Exam I - GI Drugs Flashcards
1
Q
Drug List
H2 Receptor Agonist
A
- Ranitidine
- Famotidine
2
Q
Drug List
PPIs
A
-Omeprazole
3
Q
Drug List
Anatacids
A
- Mg(OH)2
- Al(OH)3
- CaCO3
4
Q
Drug List
Mucosal Protective Agents
A
- Sucralfate
- Bismuth Subsalicylate
5
Q
Drug List
Anti-emetics
A
- Metoclopramide
- Ondansetron
6
Q
Drug List
Stimulant Laxative
A
-Lubiprostone
7
Q
Drug List
Saline Laxative
A
-Mg(OH)2
8
Q
Drug List
Antidiarrheal
A
- loperamide
- alosetron (restricted use)
9
Q
Drug List
Mesalamine
A
-sulfasalazine
10
Q
Drug List
Corticosteroid
A
-Prednisone
11
Q
Drug List
Thiopurine Anti-metabolite
A
-azathioprine
12
Q
TNFa inhibitors
A
-infliximab
13
Q
Peptic Acid Dz
Risk Factors
A
- coffee, EtOH, tobacco
- salicylates/aspirin
- NSAIDs
- Heredity/Age
- H. pylori
- Stress
14
Q
Peptic Acid Dz
Acute Reflux AKA
A
-heartburn
15
Q
Peptic Acid Dz
Chronic Reflux AKA
A
-GERD
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
Mucosal Protection
| Bismuth Subsalicylate
- selectively binds ulcers
| - adverse: blackened stool, tongue
26
Anti-emetics
| Ondansetron
- 5HT3 receptor antagonists
- chemotrigger zone
- most effective for cytotox drug (chemotx) emesis
- co-rx for chemtox emesis
- adverse: constipation
27
Anti-emetics
| Metoclopramide
- centrally acting dopamine receptor antags
- also enhances intestinal motility
- chemo/cytoxic drug emesis
- adverse: parkinsonian sx
28
Laxatives
| Contraindications
- cramps
- colic
- nausea
- vomiting
- appendicitis sx
- undiagnosed abdominal pain
29
Stimulant Laxative
Lubiprostone
Indication
- Indication: idiopathic chronic constipation
- Mech: Activates Cl channels
- Adverse: diarrhea, abdominal pain, distension
30
Saline Laxative
| Mg(OH)2
-Mech: hypertonic sol'n creates osmotic pressure;
incr fluid in GI, stims peristalsis
-Cathartic Dose: complete evac <3 hrs (colonoscopy prep)
31
Antidiarrheal Agents
| Loperamide
- 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
IBS
| Definitions
- chronic, recurring episodes cramps, bloating
- fxn'l dz: no underlying abnormalities
- diarrhea and/or constipation
- 70% women
- tx sx
33
IBS-D
Diarrhea sub-type
Drugs of choice
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
IBS-C
Constipation Sub-type
Drugs of Choice
1) Mg(OH)2
2) tegaserod, 5HT4 agonist stims ACh; emergency only
- rish of heart attack, stroke, angina
35
IBD
| Definitions
-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
Acute IBD
| Drugs of Choice
- prednisone:
1) reduce inflammation
2) reduce ulceration
3) initial remission
37
Chronic IBD
| Drugs of Choice
- azathioprine (purine anti-metabolite)
| - adverse: bone marrow suppression, rash, fever, nausea
38
Ulcerative Colitis
| Drugs of Choice
-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
Chron's Disease
| Adjunct Therapies
- infliximab, an antibody to TNFa
- binds TNFa, blocking inflammatory effects
- adverse: increased infections
- can also be use for ulcerative colitis
