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Drugs > Gastrointestinal drugs > Flashcards

Gastrointestinal drugs Flashcards

1
Q

Proton Pump Inhibitors

Examples of drugs

A

Omeprazole
Lansoprazole
Pantoprazole

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2
Q

Proton Pump Inhibitors

Mechanism of action:

A

Bind to H+/K+ ATPase pump on gastric parietal cells
Reduces HCl production and hence reduced gastric acidity

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3
Q

Proton Pump Inhibitors

Indication(s):

A
  • Peptic ulcers
  • Gastro-oesophageal reflux disease
  • H.Pylori infection
  • Prophylaxis in patients receiving long term NSAIDs
  • Zollinger-Ellison syndrome
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4
Q

Proton Pump Inhibitors

Side effects:

A
  • Nausea
  • Vomiting
  • Insomnia
  • Vertigo
  • Headaches
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5
Q

Proton Pump Inhibitors

Important pharmacokinetics / pharmacodynamics:

A

Omeprazole is an inhibitor of cytochrome P450 enzymes

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6
Q

Proton Pump Inhibitors

Patient information:

A

Avoid alcohol
Take 30-60mins before food

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7
Q

H2 Receptor Antagonists

Example(s) of drugs:

A
  • Ranitidine
  • Cimetidine
  • Famotidine
  • Nizatidine
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8
Q

H2 Receptor Antagonists

Mechanism of action:

A
  • Histamine binds to H2 receptors on gastric parietal cells stimulating gastric acid secretion
  • Drugs antagonise the effect of histamine at these H2 receptors
  • Reduced cAMP and hence reduced activity of H+/K+ ATPase pump
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9
Q

H2 Receptor Antagonists

Indication(s):

A
  • Peptic ulcer
  • Gastro-oesophageal reflux disease
  • Zollinger-Ellison syndrome
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10
Q

H2 Receptor Antagonists

Side Effects

A

Headache
Dizziness
Diarrhoea
Reduced B12 absorption
Gynaecomastia

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11
Q

H2 Receptor Antagonists

Important pharmacokinetics / pharmacodynamics:

A

Cimetidine is an inhibitor of cytochrome P450 enzymes.

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12
Q

H2 Receptor Antagonists

Patient information:

A

Avoid high protein diet
Take without regard to meals

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13
Q

Laxatives

Example(s) of drugs:

A

Lactulose
Senna

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14
Q

Laxatives

Mechanism of action:

A
  • Lactulose – reduces water reabsorption in intestine; it pulls water into the bowel and thus promotes distention and movement
  • Senna – stimulant / irritant agent
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15
Q

Laxatives

Indication(s):

A
  • Constipation
  • Pregnancy
  • Prophylaxis in opiate analgesic use
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16
Q

Laxatives

Side effects:

A
  • Dehydration
  • Salt loss
  • Abdominal cramps
  • Fatigue
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17
Q

Laxatives

Important pharmacokinetics / pharmacodynamics:

A
  • Lactulose - consists of monosaccharides: fructose and galactose. Breakdown of this in the intestine by colonic bacteria increases osmotic pressure
  • Senna - recommended for short term use only. Risk of organ failure with long term use or abuse.
18
Q

Laxatives

Patient information:

A

Take liberally without regard to meals

19
Q

Laxatives

Other Information

A

Types of laxatives

A. Bulk producing agent – adds more substance so that they can pass through intestine easily (lactulose)

B. Stool softeners – adds more water and fat into the stool

C. Stimulant or irritant – acts on intestinal mucosa and alters water and electrolyte secretion (senna)

D. Hydrating agents – intestines hold more water (milk of magnesia)

20
Q

Anti-Emetic Drugs

Example(s) of drugs:

A

Cyclizine

21
Q

Anti-Emetic Drugs

Mechanism of action:

A
  • Histamine H1 receptor antagonist
  • Acts on vomiting center in the medullary region
  • Mild anti-cholinergic and anbti-muscarinic effects
22
Q

Anti-Emetic Drugs

Indication(s):

A
  • Nausea and vomiting
  • Motion sickness
  • Vertigo and dizziness
  • Prophylaxis alongside chemotherapy and opiate analgesic use
23
Q

Anti-Emetic Drugs

Side effects:

A
  • Headache
  • Sedation
  • Diarrhoea
24
Q

Anti-Emetic Drugs

Important pharmacokinetics / pharmacodynamics:

