Gastrointestinal Drug Therapy Flashcards
Orlistat a lipase inhibitor treats what ?
Rashes
GURD
Obesity
Diarrhea
Obesity
Name some adverse effects if taking orlistat?
Fecal urgency
Oily spotting
Flactence
What bacterium oftenly causes duodenal and gastric ulcers ?
Stephlacoccus areus
Helicobactor pylori’
Antacids
Helicobactor pylori
The treatment for GERD and duodenal and gastric ulcers would be what type of drugs ?
-IDINE’s
-Prazole’s
Prazoles
E.g: omeprazole, lansoprozole etc
These are proton pump inhibitors
Which antagonists prevent histamine induced acid release ?
H6 receptor
H6 receptor
H4 receptor
H2 receptor
H2 Receptor antagonists
What drugs end in -tidine
H2 receptor antagonists ?
Acid based gastric drugs ?
Proton pump inhibitors ?
H2 Recptor antagonists
Which drug binds to cytochrome P450 therefore adverse drug interactions with drugs transformed via cytochrome P450 are common ?
Cimetidine
Ranitidine
Famotidine
Nizatidibe
Cimetidine
What causes constipation ?
Choose 2 options
Aluminium salts
Calcium carbonate antacids
Magnesium salts
Aluminium salts
Calcium carbonate antacids
Drug: cimetidine
What causes diarrhea ?
Aluminium salts
Calcium carbonate antacids
Magnesium salts
Magnesium salts
Drug: cimetidine
What does antacids do?
Increase absorbtion
Decrease absorbtion
Delay absorbtion
Prevent absorbtion
…of ther drugs due to the the altering PH in the duodenum and a stomach
Decrease absorbtion
This is true for aluminium salts too
What causes hypophosphatemia ?
Phosphate salts
Magnesium salts
Aluminium salts
Not as obvious as you think ! 💭
Aluminium salts
Sucralfate ….
Helps decrease diarrhea ?
Helps form protective layer over mucosa?
Helps with absorbtion decreasing constipation ?
If you can name the MAIN side effect
Helps form protective layer over mucosa esp on ulcerated areas
MAIN Side effect: Constipation
Metacloprimide & Cisapride …
Increase gastric emptying
Decrease gastric emptying
Makes gastric emptying harder so they’re used in COMBO with other drugs
Increase gastric emptying
Was it metoclopramide ir cisapride that causes cardiac arrhythmias so it’s been removed from the markets in U.S?
Cisapride
Which receptors does metaclopramide work on?
5-HT4 receptors ?
5-CHL45 Receptors ?
HR4-CL Receptors ?
5 - HT4 Receptors
Misoprostol …
Increases or decreases bicarbonate & murine release ?
Increases or decreases acid secretion
And treats what?
1) increases
2) decreases
NSAIDS induced ulcers
Metamucal, dulcolax and Ex Lax
Laxatives, oral or rectal drugs ?
Laxatives
What does MILK OF MAGNESIA do ?
Draws water into Colon
Improves water and fat penetration into💩
Draws water into colon
What drug improves the fat and water penetration into 💩
Colace
Bulk - forming drugs
Stimulant laxatives
Colace
Tegaserod a 5-HT4 agonist was approved for what type?
IBS-D ?
IBS-C ?
IBS - C
What does bulk forming agents contain so that it makes the stoools softer ?
Plant matter that absorbs water
Stimulants (laxatives) increase what 2 things in the feces and increase motility?
Softening agents and water ?
Water and sodium ?
Water and electrolytes ?
Increase water and electrolytes
Lubiprostone a prostaglandin E1 analogue is approved Tx for chronic constipation and IBS-C. What does it activate
Sodium
Magnesium
Chloride
Channels in epithelium of GI tract ?
Which then stimulates what ?
Chloride channels in the GI tract that stimulates intestinal fluid secretion.
Another approved drug IBS-C pts can take are Guanylate Cyclades-C agonists. What do they do ?
What do they bind to ? Which leads to what?
Binds to receptors leading to increased secretions into the lumen and accelarated transit.
What 2 conditions make up Inflammatory bowel disease ?
Crohns
Colitis
Coeliac disease
Ulcerative colitis
Crohn’s disease and ulcerative colitis
Antibodies and antibody fragments bind to tumour necrosis factor to block what cascade in Inflammatory bowel disease?
