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Pharmacology > Agents for Gastrointestinal DIsorders > Flashcards

Agents for Gastrointestinal DIsorders Flashcards

1
Q

Antacid best taken at night

A

H2 receptor antagonist

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2
Q

Antacid best taken in the morning

A

Proton pump inhibitor

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3
Q

Causes of peptic ulcer disease

A

NSAIDs and H. pylori

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4
Q

Receptors facilitating HK-ATPase

A

M3 (Muscarinic), CCK2 (Gastrin), and H2 (Histamine)

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5
Q

Prostaglandin analog to save and protect the mucosa

A

Misoprostol

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6
Q

Protects mucosa from acids

A

Sucralfate

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7
Q

Basal rate of acid secretion

A

1-5 microEq

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8
Q

Fast acting antacids

A

Sodium bicarbonate and Calcium bicarbonate

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9
Q

Adverse effect of Aluminum hydroxide

A

Constipation

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10
Q

Adverse effect of Magnesium hydroxide

A

Osmotic diarrhea

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11
Q

Effects of antacids

A

Increased LES pressure and gastric emptying time, pepsin inactivation, and mucosal protection

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12
Q

Duration of action of antacids in a fasting state

A

30 mins (due to gastric emptying)

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13
Q

Duration of action of antacids with meals

A

2 to 3 hours

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14
Q

Minimum neutralizing capacity of antacid

A

5 mEq/dose

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15
Q

pH level at which ulcers start to heal

A

3.5

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16
Q

Adverse effects of Calcium bicarbonate and Sodium bicarbonate

A

Belching

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17
Q

Antacids should be taken 2 hours before or after ingestion of:

A

Tetracycline
Fluoroquinolone
Itraconazole
Iron preparation

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18
Q

Most potent H2 receptor antagonist

A

Famotidine

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19
Q

Least potent H2 receptor antagonist

A

Cimetidine

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20
Q

Modified histamine molecule with an imidazole ring

A

Cimetidine

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21
Q

Modified histamine molecule with a furan ring

A

Ranitidine

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22
Q

Modified histamine molecule with a thiazole ring

A

Famotidine

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23
Q

MOA of H2RA

A

Inhibitors of histamine at H2 receptor; decrease gastrin and pepsin secretion

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24
Q

Clinical uses of H2RA

A

GERD
PUD
NUD
Stress related gastritis

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25
Q

Adverse effect of Cimetidine

A

Inhibits estradiol metabolism causing hyperprolactinemia

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26
Q

H2RA increases bioavailability of ethanol EXCEPT

A

Famotidine

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27
Q

PPI with the shortest half-life

A

Omeprazole

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28
Q

PPI that is the fastest activated at pH 1.2

A

Rabeprazole

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29
Q

Most potent suppressor of gastric acid secretion

A

Proton Pump inhibitors

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30
Q

Drugs that inhibit both fasting and meal stimulated secretion

A

H2RA and PPI

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31
Q

Healing time of duodenal ulcers

A

4 weeks

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32
Q

Healing time of gastric ulcers

A

6 to 8 weeks

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33
Q

PPI Therapy for actively bleeding ulcers

A

80mg initial IV bolus then 80mg constant infusion at 8mg/hr

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34
Q

PPI is given with what drugs when used as treatment for H. pylori associated ulcers?

A

Amoxicillin and Clarithromycin

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35
Q

PPIs affect the absorption of:

A

Vit B12, Iron, Calcium, and Zinc

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36
Q

PPI, PG, H2RA, and Antacids are used to:

A

heal the ulcer, pain relief, and prevent complications

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37
Q

Regimen to reduce recurrence of ulcer:

A

HP eradication, PPI, and H2RA

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38
Q

This drug group reduces clopidogrel activity

A

Proton Pump Inhibitors

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39
Q

MOA of Sucralfate

A

Binds to necrotic ulcer tissue and serves as barrier to acid, pepsin, and bile for up to 6 hours

