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Gastrointestinal > Drugs Affecting the Gastrointestinal System > Flashcards

Drugs Affecting the Gastrointestinal System Flashcards

1
Q

What are some causes of peptic ulcers?

A

H. pylori, NSAIds, smoking, caffeine, alcohol, glucocorticosteroids, bile

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2
Q

Why are prostaglandin E2 and I2 protective against ulcers?

A

The stimulate secretion of mucus and bicarbonate and increase mucosal blood flow to remove stray H+ ions

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3
Q

What is the action of H2 receptor antagonists?

A

Block effects of gastrin, acetylcholine and histamine on parietal cells

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4
Q

How do parietal cells secrete acid?

A

With a proton pump which exchanges H+ for K+ with an ATPase

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5
Q

What is omeprazole?

A

A proton pump inhibitor

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6
Q

What is esomeprazole?

A

A proton pump inhibitor

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7
Q

What is ranitidine?

A

An H2 receptor antagonist

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8
Q

What is magnesium hydroxide?

A

An antacid - used to neutralise stomach acid

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9
Q

What is a contraindication of antacids?

A

Kidney problems

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10
Q

What are some side effects of antacids?

A

diarrhoea and constipation

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11
Q

Why do antacids cause rebound acidity?

A

Because they stimulate gastrin release

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12
Q

What are cytoprotective agents?

A

They coat the ulcer site to protect it from the acid

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13
Q

What is hyoscine butylbromide?

A

a muscarinic receptor antagonist - to reduce motility

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14
Q

What is mebeverine?

A

a non specific muscle relaxant

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15
Q

What is misoprostol?

A

A synthethetic prostaglandin E analogue - to increase mucus secretion and mucosal blood flow and decrease acid secretion

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16
Q

What the contraindication of misoprostol?

A

Pregnancy - will induce motility in uterus and cause an abortion

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17
Q

What are other side effects of misoprostol?

A

colic and diarrhoea

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18
Q

What are two inputs to the vomiting centre?

A

the chemoreceptor trigger zone and the vestibular apparatus

19
Q

What are the receptors for the chemoreceptor trigger zone to the vomiting centre?

A

D2 receptors and 5HT3 receptors

20
Q

What are the receptors for the vestibular apparatus to the vomiting centre?

A

H1 receptors and muscarinic receptors

21
Q

What is hyoscine hydrobromide?

A

a muscarinic receptor antagonist that crosses the blood blood brain barrier for motion sickness

22
Q

What are the side effects of hyoscine hydrobromide?

A

anti SLUD - dry mouth, dry eyes, urinary retention, constipation

23
Q

What is promethazine?

A

An H1 receptor antagonist for motion sickness (phenergen)

24
Q

What is metoclopramide?

A

A D2 receptor antagonist for vomiting and nausea associated with the chemoreceptor trigger zone - also a weak 5HT3 antagonist and a potent 5HT4 agonist - facilitates gastric emptying via increased ACh (but not diarrhoea)

25
Q

What is the effect of facilitating gastric emptying in metoclopramide?

A

changes the absorption of other drugs

26
Q

What is prochlorperazine?

A

A D2 receptor antagonist for vomiting and nausea associated with the chemoreceptor trigger zone

27
Q

What are the side effects of D2 receptor antagonists?

A

extra pyramidal side effects - motor movements like parkinsons and sometimes irreversible tardive dyskinesia

28
Q

What is ondansetron?

A

A 5HT3 receptor antagonist - used for vomiting and nausea associated with the chemoreceptor trigger zone - blocks both receptors on the the chemoreceptor trigger zone and on vagal afferents which receive signals from the enterochrommaffin cells

29
Q

What are the side effects of 5HT3 receptor antagonists?

A

very few - minor headache and constipation

30
Q

What is aprepitant?

A

An NK1 receptor antagonist - a substance P antagonist - substance P is found in high concentrations in the vomiting centre in the brain

31
Q

What is dexamethasone?

A

A glucocoritcosteroid used to treat nausea and vomiting although not technically an antiemetic

32
Q

What is rabione?

A

A synthetic cannabinoid - used as an antiemetic

33
Q

What is apomorphine?

A

A dopa receptor agonist - a very potent emetic

34
Q

What causes constipation?

A

certain drugs e.g. opioids, lifestyle factors, inadequate dietary fibre intake, inappropriate bowel habits, inadequate activity, spinal injury, dementia, depression, hypothyroidism

35
Q

Apart from constipation, when else are laxatives used?

A

Before a colonoscopy, hernias, prolapsed rectum

36
Q

What are bulking agents?

A

indigestible vegetable fibre taken with water to stimulate normal reflex bowel movements

37
Q

What is docusate?

A

A faecal softener - acts as an emulsifying agent

38
Q

What is liquid paraffin?

A

A faecal lubricant - may cause loss of fat soluble vitamins

39
Q

What is magnesium sulphate?

A

an osmotic laxative - causes osmotic fluid retention to get more mass and more distension

40
Q

What is bisacodyl?

A

A stimulant laxative - precise mode of action not known but causes increased motility

41
Q

What is senna?

A

A stimulant laxative - precise mode of action not known but causes increased motility - often used in combination with docusate

42
Q

What is loperamide?

A

An opioid that doesnt cross the blood brain barrier used as an antidiarrhoeal

43
Q

What is simethicone?

A

a defoaming polymer used to coalesce gas bubbles so they can be more easily passed

Gastrointestinal (40 decks)

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