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HLST220: Pharmacology > Chapter 83: Other GI Drugs > Flashcards

Chapter 83: Other GI Drugs Flashcards

1
Q

antiemetics are given

A

to supress nausea and vomitng

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2
Q

ematic response

A

complex reflex that occurs after activation of vomiting center in the medulla oblongata

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3
Q

what receptors are involved in the emetic response

A
  • seratonin glucocorticoids, substance P, neurokinin, dopamine, acetylcholine, histamine
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4
Q

dopamine D2 antagonists examples

A

prochlorperazine

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5
Q

seratonin antagonists example

A

ondansetron

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6
Q

antihistamines (h1 antagonists) example

A

dimenhydrinate

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7
Q

glucocorticoids examples

A

dexamethasone

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8
Q

neurokinin 1 receptor antagonists examples

A

aprepitant

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9
Q

cannabinoids examples

A
  • dronabinol
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10
Q

antiemetic drug classes

A
  • dopamine antaginists
  • seratonin antagonists
  • antihistamines
  • anticholinergics
  • benzodiazepine (GABA)
  • glucocorticoids
  • neurokinin 1 receptor antagonists
  • somatostatin analogues
  • cannabinoids
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11
Q

Seratonin receptor antagonists is used for

A

chemotherpay induced nausea and vomiting (aka antineoplastic induced)
- associated with radiotherapy and anesthetia
- severe morning sickness in pregancy

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12
Q

Serotonin receptor antagonists MOA

A

blockes 5-HT3 on afferent vagal nerve

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13
Q

seratonin receptor adverse effects

A

headache, constipation, prolonged Qt interval, seratonin syndrome

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14
Q

Glucocorticoids are used for

A

short term for more serious nausea and vomiting
- post opp

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15
Q

Neurokinin receptor antagonists are used for

A

prevention of postperative nausea and vomiting and CINV

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16
Q

neurokinin receptor antagonists –> Aprepitant [emend] side efects

A

fatigue, dizziness, GI upset, possible liver injury

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17
Q

neurokinin receptor antagonists –> Aprepitant [emend] drug interactions

A

oral contraceptives become ineffective , warafarin

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18
Q

three primary benefits of Benzodiazepines –> lorazepam [Ativan]

A
  • sedation
  • supression of anticipatory emesis
  • production of antrograde amnesia
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19
Q

Dopamine antagonists –> prochlorperazine [Stemetil] side effects

A
  • extrapyramidal reactions
  • anticholinergic effects
  • hypotension and sedation
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20
Q

Dopamine antagonists –> metoclopramide [Reglan, Maxeran] is used for

A

postoperative nausea and vomiting, opiods, toxins, radiation therapy. SOmetimes used in hyperemesis gradivarum

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21
Q

Cannabinoids
- Dronabinol [Marinol]
- nabilone [cesamet]
is used for

A

CINV or for appetite stimualtion

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22
Q

Cannabinoids
- Dronabinol [Marinol]
- nabilone [cesamet] adverse effects

A

drowsiness, tachycardia, hypotension

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23
Q

Cannabinoids
- Dronabinol [Marinol]
- nabilone [cesamet]
adminstration

A

oral capsules

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24
Q

what are the three types of CINV emesis

A
  • anticipatory
  • acute
  • delayed
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25
Q

anticipatory

A

occurs before drugs are given

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26
Q

acute

A
  • onset within minutes to a few hours
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27
Q

delayed

A

onset 1 day or longer after drug adminstration

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28
Q

hyperemesis gravidarum

A
  • dehydration, ketonuria, hypokalemia, loss of 5% or more of body weight
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29
Q

first line therapy drugs for nausea and vomiting in pregancy

A

Doxylamine plus vitamin B

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30
Q

drugs used in nasuea and vomiting in pregnancy

A

Doxylamine
- prochlorperazine, metoclopramide, and andoansetron

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31
Q

drugs for motion sickness

A

Scoplamine [Teansderm-V]

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32
Q

Scoplamine [Teansderm-V] side effect

A
  • dry mouth
  • blurred vision
  • drowsiness
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33
Q

Scoplamine [Teansderm-V] administration

A

transdermal patch

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34
Q

antihistamines
- Dimenhydrinate [gravol]
- meclizine [bonamine]
side effects

A
  • sedation
  • dry mouth, blurred vision, urinary retention, constipation
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35
Q

what is the most commonly used anti-emetic

A

dimenhydrinate

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36
Q

diarrhea causes

A
  • infection, maldigestion, inflammation, functional disorders of the bowel
37
Q

diarrhea complications

A

dehydration and electrolyte depletion

38
Q

what are the two major groups of antidiarrheals

A
  • specific antidiarrheal drugs
  • nonspecific antidiarrheal drugs
39
Q

opiods
- loperamide [imodium] is used for

A

diarrhea and to reduce the volume of discharge from ileostomies

40
Q

Nonspecific antidiarrheal agents

A
  • paregoric
  • opium tincture
  • bismuth subsalicylate [pepto bismol]
  • bulk forming agents (fibre)
  • anticholinergic antispasmodics (atropine)
41
Q

travellers diarrhea is mainly caused by

A

ingestion of food/beverages contaminated with pathogens
- escherichia coli

42
Q

escherichia coli

A
  • usually self limiting
  • symptoms include nausea and vomiting, fever, cramps
43
Q

travelers diarrhea treatment

A
  • ciprofloxacin
  • norfloxacin
  • bismuth subsalicylate
44
Q

IBS is characterized by

A

cramping and abdominal pain, nausea; bloating and heartburn

45
Q

IBS red flags

A
  • fever
  • weight loss over 10lbs
  • bleeding rectal / stools
  • new symptoms in clients under 50
  • severe symptoms
46
Q