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40
Q

Colloidal bismuth compounds combined with which antibiotics will enhance ulcer healing up to 98%

A

Metronidazole and Tetracycline

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41
Q

Increases prostaglandin secretion and scavenges reactive oxygen species

A

Rebamipide

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42
Q

Reduces incidence of NSAID induced ulcers and stimulates uterine contraction

A

Prostaglandin analogs

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43
Q

Agents (regimen) used to eradicate H. pylori

A

PPI (usual ulcer dose)
Amoxicillin
Clarithromycin

44
Q

Cholinomimetic agent used for GERD that stimulates M3 receptors

A

Bethanechol

45
Q

Acetylcholinesterase inhibitor used for acute colonic pseudo obstruction or Ogilvie’s syndrome

A

Neostigmine

46
Q

Drug of choice for GERD

A

Proton Pump Inhibitors

47
Q

MOA of Dopamine receptor antagonist

A

Blocks inhibitory effect of dopamine and blocks D2 receptors

48
Q

Dopamine receptor antagonist that promotes postpartum lactation

A

Domperidone

49
Q

Produce extrapyramidal symptoms of dystonia, akisthisia and Parkinsonian features

A

Metoclopramide, Trimethobenzamide

50
Q

MOA of macrolides

A

Stimulates motilin receptors and promote migrating motor complex

51
Q

MOA of Serotonin 5-HT4 receptor agonist

A

Stimulates second order enteric neurons to promote peristaltic reflex

52
Q

Neurotransmitters promoting proximal bowel contraction

A

AcH and Substance P

53
Q

Neurotransmitters promoting distal bowel relaxation

A

NO and VIP

54
Q

Serotonin 5-HT4 receptor antagonist with QT prolongation effects

A

Tegaserod

55
Q

Complex plant polysaccharide or cellulose derivatives that swell on contact with water to distend colon and promote peristalsis

A

Bulk forming agents

56
Q

Luminally active agents

A

Bulk-forming agents
Osmotic laxatives
Stool softeners

57
Q

Increases stool liquidity due to an obligate increase in fecal fluid

A

Osmotic laxatives

58
Q

Examples of osmotic laxatives

A

Milk of Magnesia
Sorbitol and Lactulose
Mg citrate and Na phosphate
Polyethylene glycol (PEG)

59
Q

Laxative for preparation in GI endoscopic procedures

A

Polyethylene glycol

60
Q

Clinical uses of osmotic laxatives

A

Treat acute constipation and prevent chronic constipation

61
Q

Adverse effect of bulk forming agents

A

Bloating and Flatus

62
Q

Adverse effect of osmotic laxatives

A

IV volume depletion and electrolyte imbalance

63
Q

Stool softeners

A

Docusate
Glycerin suppository
Mineral oil

64
Q

Adverse effects of stool softeners

A

Impair absorption of fat soluble vitamins (ADEK)

65
Q

MOA of stool softeners

A

decrease colonic absorption of water allowing easier stool passage

66
Q

Stimulants or Irritants

A

Cathartics and Chloride channel activator

67
Q

MOA of stimulant laxatives

A

Direct stimulation of ENS, colonic electrolyte and fluid secretion

68
Q

Laxative promoting melanosis coli

A

Antraquinone derivatives (aloe, senna, cascara)

69
Q

Stimulant laxative safe for acute and long term colonic atony use

A

Bisacodyl

70
Q

Potent stimulant laxative promoting intestinal motility

A

Castor Oil

71
Q

Adverse effect of cathartics

A

Colonic atony and dilation

72
Q

Stimulates type 2 chloride channel in small intestine and causes constipation recurrence on discontinuation

