Bowel Disorders/Gastrointestinal Cond.

Question 1

Parasympathetic

Answer 1

Rest and digest, inc peristalsis

Driven by acetylcholine (Ach)

Question 2

Sympathetic

Answer 2

Fight or Flight, dec peristalsis

Question 3

Serotonin receptors

Answer 3

5-HT4 inc motility and Ach release

5-HT3 involved emesis

Question 4

u Opiod receptor

Answer 4

Decrease acid secretion and propulsive waves

Increase constipation and water absorption

Question 5

Simple nausea relief

Answer 5

Antihistamines
Antacids
Peppermint and ginger

Question 6

Ondansetron (zofran) MOA

Answer 6

Blocks 5-HT3 receptors in vomiting centers of brain

Pregnancy X

Question 7

Antihistamines and anticholinergics (Emesis)

Answer 7

Simple nausea and motion sickness

Scopolamine(hyoscine)
Dramamine(dimenhyrdinate)
Benadryl(diphenhydramine)

Question 8

Scopolamine MoA

Answer 8

M1 cholinergic receptor antagonist

Blocks Ach

Question 9

Benadryl MoA

Answer 9

H1 antagonist

Question 10

D2 receptor antagonists (Emesis)

Answer 10

Used as antipsychotics and severe nausea/vomiting

Metoclopramide(reglan)
Prochlorperazine(compazine)
Haloperidol (halfol)

Question 11

Prochlorperazine (Compazine) MoA

Answer 11

Block D2 receptors

Can have anticholinergic effects

Question 12

Metoclopramide (Reglan) MoA

Answer 12

Antagonize 5-HT3 amd D2 receptors
Agonize 5-HT4 in stomach

Ok for pregnant women

Question 13

Cannaboid receptor agonist

Answer 13

Dronabinol (Marinol)

Question 14

Dronabinol (marinol) MoA

Answer 14

CB receptor agonist->antiemetic

Increase appetite

Question 15

Types of Diarrhea

Answer 15

Osmotic
Infectious
Travellers
Hormonal

Question 16

Osmotic Diarrhea

Answer 16

Too much salt pulled into stool

Question 17

Infectious diarrhea

Answer 17

Treat infection, for example use bismuth salts (pepto bismol)

Question 18

Travellers diarrhea Drugs

Answer 18

Ciproflaxin
Norfloaxin
Metronidazole

Question 19

Ciproflaxin amd Norfloaxin MOA

Answer 19

Cholera tx

Bind to DNA gyrase preventing bacteria from replicating

Question 20

Metronidazole MoA

Answer 20

Inhibit bacterial DNA synthesis

Question 21

Hormonal diarrhea

Answer 21

VIPoma
Octretide(Sandostatin)

Question 22

Octreotide(Sandostatin) MoA

Answer 22

Somatostatin analog/receptor agonist that reduces VIP secretion

Question 23

Opioids for diarrhea MoA/ Drugs

Answer 23

stimulate u receptor to dec propulsion/motility and inc water reabsorption

Difenoxin (Motofen) -active
Diphenoxylate ( Lomotil) prodrug
Loperamide(Imodium) go to OTC

Question 24

What is added to D D L opiods for diarrhea?

Answer 24

Atrophine

anticholinergic

Question 25

Bulk-Forming laxative (C)

Answer 25

Metamucil (psyllium mucilloid) insoluble fiber is bulk forming

Question 26

GI Stimulant (C)

Answer 26

Bisacodyl (Correctol, Dulcolax) Senna (Ex-Lax, Senokot) MoA-Irritate bowel mucosa to facilitate GI motility

Question 27

Stool softeners (C)

Answer 27

Docusate (Dulcolax stool softener) MoA- water and fats pulled into stool to facilitate motility

Question 28

Saline and osmotic cathartics (C)

Answer 28

``` Lactulose (chronulac) Magnesium hydroxide (milk of mag) Polyethylene glycol (miralax) ``` MoA- pull water into stool

Question 29

Opioid induced constipation drug

Answer 29

Naloxegol (movantik) MoA- opioid receptor blocker

Question 30

Herbal Agents(C)

Answer 30

Senna and flaxseed

Question 31

Why is mineral oil discouraged?

Answer 31

interfere with absorption of fat soluble vitamins

Question 32

Irritable Bowel Syndrome (IBS)

Answer 32

Normal operation of digestive tract is impaired without the presence of detectable organic disease no prototype drug

Question 33

Inflammatory Bowel Disease (IBD)

Answer 33

Crohn's Disease- TH1 mediated/ intestine or colon | Ulcerative colitis -TH2 mediated/ wall of colon

Question 34

Anti-Inflammatory Drugs for IBD

Answer 34

Sulfsalazine(azulfadine) Olsalazine(dipentum) 5-aminosalicylic acid (mesalazine) MoA-decrease inflammatory cytokines and arachidonic acid relaese (cox 1/2)

Question 35

Corticosteroids for IBD

Answer 35

Prednisone Methylprednisolone MoA- immune suppressor via stimulating GRE in nucleus

Question 36

Concerns using Prednisone with a flare?

Answer 36

Can cause immune cells to leave the blood and hide symptoms since immune system is suppressed

Question 37

Immunosuppressants for IBD

Answer 37

Azathioprine (imuran) Methotrexate Cyclosporin

Question 38

Azathiprine MoA

Answer 38

decrease cell division- immune suppression

Question 39

Methotrexate MoA

Answer 39

Blocks IL-1B at receptor, key cytokine in inflamm.

Question 40

Cyclosporin MoA

Answer 40

Inhibits caclineurin which decreases IL-2 which inhibits t cell production

Question 41

Biologics for IBD

Answer 41

Ustekinumab (stelara) Tofacitinib (xeljanz) Infliximab (remicade)

Question 42

Infliximab (remicade) MoA

Answer 42

monoclonal antibody binds TNFa

Question 43

Ustekinumab (stelara) MoA

Answer 43

monoclonal antibody inhibitig IL-12 and -23 last drug for crohn's

Question 44

Tofacitinib (xeljanz) MoA

Answer 44

Jak/ STAT inhibitor | black box warning/ last drug for UC