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Pharmacology > Drugs acting on the Gastrointestinal Tract > Flashcards

Drugs acting on the Gastrointestinal Tract Flashcards

0
Q

What are the rings of muscle called that prevent the stomach contents going back up into the oesophagus, or into the small intestine?

A

Lower oesophageal sphincter

Pyloric sphincter

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1
Q

What 5 elements/organs of the digestive system can drugs target?

A 
Oesophagus
Stomach
Small Intestine
Large Intestine
Rectum
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2
Q

What are the regions called that secrete gastric juices, including pepsin, hydrochloric acid, mucous and intrinsic factor?
FSCP

A

Fundus
Stomach Body
Cardia
Pylorus

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3
Q

What are indigestion, Gastro-Oesophageal Reflux Disorder and ulcers examples of?

A

Upper Gastrointestinal Tract Disorders

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4
Q

Name 3 Upper GI Tract Disorders:

GIU

A

Indigestion
Gastro-Oesophageal Reflux Disorder (GORD)
Ulcers

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5
Q

What disorder has the symptoms of discomfort or pain in the stomach, bloating, burping and nausea and heartburn?

A

Indigestion/dyspepsia

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6
Q

What can overeating (spicy food, alcohol and smoking), pregnancy, ulcers and anxiety/stress cause?

A

Dyspepsia/indigestion and GORD

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7
Q

What is dyspepsia?

A

Indigestion

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8
Q

What are the main symptoms of GORD?

A

Heartburn (pain in the middle of chest) and sour mouth (contents of stomach coming back up)

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9
Q

What does GORD stand for?

A

Gastro-oesophageal reflux disorder

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10
Q

What disorder has the symptoms of heart burn and sour mouth?

A

GORD

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11
Q

Overeating, pregnancy, ulcers and anxiety/stress can cause GORD. What other main cause is there?

A

Certain drugs

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12
Q

What are areas called where damage has occurred to the mucosal membrane of the oesophagus, stomach or duodenum?

A

Ulcers

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13
Q

Ulcers are damage to the mucosal membrane of where?

SOD

A

Oesophagus
Stomach
Duodenum

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14
Q

What are pain and bleeding in stools symptoms of?

A

Ulcers

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15
Q

Bacterial infection (H.pylori), NSAIDs, smoking, Zollinger-Ellison Syndrome and anxiety/stress can cause what?

A

Ulcers

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16
Q

What are the main causes of ulcers?

BANSZ

A 
Bacterial infection (H.pylori)
NSAIDs
smoking
Zollinger-Ellison Syndrome
anxiety/stress
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17
Q

What are the 3 drug groups administered for indigestion, GORD and ulcers?
AAA

A

Antacids
Anti secretory drugs and mucosal protectants
Antibiotics (just for ulcers)

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18
Q

Antibiotics are just given to treat ulcers. What can antacids and anti secretory drugs & mucosal protectants used to treat?

A

Ulcers
GORD
dyspepsia

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19
Q

What are Histamine H2 antagonists, proton pump inhibitors, chelates & complexes and prostaglandin analogues examples of?

A

Anti secretory drugs/mucosal protectants

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20
Q

What is the mechanism of action for antacids?

A

They act locally to neutralise acid in the stomach - the reduction in acid pH decreases pepsin activity

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21
Q

What type of drug acts locally to neutralise acid in the stomach?

A

Antacids

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22
Q

Antacids are administered in what form?

A

Tablets or liquids

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23
Q

What do all antacids contain?

CAM

A

Calcium
Aluminium
Magnesium Salts e.g. Maalox, Rennies

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24
Q

What do antacids such as asilone and altacite plus, which alter the surface tension of small bubbles of gas to allow the formation of large bubbles that can be got rid of contain?

A

Simeticone

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25
Q

What is the mechanism of action of antacids containing simeticone?

A

Small bubbles to large bubbles by altering surface tension

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26
Q

Antacids like gaviscon react with gastric juices to form a floating raft that protects the oesophagus from stomach contents. What do they contain?

A

Alginates

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27
Q

How do antacids with alginates work?

