Gastro (last one!!!) Flashcards
name a surfactant laxative
docusate
name some protective factors against ulcers
mucus
prostaglandins
bicaronate
circulation
why does loperamide have few effects on the brain
because it crosses the blood brain barrier properly
what drug is an enhancer of mucosal defenses
misoprostol
what causes an ulcer
imbalance between aggressive or lesional factors and defensive or protective layers
name 3 other effects that bismuth subsalicylate has
bacteriostatic
antisecretory
anti-inflammatory
name 3 antacids
Mg(OH)2
Al(OH)3
CaCO3
name the quadruple therapy with bismuth to treat h pylori
PPI
tetracycline
bismuth salts
metronidazole
what is an adverse effect of Al(OH)3
constipation
name the quadruble therapy without bismuth to treat h pylori
PPI (esomeprazole)
3 antibiotics:
amoxicillin
clarithromycin
metronidazole
what causes most duodenal ulcers
95% h pylori
5% NSAIDs
how does sucralfate work
it forms a thick protective barrier on the ulcer
name some other antidiarrheal drugs
anticholinergic drugs
verapamil
Al salts
diphenoxylate and atropine
what is an ulcer
defined area of erosion passing through the lining of the GI wall
name some AE of misoprostol
diarrhea
cramps
uterus contraction
how do lubrification laxatives work
coat the intestinal lining
how does loperamide
decreases intestinal motility which allows more time absorption of fluid and electrolytes
what type of drug is misoprostol
prostaglandin PGE1 analogue
what causes most gastric ulcers
70% h pylori
25% NSAIDs
what is the duration of quadruple therapy with bismuth
7-14 days
how do osmotic laxatives work
they draw water by osmosis into the intestine and colon
less prostaglandins in gastric mucosa leads to what
dec mucus
dec bicarbonate
dec gastric circuation
inc secretion of HCl
how do stimulate laxatives work
stimulate enterie neurons:
inc peristalsis
inc water electrolytes in colon
name 2 mucosal coating agents
sucralfate
bismuth subsalicylate
many antidiarrheal agents are derivative of what kind of drugs
opioid
loperamide is a derivative of what
morphine
describe the systematic action of NSAIDs (in regards to ulcers)
reduce the synthesis of protective prostaglandins in the gastric mucosa
how do surfactant laxatives work
alter stool consistency facilitate penetration of water into feces
what is the last line of defense for epithelial cells against ulcers
gastric circulation (allows them to dump acid)
name some H2 receptor antagonists
cimetidine
ranitidine
famotidine
nizatidine
name a lubrification laxative
mineral oil
how do antacids work
theyre alkaline compounds that neutralize gastric acid
what is a general adverse effect of antacids
can reduce the absorption of certain drugs (ciprofloxacin and tetracycline)
what are some AE of cimetidine
inhibits hepatic metabolism
anti-androgenic effect
describe the duration of antacids
short lol
how do antacids affect pepsin
by inc the gastric pH, pepsin activity reduces
name 5 drugs used int he treatment of peptic ulcers/hypersecretion of gastric acid
antacids
mucosal defenses
H2 receptor antagonists
PPIs
antibacterial drugs
what is an adverse effect of Mg(OH)2
diarrhea
what is an AE of sucralfate
constipation
how do NSAIDs topically cause ulcers
gastric epithelial cells are damaged by the absorption of the acidic drug
how do PPIs work
they inhibit the gastric H/K ATPase pump
what is the eradication rate of quadruple therapy with bismuth
85-95%
name 3 off label uses of misoprostol
cervical ripening
induction of labor
termination of pregnancy
how to H2 receptor antagonists
decreases the secretion of gastric acid by parietal cells
what are the four goals of peptic ulcer drug therapy
alleviate symptoms
promote healing
prevent complications
prevent recurrence
name some AEs of bismuth subsalicylate
black tongue
black feces
why would you wnat to use ranitidine over cimetidine
few adverse effects
name 2 bulk-forming laxitives
psyllium
inulin
how does bismuth subsalicylate work
forms a protecitve barrier over gastric mucosa
name some osmotic laxatives
lactulose
polyethylene glycol
Mg(OH)2
what two things does misoprostol do
stimulates submucosal blood flow and production of HCO3 and mucus
attenuates histamine induced gastric acid production
why do NSAIDs have an enteric coating
to try and prevent damage to GI epithelial cells
name two anti-opioid laxative
methylnaltrexone
naloxegol
name a main antidiarrheal drug
loperamide
name some aggressive or lesional ulcer factors
acid
pepsin
bile
h pylori
nsaids
name some AE of PPIs
well tolerated overall
headache
diarrhea
inc risk of osteoporosis
inc risk of C diff and GI infections
dec absorption of vit B12 and iron
name 2 stimulant laxatives
bisacodyl
sennosides
what mucosal defense forms a thick protective barrier on an ulcer
sucralfate
name some 3 PPIs
esomeprazole
pantoprazole
rabeprazole
dexlansoprazole
what kind of drug is loperamide
antidiarrheal agents
how do bulk-forming laxatives work
stimulates water retention within stool
