Gastrointestinal Drug Therapy

Question 1

Orlistat a lipase inhibitor treats what ?

Rashes
GURD
Obesity
Diarrhea

Answer 1

Obesity

Question 2

Name some adverse effects if taking orlistat?

Answer 2

Fecal urgency
Oily spotting
Flactence

Question 3

What bacterium oftenly causes duodenal and gastric ulcers ?

Stephlacoccus areus
Helicobactor pylori’
Antacids

Answer 3

Helicobactor pylori

Question 4

The treatment for GERD and duodenal and gastric ulcers would be what type of drugs ?

-IDINE’s
-Prazole’s

Answer 4

Prazoles

E.g: omeprazole, lansoprozole etc
These are proton pump inhibitors

Question 5

Which antagonists prevent histamine induced acid release ?

H6 receptor
H6 receptor
H4 receptor
H2 receptor

Answer 5

H2 Receptor antagonists

Question 6

What drugs end in -tidine

H2 receptor antagonists ?
Acid based gastric drugs ?
Proton pump inhibitors ?

Answer 6

H2 Recptor antagonists

Question 7

Which drug binds to cytochrome P450 therefore adverse drug interactions with drugs transformed via cytochrome P450 are common ?

Cimetidine
Ranitidine
Famotidine
Nizatidibe

Answer 7

Cimetidine

Question 8

What causes constipation ?
Choose 2 options

Aluminium salts
Calcium carbonate antacids
Magnesium salts

Answer 8

Aluminium salts
Calcium carbonate antacids

Drug: cimetidine

Question 9

What causes diarrhea ?

Aluminium salts
Calcium carbonate antacids
Magnesium salts

Answer 9

Magnesium salts

Drug: cimetidine

Question 10

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

Answer 10

Decrease absorbtion

This is true for aluminium salts too

Question 11

What causes hypophosphatemia ?

Phosphate salts
Magnesium salts
Aluminium salts

Not as obvious as you think ! 💭

Answer 11

Aluminium salts

Question 12

Sucralfate ….

Helps decrease diarrhea ?

Helps form protective layer over mucosa?

Helps with absorbtion decreasing constipation ?

If you can name the MAIN side effect

Answer 12

Helps form protective layer over mucosa esp on ulcerated areas

MAIN Side effect: Constipation

Question 13

Metacloprimide & Cisapride …

Increase gastric emptying

Decrease gastric emptying

Makes gastric emptying harder so they’re used in COMBO with other drugs

Answer 13

Increase gastric emptying

Question 14

Was it metoclopramide ir cisapride that causes cardiac arrhythmias so it’s been removed from the markets in U.S?

Answer 14

Cisapride

Question 15

Which receptors does metaclopramide work on?

5-HT4 receptors ?
5-CHL45 Receptors ?
HR4-CL Receptors ?

Answer 15

5 - HT4 Receptors

Question 16

Misoprostol …

Increases or decreases bicarbonate & murine release ?

Increases or decreases acid secretion

And treats what?

Answer 16

1) increases

2) decreases

NSAIDS induced ulcers

Question 17

Metamucal, dulcolax and Ex Lax
Laxatives, oral or rectal drugs ?

Answer 17

Laxatives

Question 18

What does MILK OF MAGNESIA do ?

Draws water into Colon
Improves water and fat penetration into💩

Answer 18

Draws water into colon

Question 19

What drug improves the fat and water penetration into 💩

Colace
Bulk - forming drugs
Stimulant laxatives

Answer 19

Colace

Question 20

Tegaserod a 5-HT4 agonist was approved for what type?

IBS-D ?
IBS-C ?

Answer 20

IBS - C

Question 21

What does bulk forming agents contain so that it makes the stoools softer ?

Answer 21

Plant matter that absorbs water

Question 22

Stimulants (laxatives) increase what 2 things in the feces and increase motility?

Softening agents and water ?
Water and sodium ?
Water and electrolytes ?

Answer 22

Increase water and electrolytes

Question 23

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 ?

Answer 23

Chloride channels in the GI tract that stimulates intestinal fluid secretion.

Question 24

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?

Answer 24

Binds to receptors leading to increased secretions into the lumen and accelarated transit.

Question 25

What 2 conditions make up Inflammatory bowel disease ? Crohns Colitis Coeliac disease Ulcerative colitis

Answer 25

Crohn’s disease and ulcerative colitis

Question 26

Antibodies and antibody fragments bind to tumour necrosis factor to block what cascade in Inflammatory bowel disease? Hint in the question it’s self 😉

Answer 26

Inflammatory cascade

Question 27

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

Answer 27

Steroids and 5 - ASA

Question 28

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

Answer 28

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.

Question 29

How do antibodies and antibody fragments help in Inflammatory bowel disease ?

Answer 29

Bind to tumour necrosis factor - x and blocks the inflammatory cascade

Question 30

Name the reflex which is the vomiting reflex ? Vomitus reflex Or Emetic reflex

Answer 30

Emetic reflex

Question 31

Where is the vomiting centre located in the brain ?

Answer 31

Medulla oblongata

Question 32

What’s the name of receptors in the 🤮 centre in the medulla oblongata ?

Answer 32

Muscurinic receptors

Question 33

How do Proton pump inhibitors help reduce the amount of gastric fluid (HCL) in the stomach ?

Answer 33

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

Question 34

What 3 components activate the parietal cells to release protons that then bind to a certain element to make HCL? Name the 3

Answer 34

Histamine Acetylcholine Gastrin All three release gastric components

Question 35

What element does the protons bind to, when the proton pump releases H+ to produce gastric acid

Answer 35

Chloride

Question 36

What binds to the CCK2 receptor? Gastrin Acetylcholine Histamine

Answer 36

Gastrin

Question 37

What binds to the M3 Receptor in the stomach Gastrin Acetylcholine Histamine

Answer 37

Acetylcholine

Question 38

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

Answer 38

Max effect: 2-3 days Dose lasts: 1-2 days

Question 39

What can suddenly stopping the reflux medication 💊 not gradually but suddenly do? Hint: to the gastric acid

Answer 39

Rebound effect that can cause over production of gastric acid & increase in reflux symptoms

Question 40

Short term effects of Proton pump inhibitors (PPIs): <14days Name the most common side effects: Hint: there’s 4 symptoms

Answer 40

Headache Diarrhea Nausea Abdo pain

Question 41

Long term side effects of proton pump inhibitors can cause effects. These are rare being at <1%. Name some effects if you can !

Answer 41

- 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

Question 42

What conditions is antacids used for? Peptic ulcers Ulcerative ulcers Crohn’s diseases GERD Ceoliac disease

Answer 42

GERD & peptic ulcers

Question 43

How do Antacids work Hint: acid

Answer 43

They neutralize the acid

Question 44

Why shouldn’t you give a child under 2 antacids. What do they contain Hint: 1 word answer

Answer 44

Asprin

Question 45

Why can’t you give a child under 2 antacids and those with a recent viral infection. What metabolic disorder will the child get ?

Answer 45

Reye’s syndrome

Question 46

What are the side affects of calcium and. Aluminum’ Assuming that is calcium carbonate & almunimum hydroxide Theres one symptom for both Hint: Think C

Answer 46

Calcium & almunium - constipation

Question 47

Side effects of magnesium hydroxide ? There’s only 2

Answer 47

GI upset & Diarrhea

Question 48

When should someone take antacids ?

Answer 48

Take on an empty stomach And best at bed time