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Fundamentals of Neuroscience Semester 2 > Drugs Affecting the GI Tract > Flashcards

Drugs Affecting the GI Tract Flashcards

1
Q

What is GORD?

A

gastro oesophageal reflux disease

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2
Q

What effects does GORD have?

A
  • oesophagitis
  • stricture
  • Barrett’s metaplasia
  • oesophageal -adenocarcinoma
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3
Q

How do you treat GORD?

A
  • suppress the acid
  • use proton pump inhibitors (omeprezole)
  • H2 blockers (Ranitidine)
  • antacids (increase PH)
  • alginates (Gaviscon)
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4
Q

How do alginates work?

A
  • alginate can bind calcium, when this happens to becomes rigid like a thick gel
  • bicarbonate in the alginate reacts with the acid to form carbon dioxide and water.
  • The CO2 formed gets trapped inside the gel making it more buoyant so it floats to the surface
  • a barrier is formed which prevents acid refluxing into the oesophagus
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5
Q

What causes stomach ulceration?

A

helicobacter pylori

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6
Q

In what ways does helicobacter pylori damage the stomach?

A
  • acid production

- barrer damage

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7
Q

What can Helicobacter Pylori cause?

A
  • gastritis
  • gastric and duodenal ulcers
  • gastric cancer (class 1 carcinogen)
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8
Q

How can Helicobacter pylori cause damage in such acidic conditions?

A
  • flagella so motile
  • expresses enzymes that allow it to colonise close to the epithelium like mucinase which breaks down mucin on the surface of the epithelium
  • adhesion receptors not the surface allow it to anchor on
  • urease converts urea into an ammonium ion and a bicarbonate ion
  • ammonium ion causes inflammation
  • bicarbonate ion allows it to neutralise its local environment
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9
Q

What does Hp in the antrum cause?

A
  • G cells to hyper secrete gastrin
  • decrease astral D cell somostatin release
  • leads to hypergastrinaemia and duodenal ulcers]
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10
Q

What does Hp infection of the corpus lead to?

A

-reduced acid secretion and hypochlorhydria

associated with gastric ulcers

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11
Q

How are hypergastrinaemia and hypoclorhydria treated?

A

triple therapy consisting of antibiotics amoxicillin, clarithromycin and a proton pump inhibitor

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12
Q

What is creon?

A

a prescription medicine used to treat EPI e.g where the pancreas does not make enough enzymes (e.g chronic pancreatitis)
-replaces enzymes that the pancreas isn’t producing, helping you digest fats, proteins and carbohydrates

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13
Q

Why is creon given in a delayed release capsule?

A

so that the enzymes are not released until they are needed in the small intestine

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14
Q

How do aminosalicylates work in treating IBD?

A
  • work as a scavenger of oxygen free radicals (reducing inflammation)
  • blocks production and chemotaxis of leukotrienes
  • many other actions aimed at modifying the immune response and inflammation
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15
Q

What is an example of an immunomodulator?

A

azathioprine

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16
Q

How does azathioprine work?

A

interferes with DNA synthesis and inhibits proliferation of rapidly dividing cells

17
Q

What is a biologic?

A

a monoclonal antibody against TNF-α

18
Q

What is TNF-α?

A
  • an inflammatory cytokine involved in host defence, inflammation, apoptosis and activation of immune cell functions
  • in increase in its expression is related to IBD
19
Q

What at some examples of biologics and how do they work?

A

infliximab, adalimumbab and golimumab

act as monoclonal antibody against TNF-α

20
Q

How can you prevent the initiation/ maintenance of inflammation mediated by adhesion molecules in IBD?

A
  • use inhibitors to molecules involved in lymphocyte migration and recruitment within the intestinal mucosa as this causes inflammation
  • inhibitors to these molecules interfere with adhesion interactions of endothelial cells and circulating immune cells
21
Q

What is an example of one of these inhibitors?

A

Vedolizumab

22
Q

How do corticosteroids work?

A
  • regulate gene expression

- bind to corticosteroid receptor which suppresses inflammatory processes

23
Q

How do stimulant laxatives work?

A

increase motility through chemoreceptor activation and the myenteric nerve plexus

24
Q

Examples of stimulant laxatives?

A
  • Senna

- cascara

25
Q

How do saline laxatives work?

A

by drawing water into the bowel through osmosis due to a high conc of osmotic particles

26
Q

Examples of saline laxatives?

A

Mg, sulphate, phosphate, non-absorbable sugar

27
Q

How do emollient laxatives work?

A

soften faeces

28
Q

Examples of emollient laxatives?

A

non absorbable lubricants

29
Q

Examples of bulk forming laxatives?

A

bran, methylcellulose

30
Q

Give an example of an anti-diarrhoeal?

A

lopermide

31
Q

How does loperamide reduce diarrhoea?

A
  • prolongs transit time of intestinal contents

- reduces daily faecal volume, increases viscosity and bulk density and diminishes loss of fluid and electrolytes

32
Q

What is loperamide an agonist for?

A

opioid receptor

33
Q

How does loperamide work?

A
  • decrease activity of myenteric plexus (decreases motility of circular and longitudinal smooth muscles)
  • this increases the amount of time substance stays in the intestine allowing more water to be absorbed
34
Q

What else can loperamide do?

A
  • decrease colonic mass movement

- suppresses gastrocolic reflex

35
Q

How do bulk laxatives work?

A

swells and distends colon increasing motility

36
Q

How are diseases like cholera treated?

A
  • the enterotoxin (cholera) induces intracellular concs of cAMP which increases Cl and K secretion and inhibits electroneutral NaCl absorption
  • because the second messengers do not alter function of nutrient coupled Na+ absorption given an oral rehydration solution containing glucose and Na+ works
  • see diagram on slides
37
Q

How do you treat iron deficiency anaemia?

A
  • ferrous sulphate

- vit C to promote absorption

Fundamentals of Neuroscience Semester 2 (10 decks)

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