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Body Systems Pharmacology > Gastro > Flashcards

Gastro Flashcards

1
Q

H2RA

A

Ranitidine
Famotidine

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2
Q

T or F: PPIs need the acidity of the stomach for their activation

A

T

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3
Q

PPI bind _____ to_____

A

Irreversible
H+K+ATPase @Parietal Cells

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4
Q

Which step is inhibited with PPIs

A

Last step

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5
Q

Most effective tx for Peptic Ulcer Disease

A

PPIs

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6
Q

Tx for Errosive Esophagitis unresponsive to H2RA

A

PPIs

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7
Q

First line of tx for Zollinger-Ellison Synd.

A

PPIs

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8
Q

Tx for Gastropathy caused by NSAIDs

A

PPIs

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9
Q

Clopidogrel + PPIs

A

↓ activation of PPIs

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10
Q

Warfarin + PPIs

A

↓ Warfarin clearance

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11
Q

Chronic use of PPIs

A

↑ Risk of Pneumonia

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12
Q

MOA of H2RA

A

Reversibly competing with histamine for binding to H2 receptors @basolateral memb of parietals cells
↓adenyl cyclase activity → ↓cAMP levels → ↓protein kinase A activity →↓ phosphorylation and activation of H+K+ATPase

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13
Q

Second line tx for inhibition of gastric acid

A

H2RA

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14
Q

Contraindication of Omeprazole

A

Sevre Hepatic disease

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15
Q

T or F: H2RA cross the Placenta

A

T

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16
Q

Cytoprotective Agents

A

Misoprostol
Sucralfate

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17
Q

Famotidine

A

Gastric Acid Secretion Inhibitor

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18
Q

Ranatadine

A

Gastric Acid Secretion Inhibitor

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19
Q

Cytoprotective agent: synthetic analogue of PGE1

A

Misoprostol

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20
Q

MOA of Misoprostol

A

Inhibition of gastric acid (binds and activates the EP3 receptor @Parietal cells)

Stimulation of Mucus and Bicarbonate secretion

Enchancement of mucosal blood flow

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21
Q

Misoprostol binds to which receptors

A

EP3 @Parietal Cells

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22
Q

GI drug used for Medical Abortion

A

Misoprostol

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23
Q

GERD @Pregnancy

A

Sucralfate

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24
Q

Prophylaxis of Stress Ulcers

A

Sucralfate
(also… PPIs)

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25
Q

Cytoprotective agent that causes Diarrhea

A

Misoprostol

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26
Q

Cytoprotective agent that causes Constipation

A

Sucralfate

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27
Q

Development of Bezoars

A

Sucralfate

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28
Q

Cytoprotective agent contraindicated during Pregnancy

A

Misoprostol

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29
Q

Prophylaxis of NSAID induced gastric ulcers

A

Misoprostol

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30
Q

Sucralfate cannot be coadmin with:

A

PPI
H2 blockers
Aluminium containing acids

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31
Q

Sucralfate should be avoided @

A

Px with renal failure who are at risk of aluminium overload

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32
Q

GI drug that in acidic environment undergoes extensive cost-linking to produce a viscous, sticky polymer that adhers to epithelial cells and ulcer craters

A

Sucralfate

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33
Q

Sucralfate causes the stimulation of

A

Local production of PGs
Epidermal growth factor

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34
Q

Antacids

A

Aluminium Hydroxide
Magnesium Hydroxide

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35
Q

Aluminium Hydroxide

A

Antacid

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36
Q

Magnesium Hydroxide

A

Antacid

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37
Q

GI drug provide ONLY temporary relief of symptoms

A

Antacids

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38
Q

MOA of Antacids

A

Neutralize the excess of stomach acid that causes symptoms

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39
Q

T or F: Antacids treat underlying disease

A

F

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40
Q

Drug of choice for rapid symptom relief in acid reflux

A

Antacids

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41
Q

T or F: Antacids can also be used to tx symptoms of Esophagitis

A

T

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42
Q

Common adverse effect of antacids

A

Excessive bloating and belching
Hypokalemia

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43
Q

D2 receptor antagonist

A

Metoclopramide
Domperidone

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44
Q

Prokinetic with CENTRAL antiseptic effect

A

Metoclopramide

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45
Q

Prokinetic with PERIPHERAL antiseptic effect

A

Domperidone

46
Q

T or F: Metoclopramide has NO influence in colon motility

47
Q

Prokinetic indicated for Diabetic and Postsurgery Gastroparesis

A

Metaclopramide

48
Q

Hyperemesis gravidum

A

Metaclopramide
@Pregnancy

49
Q

Prokinetic with mayor Extrapiramidal effects

A

Metaclopramide

50
Q

Adverse Effects of Metaclopramide

A

Mayor Extrapiramidal effects
Galactorrhea (due to hyperprolactinemia)

51
Q

Prokinetic that can cause serious ventricular arrythmias

A

Domperidone

52
Q

T or F: Both D2 Receptor antagonists causes Hyperprolactinemis

53
Q

Contraindications of D2 Receptor Antagonists

A

Suspected small bowel obstruction
Procalcitonin dependent tumors

54
Q

T or F: Metaclopramide is contraindicated in Parkinsons

55
Q

Antidote for Extrapiramidal effects of Metaclopramide

A

Anticholinergic agents (Benztropine, Biperiden)

