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PHARMACOLOGY (2nd year) > DR. LEAL - GASTROINTESTINAL DRUGS > Flashcards

DR. LEAL - GASTROINTESTINAL DRUGS Flashcards

1
Q

Weak bases that react with gastric hydrochloric acid to form salt and water.

A

ANTACIDS

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2
Q

Reduce or neutralize gastric and peptic
acidity.

A

ANTACIDS

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3
Q

ADVERSE DRUG RXN OF ANTACIDS

A

CONSTIPATION

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4
Q

● Reacts rapidly with hydrochloric acid (HCl) to
produce carbon dioxide and sodium chloride.
● Gastric distention and belching; metabolic alkalosis;
fluid retention.

A

SODIUM BICARBONATE

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5
Q

● Less soluble and reacts more slowly than sodium
bicarbonate with HCl to form carbon dioxide and
calcium chloride (CaCl2).
● Belching or metabolic alkalosis

A

CALCIUM CARBONATE

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6
Q

● React slowly with HCl to form magnesium chloride
or aluminum chloride and water.
● Osmotic diarrhea; constipation; not given to
patients with renal insufficiency.
BRAND NAME MAALOX AND MAALOX PLUS

A

MAGNESIUM HYDROXIDE OR ALUMINUM HYDROXIDE

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7
Q

● Parietal cells have 3 receptors: M3, H2 for the attachment of Ach, and CCK-B receptors for the attachment of gastrin.
● Histamine 2 (H2) blockers block the attachment of histamine to the H2 receptors to be able not to reach the proton pump, therefore no HCl created.

A

H2-RECEPTORANTAGONISTS

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8
Q

○ Cimetidine
○ Ranitidine
○ Famotidine
○ Nizatidine

A

H2 BLOCKERS

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9
Q

HAS THE MOST EFFECTS H2 RECEPTOR ANTAGONIST

A

CIMETIDINE

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10
Q

● Inhibits binding of dihydrotestosterone to androgen receptors.
● Inhibits metabolism of estradiol, and increases serum prolactin levels.

A

CIMETIDINE

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11
Q

GYNECOMASTIA OR IMPOTENCE IN MEN
GAACTORRHEA IN WOMEN

A

PROLONGED USED OF CMETIDINE

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12
Q

MOST POTENT H2 RECEPTOR ANTAGONIST

A

FAMOTIDINE

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13
Q

○ Omeprazole
○ Esomeprazole
○ Lansoprazole
○ Dexlansoprazole
○ Rabeprazole
○ Pantoprazole

A

PROTON-PUMPINHIBITORS

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14
Q

● Called PRO DRUGS because they need activation in an acid environment such as the stomach.
● MOA: Irreversibly inhibit gastric parietal cells proton pump secretion.

A

PROTON PUMP INHIBITORS

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15
Q

ADVANTAGES
● Short serum half-life.
● Concentrated and activated near their site of action.
● Long duration of action. Hence, they are prescribed
(signatura) one tablet once a day 30 minutes before breakfast for two weeks.

A

PROTON PUMP INHIBITORS

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16
Q

USE OF PPI

A

GERD
PUD
NONULCER DYSPEPSIA
STRESS RELATED MUCOSAL BLEDING
GASTRINOMA

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17
Q

ACUTE INTERSTITIAL NEPHRITIS
DEMENTIA IF LONG TERM
SUBNORMAL B12 LEVELS
OSTEOPOROSIS
CLOSTRIDIUM DIFFICILE INFECTION

A

ADVERSE EFFECTS OF PPIs

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18
Q

DRUG INTERACTION OF PPI’S

Inhibit the metabolism of clopidogrel, warfarin, diazepam, and phenytoin.

A

OMEPRAZOLE

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19
Q

DRUG INTERACTION OF PPI’S

Decrease metabolism of diazepaM

A

ESOMEPRAZOLE

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20
Q

DRUG INTEACTION OF PPI’S

Enhance clearance of theophylline.

