Chapter 8: Drugs Acting on the GI Tract Flashcards
1
Q
Vomiting center is located in
A
Dorsal portion of the lateral reticular formation in the medulla
2
Q
Chemoreceptor trigger zone
A
Area postrema
3
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
4
Q
Cholinergic antagonist used to treat motion sickness and in preoperative situations but not in nausea caused by chemotherapy
A
Scopolamine
5
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
6
Q
Class of antiemetics that act by inhibiting histamine pathways and cholinergic pathways of the vestibular apparatus
A
Histamine H1-receptor antagonists
7
Q
Meclizine
A
Histamine H1-receptor antagonists
8
Q
Cyclizine
A
Histamine H1-receptor antagonists
9
Q
Dimenhydrinate
A
Histamine H1-receptor antagonists
10
Q
Promethazine
A
Histamine H1-receptor antagonists
11
Q
Class of antiemetics used to treat motion sickness and vertigo
A
Histamine H1-receptor antagonists
12
Q
Histamine H1-receptor antagonist used for nausea and vomiting associated with pregnancy
A
Cyclizine
Meclizine
13
Q
Adverse effects of cholinergic antagonists
A
Drowsiness, dry mouth and blurred vision
14
Q
Adverse effectes of H1-receptor antagonists
A
Sedation, dry mouth
15
Q
Class of antiemetics that block dopaminergic receptors in the CTZ and inhibit peripheral transmission to the vomiting center
A
Dopamine receptor antagonists
16
Q
Metoclopramide
A
Dopamine receptor antagonists
17
Q
Phenothiazines
A
Dopamine receptor antagonists
18
Q
Butyrophenones
A
Dopamine receptor antagonists
19
Q
Prochlorperazine
A
Phenothiazine
Dopamine receptor antagonists
20
Q
Promethazine
A
Phenothiazine
Dopamine receptor antagonists
21
Q
Droperidol
A
Butyrophone
Dopamine receptor antagonists
22
Q
Dopamine receptor antagonist that also block muscarinic cholinoceptors
A
Prochlorperazine
23
Q
Class of antiemetics used to treat CIE, RIE and PONY but is contraindicated in Parkinson’s disease
A
Dopamine receptor antagonists
24
Q
Adverse effects of Dopamine receptor antagonists
A
Drowsiness, dry mouth, blurred vision
Extrapyramidal effects
Orthostatic hypotension
25
Dopamine receptor antagonist that is associated with QT prolongation and tosade de pointes
Droperidol
26
Class of antiemetics that are antagonists at serotonin 5-HT3 receptors
Serotonin 5-hydroxy tryptamine 3 antagonists
27
Ondansetron
Serotonin 5-hydroxy tryptamine 3 antagonists
28
Dolasetron
Serotonin 5-hydroxy tryptamine 3 antagonists
29
Granisetron
Serotonin 5-hydroxy tryptamine 3 antagonists
30
Palonosetron
Serotonin 5-hydroxy tryptamine 3 antagonists
31
Serotonin 5-hydroxy tryptamine 3 antagonist that can only be administered intravenously
Palonosetron
32
Serotonin 5-hydroxy tryptamine 3 antagonist that needs dose reduction for patients with hepatic insufficiency
Ondansetron
33
Adverse effects of Serotonin 5-hydroxy tryptamine 3 antagonists
Headache and mild constipation
34
Serotonin 5-hydroxy tryptamine 3 antagonist that prolongs QT interval
Dolasetron
35
Class of antiemetics that inhibit the vomiting center through stimulation of a CB1 subtype of cannabinoid receptors
Cannabinoids
36
Dronabinol
Cannabinoids
37
Nabilone
Cannabinoids
38
Active cannabinoid in marijuana
Δ-9-tetrahydrocannabinol
39
Alternative agents used to control CIE
Cannabinoids
40
Adverse effects of cannabinoids
Sedations, tachycardia, hypotension, behavioral alterations
41
Class of antiemetics that act as anxiolytic to reduce anticipatory emesis
Benzodiazepines
42
Lorazepam
Benzodiazepines
43
Diazepam
Benzodiazepines
44
Benzodiazepine that is useful in the treatment of vertigo
Diazepam
45
Benzodiazepine that controls symptoms in Meniere disease
Diazepam
46
Aprepitant
Neukonin 1 receptor antagonists
47
Neukonin 1 receptor antagonist used to manage the delayed phase emesis caused by chemotherapy
Aprepitant
48
Aprepitant is metabolized by
CYP3A4
49
Adverse effects of Aprepitant
Diarrhea and fatigue
50
Drugs that decrease appetite or promote satiety
Anorexigenics
51
A reversible lipase inhibitors used for the management of obesity
Orlistat
52
Contraindications of Orlistat