A

Form a raft, protecting the oesophagus

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28
Q

What is important to remember about taking antacids in relation to food and other oral medication?

A

1 hour gap for food (before or after)

2 hour gap for other meds

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29
Q

Why do we give aluminium and magnesium together in antacids?

A

Aluminium can cause constipation and magnesium can cause diarrhoea

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30
Q

When giving antacids you should monitor for electrolyte imbalance and give low sodium/sugar-free versions where appropriate. What advice can we give patients when sleeping?

A

Sleep on left side or with head/shoulders propped up

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31
Q

What are cimetidine, famotidine, nizatidine and ranitidine examples of?

A

H2 Receptor Antagonists

DINE

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32
Q

What is the mechanism of action for H2 receptor antagonists?

A

They block H2 receptors on parietal cells in the stomach and reduce acid production in the stomach

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33
Q

What type of drug blocks H2 receptors on parietal cells in the stomach and reduces acid production in the stomach?

A

H2 Receptor Antagonists

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34
Q

What are lansoprazole, esomeprazole, omeprazole, pantoprazole and rabeprazole examples of?

A

Proton Pump Inhibitors

35
Q

What do Proton Pump Inhibitors end in?

A

prazole

36
Q

What is the mechanism of action of Proton Pump Inhibitors?

A

When in acidic PH they form 2 reactive molecules, and then bind permanently to the proton pump so it never works again

37
Q

What types of drug form 2 reactive molecules in an acidic PH, then bind permanently to the proton pump so it never pumps again?

A

Proton Pump Inhibitors

38
Q

What types of drugs work quickly (within the hour), cannot be taken within 2 hours of antacids, are usually taken at bedtime and can be affected by drinking/smoking/diet that inhibit acid secretion?

A

H2 Antagonists

39
Q

What type of drug that reduces acid secretion may result in blood in stools, dizziness and headaches?

A

H2 Antagonists

40
Q

What type of H2 antagonist may retard the liver metabolism of some drugs such as warfarin etc, meaning we require medication history?

A

Cimetidine

41
Q

Proton Pump Inhibitors must be given 30 minutes before food and should not be chewed or crushed. They may interfere with the metabolism of drugs like warfarin and diazepam. What drugs may they affect the absorption of?

A

Digoxin

42
Q

When should you take Proton Pump Inhibitors?

A

30 minutes before food

43
Q

What is the name of a gram negative bacteria that causes inflammation of the stomach lining and can cause ulcers?

A

H.pylori

44
Q

H.pylori is treated by 2 antibiotics and acid secretion reduction (PPI or H2antagonist. What is this called?

A

Triple Therapy

45
Q

What are clarythromycin and amoxycillin examples of?

A

Antibiotics

46
Q

Which antibiotic can you not give to someone with a penicillin allergy?

A

Amoxycillin

This can also cause diarrhoea

47
Q

In triple therapy, what can cause GI upset?

A

Antibiotics.

Some can also not be taken with alcohol or can cause abnormal tastes

48
Q

What drug is used to treat NSAID induced ulcers?

A

Misoprostol

49
Q

What is the mechanism of action of Misoprostol?

A

It is a synthetic prostaglandin - preventing acid production and stimulating mucous release

This is needed as NSAID ulcers inhibit cox1 which produces this

50
Q

Who can you not give misoprostal to?

A

Pregnant women - it can cause spontaneous labour/abortion

51
Q

How does sucralfate treat ulcers?

A

It reacts with acid to form a sticky paste, which coats the ulcer

52
Q

How long does sucralfate last for?

A

6 hours

53
Q

What is the site of action for antispasmodics?

A

The intestine

54
Q

What type of drug reduces gut motility by relaxing smooth muscle?

A

Antispasmodics

55
Q

What drugs are used to treat IBS and diverticular disease?

A

Antispasmodics

56
Q

What are dicyclomine hydrochloride, hyoscine butyl-bromide and probantheline bromide examples of?

A

anti-muscarinics/antispasmodics

57
Q

What can help with smooth muscle contraction?