A

Lubiprostone

73
Q

MOA of opioid antagonist

A

Inhibits peripheral mu opioid receptors

74
Q

Treatment of opioid induced consipation in patients receiving palliative care

A

Methylnaltrexone

75
Q

Short term use in post-operative ileus after small and large bowel resection

A

Alvimopan

76
Q

Osmolarity of replacement therapy

A

200-320 mmol/L

77
Q

Non-prescription anti-diarrheal opioid agent with no analgesic property

A

Loperamide (Diatabs)

78
Q

Anti-diarrheal opioid agent that contains small amount of atropine that can cause CNS toxicity in higher doses

A

Diphenoxylate (Lomotil)

79
Q

Bile salt binding protein resins

A

Cholestyramine and Colestipol

80
Q

Reduces intestinal fluid secretion and contracts vascular smooth muscle leading to reduction of portal and splanchnic blood flow

A

Somatostatin

81
Q

Synthetic octapeptide with similar action to somatostatin given SC or IV only

A

Octreotide

82
Q

MOA of Serotonin 5-HT3 receptor antagonists

A

Inhibit colonic motility, increasing transit time

Inhibit afferent GI 5-HT3 receptors to decrease visceral pain

83
Q

Drug that is a Serotonin 5-HT3 receptor antagonist

A

Alosetron

84
Q

Drug that is a Serotonin 5-HT4 receptor antagonist

A

Tegaserod

85
Q

Drugs used for emesis secondary to vagal stimulation

A

5-HT3 antagonists (-setron) Ondansetron

86
Q

Adverse effects of Dolansetron

A

Prolonged QT interval

87
Q

Enhances efficacy of 5-HT3 receptor antagonists for prevention of vomiting

A

Corticosteroids (Dexamethasone and Methylprednisolone)

88
Q

Antipsychotic agent with potent antiemetic and sedative properties

A

Phenothiazines and Butyrophenones

89
Q

Weak antiemetic activity as single agents and prevents motion sickness

A

H1 antihistamines and anticholinergics

90
Q

Muscarinic receptor antagonist that is the best agent to prevent motion sickness

A

Hyoscine (Scopolamine)

91
Q

Less sedation used for motion sickness and treatment of vertigo

A

Meclizine

92
Q

Sedative used in conjuction with other antiemetics in patients undergoing chemotherapy

A

Diphenhydramine

93
Q

Cannabinoid reecptor agonist that is a major psychoactive chemical in marijuana used as appetite stimulant and antiemetics

A

Dronabinol (THC)

94
Q

THC analog

A

Nabilone

95
Q

First line treatment for mild to moderate ulcerative colitis

A

5-aminosalicylic acid

96
Q

Purine analogs used in induction and maintenance of remission of ulcerative colitis and Crohn’s disease

A

Azathiorpine and 6-mercaptopurine

97
Q

Immunosuppressive agent that inhibits dihydrofolate reductase and interferes with IL-1 action

A

Methotrexate

98
Q

Drugs used for acute and chronic treatment of ulcerative colitis and Crohn’s disease with inadequate response to conventional therapies

A

Anti-tumor necrosis factor therapy:

Infliximab (-umab)

99
Q

MOA of anti-integrin therapy (Natalizumab)

A

Prevents binding of inflammatory cells to integrin and vascular adhesion molecules

100
Q

Bile acid therapy for gallstones

A

Ursodiol

101
Q

Inhibits glucagon release and used as treatment for bleeding esophageal varices

A

Somatostatin and Octreotide

102
Q

Causes splanchnic arterial vasoconstriction to regulate upper GI bleeding

A

Vasopressin and Terlipressin

103
Q

Prophylaxis for variceal bleeding

A

Beta-receptor blockers

104
Q

Used in non-variceal bleeding

A

Proton pump inhibitor

105
Q

Used enteral for burn and trauma patients

A

Glutamine

106
Q

Immuno nutrition considered for critically ill patients

A

Selenium (antioxidants)

107
Q

Enteral formula for acute respiratory distress syndrome

A

Fish oils

Pharmacology (4 decks)

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