Cholestatis and malabsorption syndromes
53
Type of vitamins that should be supplemented when taking Orlistat
Fat-soluble vitamins
| A, D, E, K
54
Appetite enhancer that may be used in patients with AIDS and cancer
Dronabinol
55
A progestational agent that has a side effect of increased appetite
Megestrol
56
Agent used as a 2nd or 3rd line therapy for breast cancer patients who have progressed on Tamoxifen
Megestrol
57
Weak bases that are taken orally to partially neutralize gastric acid, reduce pepsin activity, and stimulate prostaglandin production
Antacids
58
Antacids that can cause metabolic alkalosis, thus, should not be used for long term treatment
Sodium bicarbonate
| Calcium bicarbonate
59
Antacid that may stimulate gastrin release and thereby cause rebound acid production
Calcium bicarbonate
60
Antacids that produces no systemic effects, thus, can be used for long term treatment
Magnesium hydroxide
| Aluminum hydroxide
61
Most frequent adverse effect of Magnesium hydroxide
Diarrhea
62
Most frequent adverse effect of Aluminum hydroxide
Constipation
63
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
Histamine H2-receptor antagonists
64
Cimetidine
H2-receptor antagonists
65
Ranitidine
H2-receptor antagonists
66
Famotidine
H2-receptor antagonists
67
Nizatidine
H2-receptor antagonists
68
Predominant final mediator that stimulate parietal acid secretion
Histamine
69
Adverse effects of H2-receptor antagonists
Mild GI upset and headache
70
H2-receptor antagonist that can cause confusion with IV administration especially in the elderly
Cimetidine
71
H2-receptor antagonist that also acts as an androgen-receptor antagonist and can induce gynecomastia and impotence
Cimetidine
72
H2-receptor antagonists that is metabolized by the cP450 and increase the half-life of Warfarin, Theophylline, Phenytoin, and Benzodiazepines
Cimetidine
73
Inhibitors of gastric acid production that acts as irreversible inhibitors of the H+/K+-ATPase proton pump in parietal cells
Proton pump inhibitors
74
Omeprazole
Proton pump inhibitors
75
Lansoprazole
Proton pump inhibitors
76
Dexlansoprazole
Proton pump inhibitors
77
Esomeprazole
Proton pump inhibitors
78
Pantoprazole
Proton pump inhibitors
79
Rabeprazole
Proton pump inhibitors
80
Proton pump inhibitors should be administered ____ before meals
1 hour
81
Proton pump inhibitor that is FDA approved to reduce stress-related mucosal bleeding
Omeprazole
82
Inhibitors of gastric acid production that are used to heal ulcers caused by NSAIDs and useful in patients with untreatable hyper-acid secreting gastrinomas
Proton pump inhibitors
83
Adverse effects of Proton pump inhibitors
Headache, GI disturbances
| Increased incidence of respiratory and enteric infections
84
Protective agent that stimulates mucosal production of prostaglandins and inhibits pepsin
Sucralfate
85
Protective agent that is used in the critical care setting to prevent stress-related bleeding
Sucralfate
86
Sucralfate has a particular affinity for exposed proteins in the crater of this types of ulcer
Duodenal ulcer
87
An analog of prostaglandin E1 that acts in the GI tract to stimulate bicarbonate and mucus production
MIsoprostol
88
A prokinetic agent that is used to treat reflux esophagitis, gastric motor failure and diabetic gastroparesis
Metoclopramide
89
Antiemetic used for nausea associated with chemotherapy (eg. cisplatin and doxorubicin) and narcotic-induced vomiting
Metoclopramide
90
An oral naturally occuring bile acid that requires months to reach full effect
Ursodiol
91
Ursodiol effectively dissolves this type of gallstones
Cholesterol gallstone
92
Agent used to prevent gallstones in patients who are undergoing rapid weight loss
Ursodiol
93
Agent used to treat exocrine pancreatic insufficiency associated with cystic fibrosis and pancreatitis
Pancrelipase
94
Treatment of choice for chronic constipation
Bulk forming laxatives
95
Psyllium
Bulk forming laxatives
96
Methylcellulose
Bulk forming laxatives
97
Polycarbophil
Bulk forming laxatives
98
Poorly absorbed ions that retain water in the lumen by osmosis and cause a reflex increase in peristalsis