IBS differential diagnosis

A
  • IBD
  • infectious diarrhea
  • colorectal polyp/cancer
  • CBC, ESR, CRP, Celiac stool occult blood
47
Q

what are the 4 groups of drugs used for IBS

A
  • antispasmodics
  • bulk forming agents
  • antidiarrheals
  • tricyclic antidepressants
48
Q

IBS cause

A

unknown casue

49
Q

Linaclotide [constella] use

A

IBS

50
Q

Linaclotide [constella] MOA

A
  • gaunylate cyclase agonist
  • induces intestinal and bicarbonate secretion resulting in increased intestinal motility
51
Q

Linaclotide [constella] adverse effect

A

diarrhea, abdominal pain

52
Q

Linaclotide [constella] dose

A

72-290mcg daily teken 30 mins before first meal of the day

53
Q

eluxadoline [viberzil] use

A

IBS-D in adults

54
Q

eluxadoline [viberzil] MOA

A

mixed mu opioid receptor agonist and delta antagonist

55
Q

eluxadoline [viberzil] adverse effects

A

Gi (constipation), dizziness, fatigue

56
Q

eluxadoline [viberzil] warnings

A

pancreatitis in glients without gullbladder

57
Q

eluxadoline [viberzil] dose

A

100 mg BID with food

58
Q

Inflammatory Bowel Disease (IBD)

A
  • crohns disease
  • ulcerative colitis
59
Q

crohns disease

A
  • characterized by transdermal inflammation
  • usually affects terminal ileum
  • severity diffrences: pain level, types of meds
60
Q

Ulcerative colitis

A
  • inflamamtion of mucosa and submucosa of the colon and rectum
  • may cause rectal bleeding
  • severity diffrences: <4 to >10 stools per day
61
Q

Drugs for IBD

A
  • 5 Aminosalicylates (sulfasalazine; 5-ASA)
  • glucocorticoids (hydrocortisone; prednisone)
  • immunosuppressant (azathioprine)
  • Immunomodulators (infliximab)
  • antibiotics
62
Q

5 aminosalicylates example

A

Sulfasalazine [Salazopyrin]

63
Q

Sulfasalazine [Salazopyrin] is used for

A

acute episodes of mild to moderate ulcerative colitis; also used during admission

64
Q

Sulfasalazine [Salazopyrin] adverse effects

A

nausea, fever, rash, hematological

65
Q

budesonide [entocort] is used for

A

mild to moderate crohns disease that involves the ileum and ascending colon

66
Q

prolonged use of glucocorticoids can cause

A

severe adverse effects, including adrenal suppression, osteoporosis, increased susceptibility to infection, and a cushingoid syndrome

67
Q

immunosuppressants example

A

Azathioprine [Imuran]

68
Q

Azathioprine [Imuran] is used for

A

induce and maintain remission in both ulcerative colitis and crohns disease

69
Q

Azathioprine [Imuran] adverse effects

A

pancreatitis and neutropenia

70
Q

immunomodulators examples

A

Infliximab [Remicade]

71
Q

Infliximab [Remicade] is used for

A

moderate to severe crohns disease and can be used for ulcerative colitis

72
Q

Infliximab [Remicade] adverse effects

A

infections, infusion reactions, increased risk of lymphoma

73
Q

antibiotics is crohns disease

A

can help control symptoms

74
Q

antibiotic use in ulcerative colitis

A

antibiotics largely ineffective

75
Q

antibiotics example

A
  • metronidazole [flagyl]
  • ciprofloxacin [cipro]
76
Q

metronidazole [flagyl]

A
  • long term therapy is required
  • prolonged use of high dose risk of peripheral neuropathy
77
Q

Ciprofloxacin [Cipro]

A

highly effective in patients with mild or moderate crohns disease

78
Q

prokinetic agents

A

increase tone and motility of GI tract
supress emesis

79
Q

prokinetic agents examples

A

Metoclopramide [Reglan, Maxeran]

80
Q

Metoclopramide [Reglan, Maxeran] uses PO

A

diabetic gastroparesis and suppression of gastroesophageal reflux

81
Q

Metoclopramide [Reglan, Maxeran] therapeutic uses IV

A

supression of postoperative nausea and vomiting, supression of CINV, faciliation of small bowel intubation and facilitation of radiologic examination of GI tract

82
Q

Metoclopramide [Reglan, Maxeran] adverse effects

A
  • high dose therapy: sedation, diarrhea common
  • long term high dose therapy: can cause irreversible tardive dyskinesia (TD)
83
Q

pancreatic enzymes is used for

A

deficency of digestive enzymes

84
Q

Pancrelipase mixture

A

lipase, amylases, and proteases prepared from hog pancreas

85
Q

pancreatic enzyme example

A

Pancrelipase

86
Q

Pancrelipase adverse effects

A

abdominal discomfort, flatulence, headache, diarrhea, cramping

87
Q

Pancrelipase administration

A

dose individually; taken with every meal and snack

88
Q

Anorectal preparations

A
  • symptomatic relief of hemorrhoids and other anorectal disorders
89
Q

anorectal preperations examples

A
  • local anesthetics (pramoxine)
  • anti inflammatory (hydrocortisone)
  • emollients (glycerin)
  • astringents (witch hazel)

HLST220: Pharmacology (46 decks)

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