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Hugh's MD1 Abdominal > Gastro Drugs > Flashcards

Gastro Drugs Flashcards

1
Q

What is a potential side effect of systemic antacid use?

A

Metabolic alkalosis

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1
Q

What type of drugs are Neurokinin1 (NK-1) receptor antagonists?

A

Anti-emetics

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2
Q

What does H1 receptor antagonists treat?

A

Motion sickness

Hay fever

Nausea and Vomiting

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2
Q

How do bulking agents work?

A

They absorb water > increase in size > stimulates movement

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3
Q

How does hyoscine butylbromide act as a anti-diarrhoeal?

A

Muscarinic receptor antagonists therefore decrease gut motility

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4
Q

What is misoprostol?

A

A synthetic prostaglandin E2 analogue

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4
Q

What effect do cannabinoids have?

A

Anti-emetic

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4
Q

What is the problem with lipid paraffin?

A

Takes vitamins with it

Leaks out of the anus

Can cause pneumonia is aspirated

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5
Q

What is hyoscine hydrobromide?

A

A muscarinic receptor antagonist used for motion sickness

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6
Q

What drugs are used for nausea associated with migraine?

A

Metoclopramide

Chlorpromazine

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7
Q

How long is it advisible to stay on proton pump inhibitors for ulcers to heal?

A

8 weeks

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7
Q

Metoclopramide has another effect apart from being a anti-emetic, what is it?

A

Increase stomach and upper small intestine motility

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8
Q

What type of drug is Esomeprazole?

A

Proton pump inhibitor

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9
Q

What drugs target the chemoreceptor trigger zone?

A

Dopamine D2 receptor antagonists - Metoclopramide and Prochlorperazine

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9
Q

How does metoclopradine increase gut motility

A

Block dopamine’s inhibition of ACh release (being a dopamine D2 receptor antagonists)

Agonist of 5HT4 receptor > increase ACh release

Note: ACh acts on gastric smooth muscle to increase motility

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9
Q

Name a Serotonin 5HT3-Receptor Antagonists

A

Ondansetron

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10
Q

What are Ranitidine and Cimetidine?

A

H2 receptor antagonists

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11
Q

What type of drug is Hyoscine butylbromide?

A

Spasmolytic

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12
Q

At what point do extrapyramidal side effects of certain anti-emetic drugs become irreversible?

A

When tardic dyskinesia develops

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14
Q

Parkinson’s like symptoms or extrapyramadial side effects are cause by which class of drugs?

A

Dopamine D2 antagonists

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15
Q

What are Serotonin 5HT3-Receptor Antagonists used for?

A

Extremely potent anti-emetics

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16
Q

How does Rantidine work?

A

It is a H2 receptor antagonist

It blocks histamine stimulation of acid secretion in parietal cells

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17
Q

What are the side effects of H2 receptor antagonists?

A

No major side effects in current ones

Cimetidine causes gynecomastia in males

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17
Q

What are some causes of constipation?

A

Drugs (esp opioids)

Inadequate dietary fibre/water

Inadequate exercise

Spinal injury

Ignoring the “call” to go

Bowel cancer

Depression

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18
Q

Which opioid is used as an anti-diarrhoeal? Why?

A

Loperamide

Doesn’t cross the BBB therefore doesn’t cause the CNS effects

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19
Q

Which class of drug was classically thought to danger the colon with long term however has recently been found not to?

A

Irritant laxatives

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20
Q

What type of drug is liquid paraffin?

A

Oil lubricant

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20
Q

What are the most used laxative currently?

A

Irritant laxatives

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21
Q

What is the main side effect of Promethazine and other drugs of its class?

A

Sedation

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23
Q

What are H2 receptor antagonists indicated for?

A

Gastric ulcers

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24
Q

Name a bulking agent

A

Brann

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26
Q

How must antacids be administered to allow for ulcer healing?

A

Constant use - their action is short lived

27
Q

Name a detergent laxative and their mechanism of action

A

Docusate

Increase water content of faeces

28
Q

What type of drug is bisacodyl?

A

Irritant laxative

29
Q

Name the two important inputs to the vomiting centre due to their being targeted by anti-emetic drugs

A

Chemoreceptor trigger zone

Vestibular apparatus

30
Q

When are proton pump inhibitors indicated?