A

LANSOPRAZOLE

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21
Q

PROSTAGLANDIN ANALOGS

○ Methyl analog of PGE1.
○ Administered 3-4x daily if used as mucosal
protective agent. But if used as an abortifacient, they can use up to 10 tablets inserted in the vagina.

A

MISOPROSTOL

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22
Q

FOUR-DRUG REGIMENS FOR ERADICATION OF H. PYLORI INFECTION

A
  1. PPI2xaday
  2. Bismuth subsalicylate (2 tablets; 262 mg each)
  3. Tetracycline (500 mg)
  4. Metronidazole (500 mg)
    ○ Taken 4x daily for 10-14 days.
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23
Q

FOUR-DRUG REGIMENS FOR ERADICATION OF H. PYLORI INFECTION

A
  1. PPI2xaday
  2. 3 capsules of a combination (each capsule containing Bismuth subsalicylate 140 mg
    Metronidazole 125 mg
    Tetracycline 125 mg
    ○ Taken 4x daily for 10-14 days.
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24
Q

Extrinsic innervation of the digestive tract is made up of the

A

sympathetic AND parasympathetic system (via the vagus nerve and the pelvic nerve

SC- SYMPATHETIC - CRANIOSACRAL
PT - PARASYMPATHETIC - THORACOLUMBAR

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25
Q

specialized, spindle-shaped cells located in the gut wall that function as pacemaker cells and help regulate slow-wave peristalsis of the gut

A

Interstitial cells of Cajal (ICCs)

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26
Q

Controlling muscle activity along the length of the
gut with specific effects:
○ Increased muscle tone
○ Increased intensity of the rhythmical
contractions
○ Increased velocity of conduction of excitatory waves along gut wall, causing more rapid movement of gut peristaltic waves.

A

MYENTERIC PLEXUS
AUERBACH’S PLEXUS

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27
Q

Composed of excitatory as well as an inhibitory neuron.

A

MYENTERIC PLEXUS
AUERBACH’S PLEXUS

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28
Q

● Controlling function within the inner wall of each minute segment of intestine such as:
○ Local intestinal secretion
○ Local absorption
○ Local contraction of submucosal muscle
that causes various degrees of infolding of
GI mucosa.

A

SUBMUCOSAL PLEXUS
MEISSNER PLEXUS

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29
Q

● Composed mainly of excitatory neurons.

A

SUBMUCOSAL PLEXUS
MEISSNER PLEXUS

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30
Q

○ Increase esophageal peristaltic amplitude.
○ Increase lower esophageal sphincter
pressure.
○ Enhance gastric emptying.
○ No effect on small intestine or colonic
motility.

A

METOCLOPRAMIDE AND DOMPERIDONE
Dopamine D -receptor Antagonists

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31
Q

Also block dopamine D2 receptors in the
chemoreceptor trigger zone of the medulla (area postrema), resulting in potent antinausea and antiemetic action.

A

METOCLOPRAMIDE AND DOMPERIDONE
Dopamine D -receptor Antagonists

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32
Q

CLINICAL USES
● Gastroesophageal Reflux Disease ● Impaired gastric emptying
● Nonulcer dyspepsia
● Prevention of vomiting
● Postpartum lactation stimulation

A

METOCLOPRAMIDE AND DOMPERIDONE
Dopamine D -receptor Antagonists

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33
Q

ADVERSE EFFECTS
● Extrapyramidal effects (dystonias, akathisia,
parkinsonian features) due to central dopamine
receptor blockade.
● Elevated prolactin levels.

A

METOCLOPRAMIDE AND DOMPERIDONE
Dopamine D -receptor Antagonists

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34
Q

● Stimulate muscarinic M3 receptors on muscle
cells and at myenteric plexus synapses.
● Multiple cholinergic effects.

A

BETHANECHOL

CHOLINOMIMETICAGENTS

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35
Q

● Acetylcholinesterase inhibitor.
○ Acetylcholine increases since the degrading enzyme is inhibited.
● Enhance gastric, small intestine, and colonic emptying.
● Acute Colonic Pseudo-obstruction or Ogilvie’s syndrome.