A

Peppermint oil, aleverine citrate and mebeverine hydrochloride

58
Q

You should take caution giving anti muscarinics to the elderly as they may cause confusion. What other side effects do they have?

A

Constipation and dry mouth

59
Q

What is the site of action for propellants/gut motility stimulants?

A

The intestine and stomach sphincters

60
Q

What type of drug’s mechanism of action works as a dopamine receptor antagonist, increasing peristalsis, relaxing the pyloric sphincter and increasing the oesophageal sphincter?

A

Propellants/Gut motility stimulants

61
Q

What receptor do gut motility stimulants work on?

A

Dopamine

62
Q

What are metoclopramide and domperidone examples of?

(They are used to treat nausea/vomiting, IBS and dyspepsia/reflux…

A

Gut motility stimulants/propellants

63
Q

Why should you not use metoclopramide in elderly or children?
(This is a Gut motility stimulant)

A

Side effects are movement disorders, confusion and restlessness

64
Q

Name 2 lower GI Tract Disorders

A

Constipation and Acute Diarrhoea

65
Q

Everyone has different bowel patterns, but what influences everyones pattern?

A

What you eat and fluid intake

66
Q

What usually causes acute diarrhoea?

A

Infection from poor hygiene or food poisoning

67
Q

What is the first line treatment for diarrhoea?

A

Oral Rehydration Therapy

68
Q

What are dioralyte and electrolade examples of?

A

Oral Rehydration Therapy

69
Q

What is the site of action for antidiarrhoeals?

A

Small and large intestine

70
Q

What drug contains glucose, water and electrolytes lost, stimulates absorption of water and electrolytes, and should be drank in small sips over a period of time?

A

Oral Rehydration Therapy

71
Q

What are loperamide, co-phenotrope and morphine examples of?

A

Antidiarrhoeals

72
Q

Opioid related drugs decrease peristalsis in the small and large intestine and decrease explosive contractions in the colon.
What are they?

A

Antidiarrhoeals

73
Q

What drugs have the side effects of nausea and vomiting, constipation, drowsiness, abdominal discomfort and a fast heart rate?

A

Antidiarrhoeals

74
Q

When administering Antidiarrhoeals you should monitor for GI reactions, CNS effects and electrolyte balance and fluid intake.
What should they not really be taken with?

A

Alcohol, some pain killers and sedatives - which have the opposite effect

75
Q

What are the 3 types of laxative?

BOS

A

Bulk forming
Stimulant
Osmotic

76
Q

Bulk forming laxatives take a few days to work and require a certain amount of fluid. How do they work?

A

Increasing faecal mass to stimulate peristalsis

77
Q

When are you likely to use a bulk forming laxative?

A

During pregnancy or before a colostomy/ileostomy

78
Q

What are ispaghula husk, methylcellulose and sterculla examples of?

A

Bulk forming laxatives

79
Q

Stimulant laxatives have rapid action 6-12 hours and can cause cramps and abdominal pain.
How do they work and why should they only be used in acute cases?

A

They increase peristalsis moving stool through the large intestine. Take them at bedtime so poo in the morning.
They can cause lazy bowel.

80
Q

What are bisacodyl, dantron, senna and sodium picosulfate examples of?

A

Stimulant Laxatives

81
Q

Osmotic laxatives can be rapid or take up to a couple of days to work. They require a certain amount of fluid and cannot be used by lactose intolerant people.
How do they work?

A

They are made up of large sugars/magnesium and sodium salts that are not soluble and draw water into the gut.
The water makes the stools softer and easier to pass

82
Q

Name a rapidly acting osmotic laxative that is administered rectally as an enema:

A

phosphates and sodium salts

p and s = poo and shit

83
Q

Which osmotic laxatives take a couple of days to work?

A

Lactulose and Macrogols

84
Q

Which sodium salts administered orally are rapid acting?

A

Magnesium salts

85
Q

What type of laxative has side effects of abdominal cramps, wind and diarrhoea?

A

Osmotic Laxatives

86
Q

When should you not give laxatives?

A

When nausea or vomiting is present and when the situation is not acute

Pharmacology (13 decks)

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