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GI Final > Anti-Kinetic Drugs (Quiz 4) > Flashcards

Anti-Kinetic Drugs (Quiz 4) Flashcards

1
Q

what is gastroparesis

A
  • failure of the stomach to empty properly
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2
Q

what does motilin do

A
  • stimulate motility
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3
Q

what does dopamine do for motilityhow

A
  • inhibits motility- inhibitory presynaptic dopamine receptor (D2)
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4
Q

what does acetylcholine do for motility

A
  • stimulates motility
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5
Q

MOA of Metoclopramide

A
  • inhibition of dopamine D2 receptor- increase contraction and motility
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6
Q

Toxicities of Metoclopramideshort or long term use

A
  • acute dystonia - short term- tardive dyskinesia - long term- hyperprolactinemia- anxiety, restlessness, depression
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7
Q

what are acute dystonia and tardive dyskinesia known as

A
  • extrapyramidal symptoms (EPS)
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8
Q

how EPS’s causedimportant brain parts involved

A
  • inhibition of central dopamine pathway that regulates skeletal muscle movement- substantia nigra- dorsal striatum
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9
Q

how does Metoclopramide cause hyperprolactinemia

A
  • inhibits central dopamine pathway that inhibits release of prolactin- therefore excessive prolactin secreted
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10
Q

Erythromycin MOA

A
  • motilin receptor agonists
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11
Q

side effect of Erythromycin

A
  • GI distress
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12
Q

pharmacokinetics issues with Erythromycin

A
  • tachyphylaxis (desensitization) after 10-14 days
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13
Q

what drug do you use if metoclopramide fails

A
  • erythromycin
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14
Q

MOA of Neostigmine

A
  • indirect acting cholinergic agonist- inhibits acetylcholinesterase and increases amount of acetylcholine at synapse
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15
Q

toxicities of Neostigmine

A
  • pro parasympathetic effects- excessive saliva production- decreased CO- bradycardia
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16
Q

what is the antidote to Neostigmine

A
  • atropine
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17
Q

role of prostaglandin E2

A
  • inhibits gastric acid secretion
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18
Q

MOA of Sucralfate

A
  • polymerizes at low pH of stomach- negatively charged so binds positively charged proteins in stomach ulcer- forms a barrier
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19
Q

types of antacids

A
  • NaHCO3- CaCO3- Al(OH)3- Mg(OH)2
20
Q

MOA of antacids

A
  • directly neutralize stomach acid
21
Q

toxicity of NaHCO3

A
  • metabolic alkalosis
22
Q

toxicity of Mg(OH)2 and Al(OH)3how do we solve this

A
  • diarrhea- constipation- combine the two to off-set each other’s toxicities
23
Q

toxicity of antacidshow

A
  • hypophosphatemia- molecules are insoluble and prevents PO4 absorption
24
Q

which are the antihistamines

A
  • Ranitidine- Famotidine- Cimetidine
25
Q

MOA of Antihistamines

A
  • competitive, reversible inhibitors of H2 receptor in parietal cells
26
Q

can acid-peptic antihistamines significantly cross the blood brain barrier

A
  • no
27
Q

pharmacodynamics issue with Antihistamines

A
  • other pathways may compensate for blockage and build up tolerance
28
Q

important toxicity of Cimetidinewhich drugswhat’s the exception to the rule

A
  • drug interactions due to inhibition of CYP enzymes- will reduce their clearance- warfarin- anti-epileptics- theophylline- clopidogrel - doesn’t get activated- oral contraceptives
29
Q

importance of theophylline

A
  • low therapeutic index
30
Q

proton pump inhibitor drugs

A
  • omeprazole- esomeprazole- lansoprazole- pantoprazole- rabeprazole
31
Q

MOA of PPIs

A
  • irreversible non competitive antagonist of H+/K+ pump
32
Q

toxicities of PPIs

A
  • C. diff infection- hypomagnesia- vitamin B12 malabsorption - AIN
33
Q

pharmacokinetics issues with PPIs

A
  • pH trapping drives them into secretory canaliculus
34
Q

MOA of Misoprostol

A
  • prostaglandins E2 analog- inhibits gastric H+ secretion
35
Q

toxicities of Misoprostsal

A
  • promotes abortion of fetus
36
Q

what are some neurotransmitters associated with signals that affect vomiting

A
  • dopamine- serotonin- acetylcholine- neurokinin
37
Q

MOA of Ondansetronwhat’s it used for

A
  • serotonin antagonist- anti-emetic
38
Q

Toxicities of Odansetron

A
  • prolonged QT interval
39
Q

MOA of Prochlorperazine and promethazinewhat are they used for

A
  • D2 receptor antagonists- anti-emetic
40
Q

toxicities of Prochlorperazine and promethazine

A
  • acute dystonia- tardive dyskinesia- prolonged QT
41
Q

for what conditions do you use sucralfate

A
  • GERD (pregnancy)
42
Q

for what conditions to you use antacids

A
  • GERD
43
Q

for what conditions do you use antihistamines

A
  • GERD- peptic ulcer disease
44
Q

for what conditions do we use PPIs

A
  • GERD- peptic ulcer disease- Zollinger-Ellison syndrome- NSAID associated ulcers- H. pylori eradication
45
Q

for what conditions do we use misoprostol

A
  • NSAID associated ulcers

GI Final (27 decks)

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