Hint in the question it’s self 😉
Inflammatory cascade
What are are the primary therapies used to control the inflammatory process in ulcerative colitis ?
Choose 2
Steroids
Immunosuppressants
5-aminosalicyclate (5 - ASA)
Antibiotics
Tumour necrosis factor
Steroids and 5 - ASA
How does 5-ASA work in controlling inflammation ?
5-ASA inhibits prostaglandins activity and doesn’t work on parietal cells
OR
5 - ASA inhibits leukotriene production and has anti prostaglandin & antioxidant activity
5 - ASA inhibits leukotriene production and has anti prostaglandin & antioxidant activity
5-aminosalicylic acid (5-ASA) is an antiinflammatory drug widely used in the treatment of inflammatory bowel diseases.
It is known to inhibit the production of cytokines and inflammatory mediators, but the mechanism underlying the intestinal effects of 5-ASA remains unknown.
How do antibodies and antibody fragments help in Inflammatory bowel disease ?
Bind to tumour necrosis factor - x and blocks the inflammatory cascade
Name the reflex which is the vomiting reflex ?
Vomitus reflex
Or
Emetic reflex
Emetic reflex
Where is the vomiting centre located in the brain ?
Medulla oblongata
What’s the name of receptors in the 🤮 centre in the medulla oblongata ?
Muscurinic receptors
How do Proton pump inhibitors help reduce the amount of gastric fluid (HCL) in the stomach ?
The medication binds onto the proton pump
Omeprazole is a type of medicine called a proton pump inhibitor (PPI). Proton pumps are enzymes in the lining of your stomach that help it make acid to digest food. Omeprazole prevents proton pumps working properly which reduces the amount of acid the stomach makes
What 3 components activate the parietal cells to release protons that then bind to a certain element to make HCL?
Name the 3
Histamine
Acetylcholine
Gastrin
All three release gastric components
What element does the protons bind to, when the proton pump releases H+ to produce gastric acid
Chloride
What binds to the CCK2 receptor?
Gastrin
Acetylcholine
Histamine
Gastrin
What binds to the M3 Receptor in the stomach
Gastrin
Acetylcholine
Histamine
Acetylcholine
what’s the max effect of these proton pumps medications and how long does the dosage last ?
Max efffect:
2-3 days, 4-6days, 6+ days
Dosage lasts:
4-6 days, 1-2days, 6+ days
Max effect: 2-3 days
Dose lasts: 1-2 days
What can suddenly stopping the reflux medication 💊 not gradually but suddenly do?
Hint: to the gastric acid
Rebound effect
that can cause over production of gastric acid & increase in reflux symptoms
Short term effects of Proton pump inhibitors (PPIs): <14days
Name the most common side effects:
Hint: there’s 4 symptoms
Headache
Diarrhea
Nausea
Abdo pain
Long term side effects of proton pump inhibitors can cause effects. These are rare being at <1%. Name some effects if you can !
- Infections: C.Diff (diarrhea, fever, stomach pain)
- Pneumonia (increased risk of developing)
Possibly due to how out stomach acid plays a role in immune function,
*⬇️stomach acid = ⬇️immune function
- Deficiency in Vit B12, Mg, Fe (iron), Ca ⬇️stomach acid = ⬇️nutrient absorbtion
- ⬇️ca= ospteroporosis - hip fractures
- CKD
What conditions is antacids used for?
Peptic ulcers
Ulcerative ulcers
Crohn’s diseases
GERD
Ceoliac disease
GERD & peptic ulcers
How do Antacids work
Hint: acid
They neutralize the acid
Why shouldn’t you give a child under 2 antacids. What do they contain
Hint: 1 word answer
Asprin
Why can’t you give a child under 2 antacids and those with a recent viral infection. What metabolic disorder will the child get ?
Reye’s syndrome
What are the side affects of calcium and. Aluminum’
Assuming that is calcium carbonate & almunimum hydroxide
Theres one symptom for both
Hint: Think C
Calcium & almunium - constipation
Side effects of magnesium hydroxide ?
There’s only 2
GI upset & Diarrhea
When should someone take antacids ?
Take on an empty stomach
And best at bed time
