5 GIT Drugs

Question 1

Drug receptor interaction:

Beltanechol

Answer 1

Muscarinic receptor

Question 2

Drug receptor interaction

Metrochlopramide

Answer 2

Serotonin

5HT4 receptor antagonist and Vargas and central 5HT3 antagonism

Question 3

Drug receptor interaction

Domperidone

Answer 3

Dopamine D2 receptor antagonist

** elevate prolactin level

Question 4

Drug receptor interaction

Neostigmine

Answer 4

muscarinic receptor antagonist or ach esterase inhibitor

Question 5

Therapeutic approach to inflammatory bowel disease

Answer 5

aminosalicylates, glucocorticoids, purine analogs, antitumor necosis factor therapy, anti integrin therapy and methotrexate

Question 6

Budesonide

Answer 6

inflam bowel dis

glucocorticoids

Question 7

azathioprine and 6 mercaptopurine

Answer 7

purine analogs inflam bowel disease

Question 8

infliximab, adalimumab, certolizumab

Answer 8

antitumor necrosis factor therapy inflammatory bowel disease

Question 9

natalizumab

Answer 9

anti integrin therapy inflammatory bowel disease

Question 10

dumping syndrome
octreotide
adverse effects?

Answer 10

sludge or gallstone formation

Question 11

somTostatin

Answer 11

octreotide
anti diarrheal
slow motility and inhibit gallbladder contraction thefore AD steatorrhea

Question 12

melanosis coli

Answer 12

it is a brown pigmentation of colon due to chronic use of anthraquinone derivatives such as aloe, senna, and cascara

anthraquinone derivatives are stimulant laxatives

Question 13

dependence

Answer 13

due to prolonged use of diphenoxylate aka lomotil an opiod agonists that is used as anti diarrheal agents

Diphenoxylate can cross BBB compared to loperamide that cant cross BBB

Question 14

visual disturbance

Answer 14

can be caused by HIGH dose of antispasmodics or anticholinergics such as dicyclomine and hyoscyamine

use for irritable bowel syndrome

by inhibiting muscarinic receptors in the enteric plexus and on smooth muscle

Question 15

diarrhea predominant IBS

recommended drugs

Answer 15

alosetron
a serotonin 5HT3 receptor antagonists

long duration of action

AD can cause ischemic colitis and constipation

Question 16

constipation predominant IBS

recommended drug

Answer 16

tegaserod
serotonin 5HT4 receptor antagonist

AD increase number of cardiovascular death therefore it wAs removed from the market

Question 17

lubiprostone

Answer 17

chloride channel activator
stimulate type 2 Cl channel in SI

women with IBS with predominant constipation
Category C for pregnancy

for chronic constipation== 25mcg bid

Question 18

mild inflammatorry bowel disease therapy

Answer 18

budesonide (ileitis)
topical corticosteroids (proctitis)
antibiotics
5 aminosalicylates

Question 19

moderate inflam bowel disease therapy

Answer 19

TNF antagonists
oral corticosteroids
methotrexate
azathioprine/ 6 mercaptopurine

Question 20

severe inflam bowel disease therapy

Answer 20

surgery
natalizumab
cyclosporine
TNF antagonists
IV corticosteroids

Question 21

motion sickness

Answer 21

Meclizine
aka Bonamine

H1 Antihistaminic agent
prevention of motion sickeness and treatment of vertigo due to labyrinth dysfunction

antiemetic agent

Question 22

naturally occuring hydrated magnesium aluminum silicate

used as antidiarrheal agent

Answer 22

Kaolin
attapulgite

colloidal bismuth compounds anti diarrheal
kaolin and pectin

acts as absorbent bacterial toxins thus decrease stool liquidity and number of nonselective absorption

Question 23

bulk forming laxatives (4)

Answer 23

psyllium
bran
methylcellulose
polycarbophil

absord water bulky emollient gel
promotes peristalsis

AD increased bloating and flatus

Question 24

osmotic laxatives(3 class)

Answer 24

non absobable sugar or salts ( saline laxatives, magnesium hydroxide, magnesium sulfate, sorbitol)

nondigestible sugars and alcohol
(magnesium citrate, sodium phosphate, lactulose)

balanced polyethylene glycol PEG LAVAGE

Question 25

stool surfactant or softeners (3)

Answer 25

docusate
glycerinsuppository
mineral oil

Question 26

T OR F

PPIs inhibit both fasting and meal stimulatd acid secretion

Answer 26

True

because they block the common pathway of acid section, proto pump

Question 27

T OR F

histamin receptor antagonist provide prolonged 24hours suppressiom of acid secretion

Answer 27

H2 receptor antagonist used for peptic ulcer disease

cimetidine, ranitidine, famotidine and nizatidine

undergo first pass hepatic metab

suppress basal and meal stimulated acid secretion in linear dose dependent manner

6-10 hours

Question 28

T OR F

antacids neutralize gastic acid up to 10 hours

Answer 28

antacids acts rapidly only 1-2 hours

Question 29

T OR F

PPIs provide rapid 1-2nours of neutralizationod gastric acid

Answer 29

short serum half life 1.5 hours but acid inhibition lasts up to 24hours owing to irreversible inactivation of proton pump

Question 30

mucosal protective agents

Answer 30

sucralfate
prostaglandin analogs ( misoprisol)
bismuth (bismuth subsalicylate and bismuth subcitrate)

Question 31

this drug forms a viscous tenacious paste that binds selectively to ulcers

Answer 31

sucralfate

mucosal protctive agents agaist PUD
less than 3% of intact drug and aluminum absorbed from intestinal tract

AD constipation

Question 32

long term us of cimetidine may cause

Answer 32

mental status change
gynecomastia
galactorrhea

an h2 receptor antagonist
has effects on the adrenals and endocrine system

Question 33

advantage of loperamide over diphenoxylate

Answer 33

no potential for addiction

doesnt cross BBB

Question 34

5 ASA delivered to rectum and sigmoid by enema

Answer 34

Rowasa

Question 35

5 ASA delivered to rectum and sigmoid by suppository

Answer 35

Canasa

Question 36

pregnant patient

cramping abdominal pain

Answer 36

Misoprostol

Question 37

almunium hydroxide containing antacid

Answer 37

constipation