Chapter 8: Drugs Acting on the GI Tract Flashcards by Maryneil Verin | Brainscape

Q

Vomiting center is located in

A

Dorsal portion of the lateral reticular formation in the medulla

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Q

Chemoreceptor trigger zone

A

Area postrema

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Q

Class of antiemetics that reduce the excitability of the laryrinthin receptors and depress conduction from the vestibular apparatus to the vomiting center

A

Cholinoceptor antagonists

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Q

Cholinergic antagonist used to treat motion sickness and in preoperative situations but not in nausea caused by chemotherapy

A

Scopolamine

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Q

Mode of delivery of scopolamine that decreases the incidence of adverse effects and produces relief for 72 hours

A

Transdermal delivery via skin patch

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Q

Class of antiemetics that act by inhibiting histamine pathways and cholinergic pathways of the vestibular apparatus

A

Histamine H1-receptor antagonists

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Q

Meclizine

A

Histamine H1-receptor antagonists

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Q

Cyclizine

A

Histamine H1-receptor antagonists

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Q

Dimenhydrinate

A

Histamine H1-receptor antagonists

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Q

Promethazine

A

Histamine H1-receptor antagonists

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Q

Class of antiemetics used to treat motion sickness and vertigo

A

Histamine H1-receptor antagonists

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Q

Histamine H1-receptor antagonist used for nausea and vomiting associated with pregnancy

A

Cyclizine

Meclizine

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Q

Adverse effects of cholinergic antagonists

A

Drowsiness, dry mouth and blurred vision

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Q

Adverse effectes of H1-receptor antagonists

A

Sedation, dry mouth

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Q

Class of antiemetics that block dopaminergic receptors in the CTZ and inhibit peripheral transmission to the vomiting center

A

Dopamine receptor antagonists

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Q

Metoclopramide

A

Dopamine receptor antagonists

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Q

Phenothiazines

A

Dopamine receptor antagonists

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Q

Butyrophenones

A

Dopamine receptor antagonists

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Q

Prochlorperazine

A

Phenothiazine

Dopamine receptor antagonists

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Q

Promethazine

A

Phenothiazine

Dopamine receptor antagonists

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Q

Droperidol

A

Butyrophone

Dopamine receptor antagonists

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Q

Dopamine receptor antagonist that also block muscarinic cholinoceptors

A

Prochlorperazine

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Q

Class of antiemetics used to treat CIE, RIE and PONY but is contraindicated in Parkinson’s disease

A

Dopamine receptor antagonists

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Q

Adverse effects of Dopamine receptor antagonists

A

Drowsiness, dry mouth, blurred vision
Extrapyramidal effects
Orthostatic hypotension

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Q

Dopamine receptor antagonist that is associated with QT prolongation and tosade de pointes

A

Droperidol

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Q

Class of antiemetics that are antagonists at serotonin 5-HT3 receptors

A

Serotonin 5-hydroxy tryptamine 3 antagonists

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Q

Ondansetron

A

Serotonin 5-hydroxy tryptamine 3 antagonists

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Q

Dolasetron

A

Serotonin 5-hydroxy tryptamine 3 antagonists

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Q

Granisetron

A

Serotonin 5-hydroxy tryptamine 3 antagonists

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Q

Palonosetron

A

Serotonin 5-hydroxy tryptamine 3 antagonists

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Q

Serotonin 5-hydroxy tryptamine 3 antagonist that can only be administered intravenously

A

Palonosetron

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Q

Serotonin 5-hydroxy tryptamine 3 antagonist that needs dose reduction for patients with hepatic insufficiency

A

Ondansetron

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Q

Adverse effects of Serotonin 5-hydroxy tryptamine 3 antagonists

A

Headache and mild constipation

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Q

Serotonin 5-hydroxy tryptamine 3 antagonist that prolongs QT interval

A

Dolasetron

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Q

Class of antiemetics that inhibit the vomiting center through stimulation of a CB1 subtype of cannabinoid receptors

A

Cannabinoids

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Q

Dronabinol

A

Cannabinoids

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Q

Nabilone

A

Cannabinoids

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Q

Active cannabinoid in marijuana

A

Δ-9-tetrahydrocannabinol

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Q

Alternative agents used to control CIE

A

Cannabinoids

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Q

Adverse effects of cannabinoids

A

Sedations, tachycardia, hypotension, behavioral alterations

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Q

Class of antiemetics that act as anxiolytic to reduce anticipatory emesis

A

Benzodiazepines

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Q

Lorazepam

A

Benzodiazepines

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Q

Diazepam

A

Benzodiazepines

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Q

Benzodiazepine that is useful in the treatment of vertigo

A

Diazepam

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Q

Benzodiazepine that controls symptoms in Meniere disease

A

Diazepam

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Q

Aprepitant

A

Neukonin 1 receptor antagonists

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Q

Neukonin 1 receptor antagonist used to manage the delayed phase emesis caused by chemotherapy

