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Pharm Spring Exam 1 > Exam I - GI Drugs > Flashcards

Exam I - GI Drugs Flashcards

1
Q

Drug List

H2 Receptor Agonist

A
  • Ranitidine

- Famotidine

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2
Q

Drug List

PPIs

A

-Omeprazole

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3
Q

Drug List

Anatacids

A
  • Mg(OH)2
  • Al(OH)3
  • CaCO3
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4
Q

Drug List

Mucosal Protective Agents

A
  • Sucralfate

- Bismuth Subsalicylate

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5
Q

Drug List

Anti-emetics

A
  • Metoclopramide

- Ondansetron

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6
Q

Drug List

Stimulant Laxative

A

-Lubiprostone

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7
Q

Drug List

Saline Laxative

A

-Mg(OH)2

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8
Q

Drug List

Antidiarrheal

A
  • loperamide

- alosetron (restricted use)

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9
Q

Drug List

Mesalamine

A

-sulfasalazine

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10
Q

Drug List

Corticosteroid

A

-Prednisone

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11
Q

Drug List

Thiopurine Anti-metabolite

A

-azathioprine

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12
Q

TNFa inhibitors

A

-infliximab

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13
Q

Peptic Acid Dz

Risk Factors

A
  • coffee, EtOH, tobacco
  • salicylates/aspirin
  • NSAIDs
  • Heredity/Age
  • H. pylori
  • Stress
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14
Q

Peptic Acid Dz

Acute Reflux AKA

A

-heartburn

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15
Q

Peptic Acid Dz

Chronic Reflux AKA

A

-GERD

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16
Q

Peptic Acid Dz

Reflux Risk Factors

A
  • hiatal hernia
  • weakened esophageal sphincter/pressure
  • obesity
  • displaced diaphragm
17
Q

Peptic Acid Dz

Damaging Agents

A
  • Acid
  • Pepsin
  • H. pylori
18
Q

Peptic Acid Dz

Protective Agents

A
  • mucous
  • bicarbonate
  • PgE
19
Q

Gastric Acid Secretion

Stimulants

A
  • peptides>gastrin release
  • gastrin>histamine release (H2 receptors), hcl release
  • histamine>hcl release
  • vaga>ACh>parietal>HCl
20
Q

H2 Receptor Antagonists

A
  • low toxicity
  • effective for nocturnal secretions
  • prophylaxis for NSAID tx duodenal ulcers
21
Q

PPIs

A
  • irreversible inhibition (long-term effect) of H+/K+ ATPase
  • pro-drug; protonation of weak base in parietal cell canaliculus
  • P450 metab
  • adverse: nausea, diarrhea, dizziness
  • more effective than H2 receptor antagonists
22
Q

Antacids

A
  • weak bases, work in lumen
  • Mg(OH)2 produces diarrhea
  • Al(OH)3 and CaCO3 produce constipation
  • Co-Rx to counteract effects
  • use for occasional heartburn
  • effective for 2-3 hrs
23
Q

Antacids

Adverse

A
  • drug-drug interactions

- Al(OH)3 and CaCO3 decrease abx absorption

24
Q

Muscosal Protection

Sucralfate

A
  • forms paste at low pH
  • adheres to pos-charged proteins
  • protects cells against acid, pepsin
  • take before meal
  • adverse: adsorbs drugs; take 2 hrs after admin
  • do not co-admin w/ antacid>black stools
25
Q

Mucosal Protection

Bismuth Subsalicylate

A
  • selectively binds ulcers

- adverse: blackened stool, tongue

26
Q

Anti-emetics

Ondansetron

A
  • 5HT3 receptor antagonists
  • chemotrigger zone
  • most effective for cytotox drug (chemotx) emesis
  • co-rx for chemtox emesis
  • adverse: constipation
27
Q

Anti-emetics

Metoclopramide

A
  • centrally acting dopamine receptor antags
  • also enhances intestinal motility
  • chemo/cytoxic drug emesis
  • adverse: parkinsonian sx
28
Q

Laxatives

Contraindications

A
  • cramps
  • colic
  • nausea
  • vomiting
  • appendicitis sx
  • undiagnosed abdominal pain
29
Q

Stimulant Laxative
Lubiprostone
Indication

A
  • Indication: idiopathic chronic constipation
  • Mech: Activates Cl channels
  • Adverse: diarrhea, abdominal pain, distension
30
Q

Saline Laxative

Mg(OH)2

A

-Mech: hypertonic sol’n creates osmotic pressure;
incr fluid in GI, stims peristalsis
-Cathartic Dose: complete evac <3 hrs (colonoscopy prep)

31
Q

Antidiarrheal Agents

Loperamide

A
  • Mech: binds mu opiod receptors in intestinal sm. musc
  • Effect: slows intestinal transit time
  • Adverse: toxic megacolon, constipation, rare CNS sx
  • Contra’d: ulcerative colitis, acute bacill/amoebic dystentery
32
Q

IBS

Definitions

A
  • chronic, recurring episodes cramps, bloating
  • fxn’l dz: no underlying abnormalities
  • diarrhea and/or constipation
  • 70% women
  • tx sx
33
Q

IBS-D
Diarrhea sub-type
Drugs of choice

A

1) Loperamide (mu opiod agonist)
2) alosetron (restricted use, 5HT3 receptor antagonist)
- rare ischemic colitis side effects
3) anti-muscarinics (eg atropine; reduce sm musc tone)

34
Q

IBS-C
Constipation Sub-type
Drugs of Choice

A

1) Mg(OH)2
2) tegaserod, 5HT4 agonist stims ACh; emergency only
- rish of heart attack, stroke, angina

35
Q

IBD

Definitions

A

-chronic, relapsing structural dz w/ inflamm, ulcers, bleeding,
lesions, and immune response
-ulcerative colitis: lesions in colon; mucosal and submucosal
-Chron’s: lesions from mouth to anus, entire bowel wall

36
Q

Acute IBD

Drugs of Choice

A
  • prednisone:
    1) reduce inflammation
    2) reduce ulceration
    3) initial remission
37
Q

Chronic IBD

Drugs of Choice

A
  • azathioprine (purine anti-metabolite)

- adverse: bone marrow suppression, rash, fever, nausea

38
Q

Ulcerative Colitis

Drugs of Choice

A

-Topical sulfasalazine prodrug (5-ASA mesalamine active drug)
-for lesions in sm and lg instestine
-diff formulations target diff regions of bowel
-interrupts inflammatory pathway
-adverse: 40% intolerance; nausea, headache, hypersens,
bone marrow suppression

39
Q

Chron’s Disease

Adjunct Therapies

A
  • infliximab, an antibody to TNFa
  • binds TNFa, blocking inflammatory effects
  • adverse: increased infections
  • can also be use for ulcerative colitis

Pharm Spring Exam 1 (8 decks)

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