Salt-containing osmotic laxatives
99
Magnesium citrate
Salt-containing osmotic laxatives
100
Magnesium hydroxide
Salt-containing osmotic laxatives
101
Sodium phosphates
Salt-containing osmotic laxatives
102
Lactulose
Salt-free osmotic laxatives
103
Polyethylene glycol-electrolyte solutions
Salt-free osmotic laxatives
104
Salt-free osmotic laxative administered rectally
Glycerin
105
Salt-free osmotic laxative administered orally
Lactulose
106
Salt-free osmotic laxative used for preoperative colon preparation
Go-Lytely
| Polyethylene glycol-electrolyte solutions
107
Type of laxatives that stimulate smooth muscle contractions resulting from their irritant action on the bowel mucosa
Irritant laxatives
108
Bisacodyl
Irritant laxatives
109
Senna
Irritant laxatives
110
Cascara sagrada
Irritant laxatives
111
Chronic use of Irritant laxatives causes:
Cathartic colon
Colonic distention
Lazative dependence
112
Docusate sodium
Stool softeners
113
Glycerin
Stool softeners
114
Mineral oil
Stool softeners
115
Stool softener that has a detergent actioon that facilitates mixing of water and fatty substances to increase luminal mass
Docusate
116
Stool softener that coats fecal contents and inhibits absorption of water
Mineral oil
117
Stool softener that decreases the absorption of fat-soluble vitamins
Mineral oil
118
Anti-diarrheal agent that act on opioid μ-receptors to decrease transit rate, stimulate segmental (nonpropulsive) contraction and inhibit longitudinal contraction
Opioid agonists
119
Diphenoxylate
Opioid agonists
120
Loperamide
Opioid agonists
121
Active metabolite of Diphenoxylate
Difenoxin
122
Opioid agonist that has no CNS activity except at very high doses
Loperamide
123
Effective for both treatment and prophylaxis of Traveler's diarrhea
Bismuth subsalicylate
124
Component in Bismuth subsalicylate that inhibits prostaglandin and chloride secretion in the intestine to reduce the liquid content of the stools
Salicylate
125
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
Bismuth subsalicylate
126
Antidiarrheal agent that is an analog of somatostatin
Octreotide
127
Agent effective for the treatment of diarrhea caused by short-gut syndrome and dumping syndrome
Octreotide
128
Antidiarrheal agent used in the treatment of neuroendocrine tumors of the GI tract
Octreotide
129
Agents that interfere with the production of inflammatory cytokines
```
5-aminosalicylic acid
Mesalamine
Sulfasalazine
Olsalazine
Balsalazide
```
130
Analog of prednisolone that is used particularly to treat Crohn's disease
Budenoside
131
Used most commonly in acute exacerbation of the IBD, as well as in maintenance therapy
Prednisone and prednisolone
132
Immune suppressants that are not used in the acute setting
Azathioprine
| 6-mercaptopurine
133
Major side effect of Azathioprine and 6-mercaptopurine
Bone marrow depression
134
Agents used for maintenance and remission of IBD in patients who do not respond well to steroids
Azathioprine
| 6-mercaptopurine
135
Immune suppresant that acts via inhibition of dihydrofolate reductase
Methotrexate
136
Agent used to induce and maintain remission in patients with Crohn's disease who do not respond well to steroids
Methotrexate
137
Adverse effect of Methotrecate
Bone marrow suppression
138
Agents that bind to and neutralize tumor necrosis factor
Infliximab, Adalimumab, Certolizumab
139
Infliximab
Monoclonal antibodies
140
Adalimumab
Monoclonal antibodies
141
Certolizumab
Monoclonal antibodies
142
Natalizumab
Monoclonal antibodies
143
Monoclonal antibody that bind to INTEGRINS associated with circulating inflammatory cells
Natalizumab
144
Monoclonal antibody that is an approved alternative treatment for Ulcerative Colitis
Infliximab
145
Monoclonal antibody that is an alternative treatment for Crohn's disease
Adalimumab
Certolizumab
Natalizumab
146
A 5-HT3 antagonist that blocks enteric neurons, thereby reducing distention and inhibiting colonic motility, thereby reducing IBS-associated pain
Alosetron
147
Type of IBS that is treated by Alosetron
Diarrhea-predominant IBS in women