A

Aprepitant

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Q

Aprepitant is metabolized by

A

CYP3A4

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Q

Adverse effects of Aprepitant

A

Diarrhea and fatigue

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Q

Drugs that decrease appetite or promote satiety

A

Anorexigenics

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Q

A reversible lipase inhibitors used for the management of obesity

A

Orlistat

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Q

Contraindications of Orlistat

A

Cholestatis and malabsorption syndromes

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Q

Type of vitamins that should be supplemented when taking Orlistat

A

Fat-soluble vitamins

A, D, E, K

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Q

Appetite enhancer that may be used in patients with AIDS and cancer

A

Dronabinol

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Q

A progestational agent that has a side effect of increased appetite

A

Megestrol

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Q

Agent used as a 2nd or 3rd line therapy for breast cancer patients who have progressed on Tamoxifen

A

Megestrol

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Q

Weak bases that are taken orally to partially neutralize gastric acid, reduce pepsin activity, and stimulate prostaglandin production

A

Antacids

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Q

Antacids that can cause metabolic alkalosis, thus, should not be used for long term treatment

A

Sodium bicarbonate

Calcium bicarbonate

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Q

Antacid that may stimulate gastrin release and thereby cause rebound acid production

A

Calcium bicarbonate

Q

Antacids that produces no systemic effects, thus, can be used for long term treatment

A

Magnesium hydroxide

Aluminum hydroxide

Q

Most frequent adverse effect of Magnesium hydroxide

A

Diarrhea

Q

Most frequent adverse effect of Aluminum hydroxide

A

Constipation

Q

Inhibitors of gastric acid production that act as competitive inhibitors of the histamine H2-receptor on the parietal cell resulting in decrease in histamine-stimulated gastric acid secretion

A

Histamine H2-receptor antagonists

Q

Cimetidine

A

H2-receptor antagonists

Q

Ranitidine

A

H2-receptor antagonists

Q

Famotidine

A

H2-receptor antagonists

Q

Nizatidine

A

H2-receptor antagonists

Q

Predominant final mediator that stimulate parietal acid secretion

A

Histamine

Q

Adverse effects of H2-receptor antagonists

A

Mild GI upset and headache

Q

H2-receptor antagonist that can cause confusion with IV administration especially in the elderly

A

Cimetidine

Q

H2-receptor antagonist that also acts as an androgen-receptor antagonist and can induce gynecomastia and impotence

A

Cimetidine

Q

H2-receptor antagonists that is metabolized by the cP450 and increase the half-life of Warfarin, Theophylline, Phenytoin, and Benzodiazepines

A

Cimetidine

Q

Inhibitors of gastric acid production that acts as irreversible inhibitors of the H+/K+-ATPase proton pump in parietal cells

A

Proton pump inhibitors

Q

Omeprazole

A

Proton pump inhibitors

Q

Lansoprazole

A

Proton pump inhibitors

Q

Dexlansoprazole

A

Proton pump inhibitors

Q

Esomeprazole

A

Proton pump inhibitors

Q

Pantoprazole

A

Proton pump inhibitors

Q

Rabeprazole

A

Proton pump inhibitors

Q

Proton pump inhibitors should be administered ____ before meals

A

1 hour

Q

Proton pump inhibitor that is FDA approved to reduce stress-related mucosal bleeding

A

Omeprazole

Q

Inhibitors of gastric acid production that are used to heal ulcers caused by NSAIDs and useful in patients with untreatable hyper-acid secreting gastrinomas

A

Proton pump inhibitors

Q

Adverse effects of Proton pump inhibitors

A

Headache, GI disturbances

Increased incidence of respiratory and enteric infections

Q

Protective agent that stimulates mucosal production of prostaglandins and inhibits pepsin

A

Sucralfate

Q

Protective agent that is used in the critical care setting to prevent stress-related bleeding

A

Sucralfate

Q

Sucralfate has a particular affinity for exposed proteins in the crater of this types of ulcer

A

Duodenal ulcer

Q

An analog of prostaglandin E1 that acts in the GI tract to stimulate bicarbonate and mucus production

A

MIsoprostol

Q

A prokinetic agent that is used to treat reflux esophagitis, gastric motor failure and diabetic gastroparesis

A

Metoclopramide

Q

Antiemetic used for nausea associated with chemotherapy (eg. cisplatin and doxorubicin) and narcotic-induced vomiting

A

Metoclopramide

Q

An oral naturally occuring bile acid that requires months to reach full effect

A

Ursodiol

Q

Ursodiol effectively dissolves this type of gallstones

A

Cholesterol gallstone

Q

Agent used to prevent gallstones in patients who are undergoing rapid weight loss

A

Ursodiol

Q

Agent used to treat exocrine pancreatic insufficiency associated with cystic fibrosis and pancreatitis

A

Pancrelipase

Q

Treatment of choice for chronic constipation

A

Bulk forming laxatives

Q

Psyllium

A

Bulk forming laxatives

Q

Methylcellulose

A

Bulk forming laxatives

Q

Polycarbophil

A

Bulk forming laxatives

Q

Poorly absorbed ions that retain water in the lumen by osmosis and cause a reflex increase in peristalsis