A

NEOSTIGMINE
CHOLINOMIMETICAGENTS

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36
Q

● Stimulate motilin receptors.
● Gastroparesis: 3 mg/kg.
● Upper gastrointestinal bleeding (UGIB): promote
gastric emptying of blood before endoscopy.

A

ERYTHROMYCIN
MACROLIDES

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37
Q

● Indigestible, hydrophilic colloids that absorb water, forming a bulky, emollient gel that distends the colon and promotes peristalsis.
● Examples:
○ Psyllium
○ Methylcellulose
○ Polycarbophil

A

BULK-FORMINGLAXATIVES

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38
Q

Examples:
○ Docusate (oral or enema)
○ Glycerin suppository
○ Mineral oil
● Long-term use can impair absorption of fat-soluble vitamins (A,D,E,K).

A

STOOLSURFACTANTAGENTS (SOFTENERS)

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39
Q

● Soluble but non-absorbable compounds that result in increased stool liquidity due to an obligate increase in fecal fluid.

A

OSMOTICLAXATIVES

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40
Q

Examples:
○ Non Absorbable Sugars or Salts
- Magnesium hydroxide (milk of
magnesia)
- Sorbitol and lactulose
- Magnesium citrate, sulfate
solution
- Sodium phosphate
○ Balanced Polyethylene Glycol

A

OSMOTICLAXATIVES

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41
Q

● Aloe, Senna, and Cascara
● Occur naturally in plants.
● Poorly absorbed and after hydrolysis in the colon
● “Melanosis coli”

A

STIMULANTLAXATIVES/CATHARTICS

ANTHRAQUINONE DERIVATIVES

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42
Q

Bisacodyl: dulcolax (brand name).
● Induces a bowel movement within 6-10 hours when
given orally and 30-60 minutes when taken
rectally.
● Safe for acute and long-term use.

A

DIPHENYLMETHANE DERIVATIVES

STIMULANTLAXATIVES/CATHARTICS

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43
Q

● Prostanoic acid derivative labeled for use in chronic
constipation and irritable bowel syndrome (IBS)
with predominant constipation.

A

LUBIPROSTONE

CHLORIDESECRETIONACTIVATORS

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44
Q

increases chloride-rich fluid secretion into the intestine, which stimulates intestinal motility and shortens intestinal transit time.

A

LUBIPROSTONE

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45
Q

● Minimally absorbed, short amino acid peptides
● Stimulate intestinal chloride secretion by binding to and activating guanylate cyclase-C on the luminal surface that leads to increased intracellular and extracellular cGMP

A

LINACLOTIDE AND PLECANATIDE

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46
Q

can decrease motility of the intestine, leading to constipation.
● Commonly in post-cesarean patients.

A

OPIOID RECEPTOR ANTAGONISTS

EX.METHYLNALTREXONE BROMIDE

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47
Q

OPIOID RECEPTOR ANTAGONISTS

● Orally within 5 hours before surgery and twice
daily after surgery until bowel function has recovered, but for no more than 7 days.

A

ALVIMOPAN

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48
Q

high affinity for 5-HT4 receptors

● Approved for the treatment of patients with chronic
constipation AND IBS WITH PREDOMINANTSconstipation

A

TEGASEROD
SEROTONIN 5-HT4-RECEPTOR AGONISTS

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49
Q

SEROTONIN 5-HT4-RECEPTOR AGONISTS

treatment of chronic constipation
in women.

A

PRUCALOPRIDE

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50
Q

● An opioid but nonprescription opioid agonist.
● Does not cross the blood-brain barrier and has no analgesic properties or potential for addiction

A

LOPERAMIDE
OPIOD AGONISTS

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51
Q

● Prescription opioid agonist that has no analgesic properties in standard doses.
● Higher doses have CNS effects.
● Prolonged use can lead to opioid dependence.

