A4), fatigue, dizziness, diarrhea

62
Q

Used for highly emetogenic chemo regiments especially for DELAYED nausea and vomiting

A

Aprepitant

63
Q

Likely activation of CB1 resulting in increased appetite and antiemetic effects?

A

Cannabinoids = dronabinol (THC)

64
Q

When is dronabinol (THC) administered?

A

Prior to chemo and 2-4 hours after waters

65
Q

Euphoria, dysphoria, sedation, hallucinations, dry mouth, increased appetite?

A

Dronabinol (THC)

GEM (29 decks)

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