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Pharm I Fall 2016 NUNM Jensen > Gastro > Flashcards

Gastro Flashcards

1
Q

What do a majority of antacids contain either alone or in combination?

A

Calcium carbonate

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2
Q

What is the onset and duration of action for antacids?

A

<5 minutes

20-30 minutes

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3
Q

What are the side effects for calcium carbonate?

A

Constipation/flatulance

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4
Q

What are the interactions to consider with calcium?

A

Lilly of the Valley

Strophanthus

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5
Q

What antacid can cause diarrhea?

A

Mg

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6
Q

MOA for H2RA’s?

A

Block type 2 histamine receptors located on the parietal cells which prevents stimulation of proton pump

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7
Q

What are four main H2RA’s?

A

Famotidine (pepcid)
Ranitidine (zantac)
Cimetidine (tagamet HB)
Nizatidine (Axid AR)

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8
Q

What is the onset and duration for H2RA’s?

A

30-45 min

4-10 hours

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9
Q

What are the side effects of H2RA’s?

A 
Anti-androgenic
arrhythmias
H/A
Dizziness
GI
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10
Q

What are the interactions to avoid with H2RA’s?

A

Caffeine, St. John’s Wort

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11
Q

Which H2RA is know for it’s interactions?

A

Cimetidine (cytochrome P450 system)

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12
Q

MOA of PPIs?

A

Selective, irreversible H/K/ATPase inhibition on luminal side of parietal cells

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13
Q

What is the onset and duration of PPIs?

A

2-3 hours

24 hours

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14
Q

What are the five main PPIs?

A 
Omeprazole (Prilosec)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Rabeprazole (Aciphex)
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15
Q

What does it mean that PPIs are ‘acid-labile’?

A

They are broken down in the presence of stomach acid, which reduces their absorption. Therefore, it is recommended to take 30 minutes before eating.

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16
Q

What are the PPI side effects?

A 
Mg depletion
Osteoporosis
C. diff infection
CA pneumonia,
HA/dizziness
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17
Q

What are interactions to consider with PPIs?

A

Grapefruit and St. John’s Wort

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18
Q

Simethicone MOA?

A

Inert silicone polymer, “de-foaming” agent; reduces surface tension of gas bubbles

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19
Q

Activated charcoal MOA?

A

Highly absorptive; possible adsorbent effect
(“Adsorption is a process that occurs when a gas or liquid accumulates on the surface of a solid or, more rarely, a liquid forming a molecular or atomic film. It is different from absorption, in which a substance diffuses into a liquid or solid to form a solution.”)

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20
Q

Alpha-Galactosidase MOA?

A

A mold-derived enzyme, cleaves oligosaccharides before reaching colonic bacteria
(recommended for gas prevention with high-fiber diets)
Avoid with DM and galactosemia

21
Q

Senna MOA?

A

Anthraquinone stimulates peristaltic activity on the intestine

22
Q

Distinguishing side effect of Senna?

A

Melanosis coli

23
Q

Bisacodyl MOA?

A

Stimulates peristalsis by directly irritating the SM of the intestine

24
Q

Distinguishing side effect of Bisacodyl?

A

Electrolyte disturbances

25
Q

Polyethylene glycol MOA?

A

Osmotic laxative

26
Q

Magnesium citrate MOA?

A

Osmotic laxative

27
Q

Docusate MOA?

A

Dioctyl sodium sulfosuccinate reduces surface tension of the oil-water interface of the stool allowing oil and water to be incorporated.

28
Q

Psyllium MOA?

A

Soluble fiber, absorbs water in the intestine > viscous liquid > promotes peristalsis and reduces transit time

29
Q

What is used to reverse opioid induced constipation?

A

Opiate receptor antagonists

30
Q

Loperamide MOA?

A

Decreases GI motility by effects on the circular and longitudinal muscles. Reduces GI secretions produced by OPIOID RECEPTOR BINDING EFFECTS IN THE INTESTINAL MUCOSA.

31
Q

What are the potential interactions with loperamide?

A

Henbane, scopolia, st. john’s wort

32
Q

Can loperamide use lead to dependence and abuse?

A

Yep

33
Q

Diphenoxylate and atropine MOA?

A

Opiate receptor agonist (inhibits excessive GI motility)

OTC forms contain subtherapeutic doses of atropine to discourage abuse

34
Q

What are the four pharmacologic interventions used for IBD?

A

Corticosteroids/glucocorticoids
Aminosalicylates
Immunosuppressants
Antibiotics

35
Q

Corticosteroid (prednisone) MOA?

A

Modulates protein synthesis > reduced migration of PMN and fibroblasts.
Reverses capillary permeability and lysosomal stabilization at the cellular level to prevent or control inflammation.
Immunosuppression

36
Q

What makes glucocorticoids and mineralocorticoids different from corticosteroids?

A

Receptor affinities

37
Q

What is the advantage of budesonide (a glucocorticoid)?

A

Utilizes the release mechanism of enteric-coated tablets and capsules that delay release until pH > 5.5. (has good topical activity with low systemic bioavailability)

38
Q

Mesalamine (aminosalicylate) MOA?

A

Modulates local chemical mediators of the inflammatory response, particularly leukotrienes, and acts as a free radical scavenger or inhibitor of TNF.

39
Q

Sulfasalazine (aminosalicylate) MOA?

A

Prodrug of mesalamine. The azo bond is cleaved by colonic bacteria.

40
Q

What supplement should patients on sulfasalazine take?

A

It inhibits the absorption of dietary folate, which should be supplemented between meals.

41
Q

Azathioprine (antimetabolite) MOA?

A

Inhibits purine synthesis and DNA replication > anti-proliferative effect and induction of apoptosis of T-cells.
(prodrug that be is converted to 6-mercaptopurine)

42
Q

TNF-alpha monoclonal antibodies MOA?

A

Inhibits TNF-alpha (which is responsible for induction of proinflammatory cytokines) > enhancement of leukocyte migration, activation of neutrophils and eosinophils, and the induction of acute phase reactants and tissue degrading enzymes.

43
Q

Infliximab (anti-TNF-alpha) MOA?

A

Chimeric IgGk that binds to both free and membrane bound TNF-alpha

44
Q

Adalimumab (anti-TNF-alpha) MOA?

A

Human mAb against TNF-alpha

45
Q

Ondansetron MOA?

A

Selectively antagonizes serotonin at 5-HT3 receptors, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone.

46
Q

Promethazine MOA?

A

Blocks postsynaptic mesolimbic dopaminergic receptors (alpha-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones)

47
Q

Metoclopramide MOA?

A

Antagonizes dopamine receptors and at high doses blocks serotonin receptors in chemoreceptor trigger zones of the CNS

48
Q

What is the prokinetic mechanisms of metoclopramide?

A

Enhances the response of Ach in upper GI tract causing enhanced motility and accelerated gastric emptying without stimulating gastric, biliary, or pancreatic secretions

Pharm I Fall 2016 NUNM Jensen (11 decks)

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