A

DIPHENOXYLATE
OPIOD AGONIST

52
Q

● Prescription opioid agonist with high affinity for the
mu receptor (as well as low affinity for the delta
receptor).
● When taken orally, it binds to gut opioid receptors,
resulting in :
—slower colonic transit
—increased fecal fluid absorption.
● Approved for diarrhea-predominant IBS at a dose of 75-100 mg twice daily.

A

ELUXADOLINE
OPIOD AGONISTS

53
Q

Conjugated bile salts are normally absorbed in the terminal ileum.
● Crohn’s disease (disease of the terminal ileum) or surgical resection leads to malabsorption of bile salts, which may cause colonic secretory diarrhea.

A

BILESALT-BINDING RESINS

54
Q

Adverse Effects:
○ Bloating
○ Flatulence
○ Constipation
○ Fecal impaction
○ Exacerbation of fat malabsorption

A

BILESALT-BINDING RESINS

55
Q

___ & ___bind a number of drugs and reduce their absorption; hence, they should not be given within 2 hours of other drugs.

A

Cholestyramine and colestipol

56
Q

14-amino-acid peptide that is released in the GIT and pancreas from paracrine cells, D cells, and enteric nerves as well as from the hypothalamus.

A

SOMATOSTATIN

57
Q
  • INHIBITS SECRETION OF NUMEROUS HORMONES
  • REDUCES INTESTINAL FLUID SECRETION AND PANCREATIC
  • SLOWS GI MOTILITY
  • INHIBITS GALLBLADDER CONTRACTION
  • REDUCES PORTAL AND SPLANCHNIC BLOOD FLOW
  • INHIBITS SECRETION OF ANT. PIT. HORMONES
A

SOMATOSTATIN

58
Q

Synthetic octapeptide with actions similar to
somatostatin.

A

OCTREOTIDE

59
Q
  1. Inhibition of gastrointestinal neuroendocrine tumors (carcinoid, VIPoma) symptoms.
  2. Effective in diarrhea due to vagotomy or dumping syndrome; short bowel syndrome or AIDS.
A

OCTREOTIDE

60
Q
  1. Carcinoid and VIPoma cause secretory diarrhea and systemic symptoms such as flushing and wheezing.
  2. Inhibits intestinal secretion and has dose-related effects on bowel motility.
A

OCTREOTIDE

61
Q
  1. STEATORRHEA
  2. ALTERATIONS IN GI MOTILITIY
  3. SLUDGE OR GALLSTONES (ACUTE CHOLECYSTITIS)
  4. ALTERS BALANCE AMONG INSULIN AND GLUCAGON
  5. HYPOTHYROIDISM
  6. BRADYCARDIA
A

ADVERSE EFFECTS OF OCTREOTIDE

62
Q

● Idiopathic chronic, relapsing disorder.
● Abdominal discomfort (pain, bloating, distention,
or cramps) in association with alterations in bowel
habits (diarrhea, constipation, or both)

A

IRRITABLE BOWEL SYNDROME

63
Q

● Episodes of abdominal pain or discomfort, patients note a change in the frequency or
consistency of their bowel movements.
● Abnormal contractions in the large intestine.

A

IRRITABLE BOWEL SYNDROME

64
Q

● Inhibit muscarinic cholinergic receptors in the
enteric plexus (Auerbach) and on smooth muscle
(Miesner).

A

DICYCLOMINE and HYOSCYAMINE

65
Q

ANTISPASMODICS (ANTICHOLINERGICS

Most commonly in pediatric patients.

A

DICYCLOMINE and HYOSCYAMINE

66
Q

○ Dry mouth
○ Visual disturbances
○ Urinary retention
○ Constipation

A

Anticholinergic effects:

67
Q

● Antiemetic drugs used in chemotherapy but not in motion sickness. Chemotherapy can induce vomiting.

A

ALOSETRON

SEROTONIN5HT3-RECEPTOR ANTAGONISTS

68
Q

● Treatment of patients with severe IBS with diarrhea.