A

It can also be a central nervous system depressant

25
Q

Anti-Emetic Drugs

Patient information:

A
  • Avoid alcohol
  • Food may reduce irritation
  • Take without regard to meals
26
Q

Anti-Emetic Drugs

Other information:

A

Types of anti-emetics

A. Anti-cholinergics (Hyoscine hydrobromide)

Blocks acetylcholine neurotransmitters in the CNS and the PNS

B. Anti-histamines (Cyclizine)

H1 histamine receptor antagonist

C. Serotonin antagonists (Ondansetron)

Block serotonin receptors in the CNS and the GIT

D. Phenothiazines (Prochlorperazine)

Dopamine receptor antagonist (D2 receptor antagonist)

E. Motility stimulants (Metoclorpramide)

Dopamine receptor antagonist (D2 receptor antagonist)

27
Q

Anti-Emetic Drugs

Example(s) of drugs:

A

Metoclopramide

28
Q

Anti-Emetic Drugs

Mechanism of action:

A
  • Dopamine (D2) receptor antagonist
  • Raises activity in the chemoreceptor trigger zone – reducing input from afferent visceral nerves
  • Also increases gastric emptying and intestinal transit
  • Reduced oesophageal reflux
29
Q

Anti-Emetic Drugs

Indication(s):

A
  • Nausea
  • Vomiting
  • To increase gastric emptying
30
Q

Anti-Emetic Drugs

Side effects:

A
  • Dystonia (due to dopamine antagonism)
  • Confusion
  • Dizziness
  • Diarrhoea
  • Parkinsonism with long term use
31
Q

Anti-Emetic Drugs

Important pharmacokinetics / pharmacodynamics:

A
  • Can be given orally or parenterally
  • Dystonic reactions and movement disorders are more common at the extremes of age so caution is needed in these groups
32
Q

Anti-Emetic Drugs

Patient information:

A

Avoid alcohol
Take 30 mins before meal

33
Q

Anti-Emetic Drugs

Other information:

A

A. Anti-cholinergics (Hyoscine hydrobromide)

Blocks acetylcholine neurotransmitters in the CNS and the PNS

B. Anti-histamines (Cyclizine)

H1 histamine receptor antagonist

C. Serotonin antagonists (Ondansetron)

Block serotonin receptors in the CNS and the GIT

D. Phenothiazines (Prochlorperazine)

Dopamine receptor antagonist (D2 receptor antagonist)

E. Motility stimulants (Metoclorpramide)

Dopamine receptor antagonist (D2 receptor antagonist)

34
Q

Anti-Emetic Drugs

Example(s) of drugs:

A

Prochlorperazine

35
Q

Anti-Emetic Drugs

Mechanism of action:

A
  • Penothiazine anti-psychotic drug used as an anti-emetic
  • Dopamine (D2) receptor antagonist
  • Causes increased dopamine turnover (in mesolimbic and chemoreceptor trigger zone)
36
Q

Anti-Emetic Drugs

Indication(s):

A

Nausea and vomiting
Used as an adjunct in some psychotic disorders

37
Q

Anti-Emetic Drugs

Side effects:

A
  • Dry mouth
  • Tachycardia
  • Restlessness
  • Drowsiness
38
Q

Anti-Emetic Drugs:

Important pharmacokinetics / pharmacodynamics:

A
  • Anticholinergic and alpha-adrenergic receptors antagonism occurs leading to; sedation, muscle relaxation, and hypotension.
  • The dose differs substantially when given parenterally
39
Q

Anti-Emetic Drugs

Patient information:

A

Avoid alcohol and caffeine
Take with food along with a full glass of water

40
Q

Anti-Emetic Drugs

Other information:

A

Types of anti-emetics

A. Anti-cholinergics (Hyoscine hydrobromide)

Blocks acetylcholine neurotransmitters in the CNS and the PNS

B. Anti-histamines (Cyclizine)

H1 histamine receptor antagonist

C. Serotonin antagonists (Ondansetron)

Block serotonin receptors in the CNS and the GIT

D. Phenothiazines (Prochlorperazine)

Dopamine receptor antagonist (D2 receptor antagonist)

E. Motility stimulants (Metoclorpramide)

Dopamine receptor antagonist (D2 receptor antagonist)

41
Q
A

Drugs (8 decks)

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