A

Ulcers

Reflux

Tumours

GORD

30
Q

Name a prostaglandin E2 analogue

A

Misoprostol

31
Q

Name some important antacids

A

Magnesium hydroxide

Sodium bicarbonate (systemic)

32
Q

What side effects do all muscarinic receptor antagonists have?

A

Anti-cholinergic effects = decrease SLUD therefore:

Dry mouth

Blurring vision

Urine retention

Constipation

32
Q

What are dopamine D2 receptor antagonists indicated for?

A

Nausea and vomiting

32
Q

Name two stimulant/irritant laxatives

A

Senna

Bisacodyl

33
Q

What are emetic drugs used for?

A

Induce vomiting for the removal of ingested poisons/toxins

35
Q

Name an important spasmolytic drug

A

Hyoscine butylbromide

36
Q

How do irritant laxatives work?

A

Directly stimulate colonic myenter nerve plexus

38
Q

What do spasmolytic drugs do?

A

Prevent smooth muscle spasm to reduce their associated pain

39
Q

What specific conditions can metoclopramide be used for?

A

Migraine

Reduced motility to neurodamage in diabetes

41
Q

What type of drug is hyoscine hydrobromide?

A

Muscarinic receptor antagonist

42
Q

What is the problem with prostaglandin E2 analogues?

A

They cause uterus contraction > abortions

43
Q

What are two proton pump inhibitors?

A

Omeprazole

Esomeprazole

43
Q

What class of drugs are generally indicated for nausea due to vestibular apparatus problems?

A

H1 receptor antagonists

45
Q

T/F Hyoscine hydrobromide crosses the BBB

45
Q

Name a osmotic laxative and their mode of action

A

Magnesium sulphate

Increase water content of faeces

47
Q

What is Ranitidine?

A

A H2 receptor antagonist

49
Q

What type of drug is prochlorperazine?

A

A D2 dopamine receptor antagonist

50
Q

What does Simethicone do?

A

Reduces the surface tension of small flatus bubbles thereby facilitating their aggregation into larger bubbles and passage out of the anus

51
Q

What are prostaglandin E2 analogues used for?

A

Reduce gastric acid secretion

Increase blood flow

Increase mucous secretion

52
Q

How do proton pump inhibitors block acid secretion?

A

Irreversibly bind to proton pumps

53
Q

What type of drug is docusate?

A

Detergent laxative

54
Q

What does metaclopramide treat?

A

Nausea and vomiting

56
Q

What came first, antacids or H2 receptor antagonists?

58
Q

How do cytoprotective agents work?

A

They coat ulcer to protect it

59
Q

What must opioids be given with?

A

A laxative

60
Q

Name two dopamine D2 receptor antagonists

A

Metoclopramide

Chlorpromazine

Prochlorperazine

62
Q

Name a H1 receptor antagonist

A

Promethazine

63
Q

What type of drugs typically cause constipation?

A

Muscarinic receptor antagonists

64
Q

What is bismuth chelate

A

A cytoprotective agent

65
Q

What is the problem with cytoprotect agents?

A

They blacken the teeth, tongue and faeces

67
Q

When shouldn’t Brann or drugs from its class be used?

A

When underlying motility is slow as it contributes to constipation

69
Q

Apart from being a dopamine D2 receptor antagonists, what other effects does metoclopramide have?

A

5HT3 receptor antagonist

5HT4 receptor agonist

70
Q

In what setting are dopamine D2 receptor antagonists generally used?

A

Hospitals to relieve the symptoms associated with chemo/radio therapy and post anaesthetics

71
Q

Which dopamine D2 receptor antagonists cause extrapyramidal side effects with long term use?

A

Metaclopramide

Prochlorperazine

72
Q

What is Promethazine?

A

A H1 receptor antagonist

73
Q

How is Senna usually taken?

A

With docusate for opioid induced constipation

74
Q

T/F Neurokinin-1 receptor antagonists are used on their own

A

False, they are used with Dopamine D2 receptor antagonists

75
Q

What do dopamine D2 receptor antagonists treat?

A

Nausea

Vomiting

76
Q

Are extrapyramadial side effect reversible?

A

Yes if the drugs hasn’t been used for too long

77
Q

What is hyoscine hydrobromide indicated for?

A

Motion sickness

78
Q

How does Ondansetron work as an anti-emetic?

A

Blocks 5HT3 receptors in the CNS and local vagal sensory fibres

Hugh's MD1 Abdominal (21 decks)

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