A

ALOSETRON

69
Q

CONSTIPATION
ISCHEMIC COLITIS

A

ALOSETRON ADVERSE EFFECTS

70
Q

● Prevention and treatment of nausea and vomiting.
● Potent antiemetic properties that are mediated in
part through central 5-HT3 receptor blockade in the
vomiting center and chemoreceptor trigger zone

● Do not inhibit dopamine or muscarinic receptors.
● Do not have effects on esophageal or gastric motility
but may slow colonic transit.

A

-SETRON

ONDANSETRON, GRANISETRON, DOLASETRON, AND PALONOSETRON

71
Q

Clinical Uses
1. Chemotherapy-induced vomiting

  1. Postoperative and Post-radiation nausea
    and vomiting.
A

-SETRONS
SEROTONIN 5HT3-RECEPTOR ANTAGONISTS

72
Q

prevention of acute and delayed nausea and vomiting in patients receiving moderately to highly emetogenic chemotherapy
regimens.

A

DEXAMETHASONE
METHYLPREDNISOLONE

73
Q

● Antiemetic properties that are mediated through central blockade in the area postrema.
● No affinity for serotonin, dopamine, or corticosteroid receptors.

A

APREPITANT, NETUPITANT, ROLAPITANT AND FOSAPREPITANT

NEUROKININ RECEPTOR ANTAGONISTS

74
Q

● Used in combination with 5-HT3-receptor antagonists and corticosteroids for the prevention of acute and delayed nausea and vomiting from highly emetogenic chemotherapeutic regimens.
This combination is also used for prevention of irritable bowel syndrome.

A

APREPITANT, NETUPITANT, ROLAPITANT AND FOSAPREPITANT

75
Q

decreases the incidence of acute and delayed nausea and vomiting with highly emetogenic chemotherapeutic regimens by 15–30%.

A

OLANZAPINE

76
Q

For patients unable to tolerate oral therapy, IV _________ 115 mg may be given as a single intravenous dose 1 hour before chemotherapy.

A

FOSAPREPITANT

77
Q

ADVERSE EFFECT AND DRUG INTERACTIONS
- WEL TOLERATED
- LOW INCIDENCE OF FATIGUE AND DIZZINESS
- INHIBIT METABOLISMOF OTHER DRUGS
- DECREASES THE INR IN PATIENTS TAKING WARFARIN

A

APREPITANT, NETUPITANT, ROLAPITANT AND FOSAPREPITANT

NEUROKININ RECEPTOR ANTAGONISTS

78
Q

used in the treatment of irritable bowel syndrome.

A

ANTIPSYCHOTIC AGENTS

PHENOTHIAZINES
● Prochlorperazine, Promethazine, and
Thiethylperazine

BUTYROPHENONES
● Droperidol

THIENOBENZODIAZEPINE
● Olanzapine

79
Q

● Antiemetic properties are mediated through
inhibition of dopamine and muscarinic receptors.
● Sedative properties are due to their antihistamine
activity.

A

PHENOTHIAZINES
● Prochlorperazine, Promethazine, and
Thiethylperazine

80
Q

● Antipsychotic, also possess antiemetic properties due to their central dopaminergic blockade.
● Extrapyramidal effects and hypotension may occur.
● May prolong the QT interval.

A

BUTYROPHENONES
● Droperidol

81
Q

● Antiemetic properties may be attributable to inhibition of dopamine D2 and serotonin 5-HT1c and 5-HT3 receptors.

A

THIENOBENZODIAZEPINE
● Olanzapine

82
Q

● Primary mechanism of antiemetic action is believed to be dopamine-receptor blockade.

A

F. SUBSTITUTED BENZAMIDES

83
Q

Adverse effects:
○ Extrapyramidal: restlessness, dystonias,
and Parkinsonian symptoms.

A

SUBSTITUTED BENZAMIDES

84
Q

For prevention and treatment of nausea and vomiting: 10–20 mg orally or IV every 6 hours.

A

METOCLOPRAMIDE

85
Q

● Has weak antihistaminic activity.
● 300 mg orally, or 200 mg by IM injection.