A

Salt-containing osmotic laxatives

Q

Magnesium citrate

A

Salt-containing osmotic laxatives

Q

Magnesium hydroxide

A

Salt-containing osmotic laxatives

Q

Sodium phosphates

A

Salt-containing osmotic laxatives

Q

Lactulose

A

Salt-free osmotic laxatives

Q

Polyethylene glycol-electrolyte solutions

A

Salt-free osmotic laxatives

Q

Salt-free osmotic laxative administered rectally

A

Glycerin

Q

Salt-free osmotic laxative administered orally

A

Lactulose

Q

Salt-free osmotic laxative used for preoperative colon preparation

A

Go-Lytely

Polyethylene glycol-electrolyte solutions

Q

Type of laxatives that stimulate smooth muscle contractions resulting from their irritant action on the bowel mucosa

A

Irritant laxatives

Q

Bisacodyl

A

Irritant laxatives

Q

Senna

A

Irritant laxatives

Q

Cascara sagrada

A

Irritant laxatives

Q

Chronic use of Irritant laxatives causes:

A

Cathartic colon
Colonic distention
Lazative dependence

Q

Docusate sodium

A

Stool softeners

Q

Glycerin

A

Stool softeners

Q

Mineral oil

A

Stool softeners

Q

Stool softener that has a detergent actioon that facilitates mixing of water and fatty substances to increase luminal mass

A

Docusate

Q

Stool softener that coats fecal contents and inhibits absorption of water

A

Mineral oil

Q

Stool softener that decreases the absorption of fat-soluble vitamins

A

Mineral oil

Q

Anti-diarrheal agent that act on opioid μ-receptors to decrease transit rate, stimulate segmental (nonpropulsive) contraction and inhibit longitudinal contraction

A

Opioid agonists

Q

Diphenoxylate

A

Opioid agonists

Q

Loperamide

A

Opioid agonists

Q

Active metabolite of Diphenoxylate

A

Difenoxin

Q

Opioid agonist that has no CNS activity except at very high doses

A

Loperamide

Q

Effective for both treatment and prophylaxis of Traveler’s diarrhea

A

Bismuth subsalicylate

Q

Component in Bismuth subsalicylate that inhibits prostaglandin and chloride secretion in the intestine to reduce the liquid content of the stools

A

Salicylate

Q

Antidiarrheal agent that forms a protective coating in the GI tract and has direct microbial activity and can bind toxins produced by V. cholerae and E. coli

A

Bismuth subsalicylate

Q

Antidiarrheal agent that is an analog of somatostatin

A

Octreotide

Q

Agent effective for the treatment of diarrhea caused by short-gut syndrome and dumping syndrome

A

Octreotide

Q

Antidiarrheal agent used in the treatment of neuroendocrine tumors of the GI tract

A

Octreotide

Q

Agents that interfere with the production of inflammatory cytokines

A

5-aminosalicylic acid
Mesalamine
Sulfasalazine
Olsalazine
Balsalazide

Q

Analog of prednisolone that is used particularly to treat Crohn’s disease

A

Budenoside

Q

Used most commonly in acute exacerbation of the IBD, as well as in maintenance therapy

A

Prednisone and prednisolone

Q

Immune suppressants that are not used in the acute setting

A

Azathioprine

6-mercaptopurine

Q

Major side effect of Azathioprine and 6-mercaptopurine

A

Bone marrow depression

Q

Agents used for maintenance and remission of IBD in patients who do not respond well to steroids

A

Azathioprine

6-mercaptopurine

Q

Immune suppresant that acts via inhibition of dihydrofolate reductase

A

Methotrexate

Q

Agent used to induce and maintain remission in patients with Crohn’s disease who do not respond well to steroids

A

Methotrexate

Q

Adverse effect of Methotrecate

A

Bone marrow suppression

Q

Agents that bind to and neutralize tumor necrosis factor

A

Infliximab, Adalimumab, Certolizumab

Q

Infliximab

A

Monoclonal antibodies

Q

Adalimumab

A

Monoclonal antibodies

Q

Certolizumab

A

Monoclonal antibodies

Q

Natalizumab

A

Monoclonal antibodies

Q

Monoclonal antibody that bind to INTEGRINS associated with circulating inflammatory cells

A

Natalizumab

Q

Monoclonal antibody that is an approved alternative treatment for Ulcerative Colitis

A

Infliximab

Q

Monoclonal antibody that is an alternative treatment for Crohn’s disease

A

Adalimumab
Certolizumab
Natalizumab

Q

A 5-HT3 antagonist that blocks enteric neurons, thereby reducing distention and inhibiting colonic motility, thereby reducing IBS-associated pain

A

Alosetron

Q

Type of IBS that is treated by Alosetron

A

Diarrhea-predominant IBS in women