56
Q

T or F: Domperidone crosses only minimally the placenta, hence the limited neurological effects

57
Q

5-HT4 receptor Antagonist

A

Cinitaprida

58
Q

Cinitrapida

A

Prokinetic
5-HT4 receptor antagonist

59
Q

Prokinteic indicated @px who has failed ALL standard therapeutic modalities and who have undergone through dx evaluation (including ECG)

A

Cinitaprida

60
Q

Why is Cinitrpida no longer available in the US

A

bc of its potential to induce serious and occasionally fatal cardiac arrythmias

61
Q

Laxatives (4)

A

Castor Oil
Glycerin
Plantage Psyllium
Senosides A-B

62
Q

Stimulant laxative

A

Senosidos A-B

63
Q

Ricinelic acid (active agent) acts primarily @small intestine

A

Castor Oil

64
Q

Effects of Castor Oil

A

stimulates secretion of fluid and electrolytes
speed up intestinal transit

65
Q

Laxative characterized for its unpleasant taste

A

Castor Oil

66
Q

Laxative used as enema and suppositories

67
Q

MOA of Glycerin

A

↑ osmotic pressure → draws water to the lumen

68
Q

Bulk forming laxative

A

Plantage Psyllium

69
Q

MOA od Senosides A-B

A

stimulation of epithelial cell secretion of electrolytes into the colon lumen
causes myenteric neuronal depolarization → colon peristalsis

70
Q

Melanosis coli

A

Senosides A-B

71
Q

Antimetic

A

Dronabinol
Ondasteron
Aprepitant

72
Q

Antimetic: cannabinoid receptor antagonist

A

Dronabinol

73
Q

Antimetic: 5HT3 receptor antagonist

A

Ondasteron

74
Q

Antimetic: Aprepitant

A

NK1 antagonist

75
Q

Aprepitant

76
Q

Dronabidol

77
Q

Dronabinol Clincal uses

A

Cytotoxic drug-induced emesis (chemotherapy)
Stimulate apetite

78
Q

Adverse effects of Dronabinol

A

Psychoactive
many CNS effects
Palpitations, bloodshot eyes

79
Q

T or F: Onastern has only peripheral antimetic effect

A

F
Central = area postrema
Peripheral = inhibition of vagus nerve

80
Q

Most effective antiemetic for Cytotoxic drug induced emesis (chemotherapy)

A

5HT3
Ondastron

81
Q

Radiation induced emesis

A

Ondasteron

82
Q

Antiemetic that can cause QT interval prolongation (tornadoes point)

A

Ondasteron
Aprepitant

83
Q

Antiemetic that can cause serotonin syndrome

A

Ondasteron

84
Q

MOA of Apretitant

A

Inhibition of NK1 receptors @solitary nucleus & area postrema = CENTRAL antiemetic effect

85
Q

Antiemetic that also inhibits substance P induced vomiting (pharyngeal or gag reflex)

A

Aprepitant

86
Q

Antidiarrheals

A

Cholestryamine
Loperamide
Octreotide
Bismuth

87
Q

Antidiarrheal: bile acid sequestrants

A

Cholestyramine

88
Q

Antidiarrheal: MOR agnonists

A

Loperamide

89
Q

Antidiarrheal: SST receptor agonist

A

Octreotide

90
Q

Adsorbents Antidiarrheals

A

Bind to diarrhea causing toxins –> cannot act in cell of GI tract
Bismuth
Cholestryamine

91
Q

Sticky insoluble resin

A

Cholestryamine

92
Q

Used to tx bile acid malbasroption

A

Chelestryamine

93
Q

tongue and stool turn black

94
Q

Antidiarrheal that causes ototoxicity

95
Q

Antidiarrheal that should be avoided in pediatric px

96
Q

Antidiarrheal that ca cause discoloration and erosion of the teeth

A

Cholestyramine

97
Q

Antidiarrheal that affects absorption of fat soluble vitamins

A

Cholestyramine

98
Q

Antidiarrheal opiods

A

Loperamide

99
Q

First line tx for travelers diarrhea

A

Loperamide

100
Q

Antidiarrheal that can cause constimation, abdominal cramps, paralytic ileus and toxic megacolon

A

Loperamide (Opioids)

101
Q

Contraindication of Loperamide

A

<4yo
Px with QT prolongation

102
Q

Antidiarrheal that causes ↑LFTs

A

Cholestyramine

103
Q

Contraindications of Choletyramine

A

Hypertriglicerdemia

104
Q

Loperamide effects in GI tract

A

inhibits:
intestinal peristalsis
fluid secretion

↑sphincter tone

105
Q

Best initial tx for chemotherapy-induced diarrhea

A

Loperamide

106
Q

Antidiarrheal that inhibits 5HT

A

Octreotide

107
Q

Antidiarrheal that can be given IV or SC

A

Octreotide

108
Q

Dumping Syndrome

A

Octreotide

109
Q

Diarrhea associated with carcinoid tumors or VIP secreting tumors

110
Q

Long term use of Octreotide

A

Gallstone formation

111
Q

T or F: Bismuth has antisecretory, antiinflamatory and antimicrobial effects

112
Q

Antidiarrheal also used in the quadruple eradication of H.pylori

Body Systems Pharmacology (6 decks)

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