A

TRIMETHOBENZAMIDE

86
Q

● Weak antiemetic activity.
● Useful for the prevention or treatment of motion
sickness.
● Use may be limited by dizziness, sedation,
confusion, dry mouth, cycloplegia, and urinary retention.

A

H1 ANTIHISTAMINES & ANTICHOLINERGIC DRUGS

87
Q

Sedating properties, used in conjunction with other antiemetics for treatment of emesis due to chemotherapy.

A

FIRST-GENERATION H1 ANTAGONISTS ● Diphenhydramine

88
Q

○ Minimal anticholinergic properties that
also cause less sedation.
○ Used for the prevention of motion
sickness and the treatment of vertigo due to labyrinth dysfunction.

A

Dimenhydrinate Meclizine

89
Q

○ Prototype of antihistamine and anticholinergic drugs.
○ Best agents for the prevention of motion sickness.
○ Very high incidence of anticholinergic effects when given orally or parenterally
○ Better tolerated as a transdermal patch.

A

MUSCARINIC RECEPTOR ANTAGONIST ● Hyoscine (Scopolamine)

90
Q

treatment of IBDs.
● Differs from salicylic acid only by the addition of an amino group at the 5 (meta) position.

A

SULFASALAZINE, OLSALAZINE, BALSALAZIDE AND MESALAMINE

91
Q
  • FIRST LINE AGENT FOR TREATMENTOF MILD TO MODERATE ACTIVE ULCERATIVE COLITIS
  • FIRST LINE THERAPY FOR MILD TO MODERATE DISEASE INVOLVING COLON AND DISTAI ILEUM
A

SULFASALAZINE, OLSALAZINE, BALSALAZIDE AND MESALAMINE

92
Q

contains timed-release
microgranules that release 5-ASA throughout the small intestine

A

Mesalamine Compounds
○ Pentasa

93
Q

have 5-ASA coated in a pH-sensitive resin that dissolves at pH 6–7 (the pH of the distal ileum and proximal colon).

A

Asacol and Apriso:

94
Q

uses a pH-dependent resin that encases a multimatrix core; on dissolution of the pH-sensitive resin in the colon, water slowly penetrates its hydrophilic and lipophilic core, leading to slow release of mesalamine throughout the colon.

A

LIALDA

95
Q

delivered in high concentrations to the rectum and sigmoid colon by means of enema formulations.

A

ROWASA

96
Q

suppository

A

CANASA

97
Q

Treatment of patients with moderate to severe active IBD.

A

GLUCOCORTICOIDS

98
Q

oral controlled-release formulationS

A

BUDESONIDE

99
Q

● Purine antimetabolites that have immunosuppressive properties.
● Important agents in the induction and maintenance of remission of ulcerative colitis and Crohn’s disease.

A

AZATHIOPRINE AND 6-MERCAPTOPURINE (6-MP)

100
Q

ADVERSE EFFECT
- BONE MARROW SUPPRESSION
- HEPATIC TOXICITY

A

PURINE ANALOGS
AZATHIOPRINE AND 6-MERCAPTOPURINE(6-MP)

101
Q

cannot be used together because it will lead to leukopenia.

A

ALUPURINOL ABD AZATHIOPRINE

102
Q

INSTEAD OF ALLUPURINOL IN COMBI WITH AZATHIOPRINE
USE:

A

FEBUXOSTAT

103
Q

● Used to induce and maintain remission in patients with Crohn’s disease.

A

METHOTREXATE

104
Q

Inhibition of dihydrofolate reductase, an
enzyme important in the production of
thymidine and purines.

A

METHOTREXATE

105
Q

○ High doses: used for chemotherapy,
methotrexate inhibits cellular
proliferation.
○ Low doses: treatment of IBD (12–25
mg/wk).

A

METHOTREXATE

106
Q

A dysregulation of the helper T cell type 1 (Th1) response and regulatory T cells (Tregs) is present in IBD, especially Crohn’s disease.

A

ANTITUMORNECROSISFACTOR THERAPY

107
Q

Four monoclonal antibodies to human TNF are approved for the treatment of IBD:

A

(I-A-G-C)
○ Infliximab
○ Adalimumab
○ Golimumab
○ Certolizumab

108
Q

Adverse effects
○ Infection due to suppression of the Th1
inflammatory response.

A

ANTITUMOR NECROSIS FACTOR THERAPY

109
Q

family of adhesion molecules on the surface of leukocytes that may interact with another class of adhesion molecules on the surface of the vascular endothelium known as selectins.

A

INTEGRINS

110
Q

monoclonal antibodies directed against integrins are available for the treatment of IBD.

A

NATALIZUMAB
VEDOLIZUMAB

111
Q

○ Humanized IgG 4 monoclonal antibody targeted only against the α4 subunit.
○ Blocks several integrins on circulating inflammatory cells

A

NATALIZUMAB

112
Q

○ Humanized IgG 4 monoclonal antibody targeted only against the α4 subunit.
○ Blocks several integrins on circulating inflammatory cells

A

VEDOLIZUMAB

113
Q

● Most commonly caused by cystic fibrosis, chronic pancreatitis or pancreatic resection.
● Fat and protein digestion is impaired when secretion of pancreatic enzymes falls below 10% of normal.
● Can lead to steatorrhea, azotorrhea, vitamin malabsorption, and weight loss.

A

EXOCRINEPANCREATIC INSUFFICIENCY

114
Q

● Administered with each meal and snack.
● Dosing should be individualized according to the age and weight of the patient, the degree of pancreatic insufficiency, and the amount of
dietary fat intake

A

PANCREALIPASE

115
Q

SHORT BOWEL SYNDROME
BIRTH -
ADULT -

A

BIRTH - (200-250 CM)
ADULT - (300-800 CM)

116
Q

IN SHORT BOWEL SYNDROME
CM IF WITH ILEOCECAL VALVE
CM IF WITHOUT ILEOCECAL VALVE

A

WITH - 15 CM
WITHOUT - 20 CM

117
Q

CONGENITAL SHORT BOWELSYNDROME

A

CIG
C- CONGENITAL SHORT BOWEL
I- INTESTINAL ATRESIA
G- GASTROSCHISIS

118
Q

Binds to enteric neurons and endocrine cells,
stimulating release of a number of trophic hormones (including insulin-like growth factor) that stimulate mucosal epithelial growth and enhance fluid absorption.

A

TEDUGLUTIDE

119
Q

● <10 cm gallstones only.
● Decreases the cholesterol content of bile by reducing hepatic cholesterol secretion.
● Used for dissolution of small cholesterol gallstones.

A

URSODIOL (URSODEOXYCHOLIC ACID)

120
Q

● First-line agent used for the treatment of early primary biliary cirrhosis (PBC).

A

URSODIOL (URSODEOXYCHOLIC ACID)

121
Q

● Reduces portal blood flow and variceal pressures.
● Activity may be mediated through inhibition of release of glucagon and other gut peptides that
alter mesenteric blood flow.

A

SOMATOSTATIN
OCTREOTIDE

122
Q

○ Polypeptide hormone secreted by the
hypothalamus and stored in the posterior pituitary (oxytocin and vasopressin are stored in this part).
○ Potent arterial vasoconstrictor.

A

VASOPRESSIN

123
Q

Vasopressin analog.

A

TERLIPRESSIN

124
Q

Reduce portal venous pressures via a decrease in
portal venous inflow.
● Due to a decrease in cardiac output (β1
blockade) and to splanchnic vasoconstriction (β2 blockade) caused by the unopposed effect of systemic catecholamines on α receptors.

A

β-RECEPTORBLOCKINGDRUGS

125
Q

Nonselective β blockers such as ____ & ____ are more effective than selective β1 blockers in reducing portal pressures.

A

PROPANOLOL
NADOLOL

PHARMACOLOGY (2nd year) (18 decks)

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