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Pharmacology > Gastrointestinal Drugs (82) > Flashcards

Gastrointestinal Drugs (82) Flashcards

1
Q

Body of the stomach contains

A

-parietal cells
-ECL cells
-chief cells

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2
Q

Parietal cells

A

Produce and secrete HCl to keep stomach at pH of 1 to 2

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3
Q

What is the primary site of action for many acid controller drugs

A

Parietal cells

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4
Q

ECL cells

A

Secrete histamine
-stimulate parietal cells

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5
Q

H.pylori percentage in duodenal ulcers/gastric ulcers

A

90%- duodenal
70%- gastric

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6
Q

What is used to eradicate H pylori

A

Antibacterials

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7
Q

Inhibitors of gastric acid secretion/action (4)

A

-H2 antagonists
-proton pump inhibitors
-antacids
-other agents protecting mucosa

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8
Q

Antacid examples (4)

A

-mg salts
-calcium salts
-sodium bicarbonate
-aluminum salts

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9
Q

what do H2 Atagonists reduce?

A

Acid secretion

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10
Q

How can H2 Atagonists be sold OTC?

A

They are sold in much lower dosage forms

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11
Q

H2 Atagonists are the most popular drugs for

A

Treatment of acid related disorders

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12
Q

Example of H2 Atagonists

A

Cimetidine

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13
Q

Cimetidine has some..

A

Drug interactions
-so less used

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14
Q

MOA of H2 Atagonists

A

Block histamine H2 receptors of acid producing parietal cells
-receptor antagonist

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15
Q

H2 Atagonists cause a decreased production

A

Of HCl

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16
Q

Indications of H2 Atagonists

A

-GERD
-PUD
-adjunct therapy in control of upper GI bleeding
-pathological gastric hypersecretory conditions

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17
Q

AE H2 Atagonists

A

Low incidence
-impotence and gynecomastia
-CNS depression and confusion in elderly patients

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18
Q

Cimetidine AE

A

May induce impotence and gynecomastia
-antiandrogenic effect

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19
Q

Cimetidine MOA

A

Inhibits liver cytochrome P-450

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20
Q

Cimetidine could affect what aspects of other drugs?

A

Affects the metabolism of other drugs causing increased drug levels
-example warfarin

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21
Q

Need increased care with Cimetidine in patients with

A

Impaired renal or liver function, and cautiously in confused, disoriented or elderly patients

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22
Q

Cimetidine need to be take 1 hour before taking..

A

Antacids
-affects absorption

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23
Q

Proton pump inhibitors work by

A

Inhibition of the pump that moves H+ into stomach of lumen

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24
Q

Proton pump inhibitors are more effective than

A

H2 antagonists

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25
Q

Proton pump inhibitors MOA

A

Irreversibly bind to H+/K+ ATPase enzyme
-normal acid secretion needs parietal cell to synthesize new H+/K+ ATPase

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26
Q

Examples of Proton pump inhibitors

A

Omeprazole

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27
Q

Omeprazole

A

Enteric coated and broken down by acid

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28
Q

Indications of Proton pump inhibitors

A

-GERD maintenance therapy
-erosive esophagitis
-short term tax of active duodenal and benign gastric ulcers
-zollinger Ellison syndrome

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29
Q

Zollinger Ellison syndrome

A

Gastric producing tumour

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30
Q

AE Proton pump inhibitors

A

Safe for short term therapy
-headaches, GI

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31
Q

Proton pump inhibitors should be used in caution in patients with

A

Liver disease

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32
Q

Drug interactions with Proton pump inhibitors

A

Inhibit the absorption of drugs that require an acidic GI environment for absorption

33
Q

Typical therapy for H pylori infection

A

Triple therapy
-antibacterials
-Proton pump inhibitors
-takes seve to fourteen days

34
Q

Proton pump inhibitors may increase the serum of what three drugs

A

-diazepam
-phenytoin
-inc risk of bleeding with warfarin

35
Q

Proton pump inhibitors + diazepam

A

BZD used in many CNS conditions

36
Q

Instructions when taking omeprazole (3)

A

-capsule should be swalllowed whole, never crushed, open or chewed
-it may be given with antacids
-treatment is short term

37
Q

Antacids MOA

A

chemically neutralize acid

38
Q

Antacids do not prevent

A

Acid production

39
Q

Antacids can be used alone or in combination with

A

-aluminum salts
-magnesium salts
-calcium salts
-sodium bicarbonate

40
Q

Aluminum salts: salts are made up of

A

Carbonate and hydroxide

41
Q

Aluminum salts may cause

A

Constipation

42
Q

How do you reduce constipation in Aluminum salts

A

Take them with magnesium salts

43
Q

Example of Aluminum salts

A

Aluminum hydroxide

44
Q

Magnesium salts: salts made up of

A

Carbonate, hydroxide, oxide trisilicate

45
Q

Magnesium salts commonly cause

A

Diarrhea
-usually paired with agents to counteract the diarrhea

46
Q

Magnesium salts can be dangerous when used with

A

Renal failure
-due to accumulation

47
Q

Calcium salts: salts made up of

A

Many, but carbonate is most common

48
Q

Calcium salts may cause

A

Constipation and kidney stones

49
Q

Example of calcium salts

A

Calcium carbonate

50
Q

Sodium bicarbonate (3)

A

-highly soluble
-quick onset, short duration
-may cause metabolic alkalosis

51
Q

Sodium component of sodium bicarbonate

A

May cause problems in clients with HF, hypertension or renal insufficiency

52
Q

AE of antacids:

A

I’m nail and depends on compound used

53
Q

AE of antacids: aluminum and calcium

A

Constipation

54
Q

AE of antacids: magnesium

A

Diarrhea

55
Q

AE of antacids: calcium carbonate

A

Constipation, produces gas and belching

56
Q

Calcium carbonate is often combined with

A

Simethicone

57
Q

Interactions of antacids can effect

A

Absorption of other drugs
-reduce absorption of other drugs given at the same time

58
Q

Drug interactions with chelation

A

Chemical binding, inactivation of another drug
-produces insoluble complexes

59
Q

Insoluble complexes of chelation causes

A

Reduced drug absorption
-tetracycline

60
Q

Need to assess for ____ when giving antacids

A

Allergies and pre-existing conditions that may restrict the use of antacids

61
Q

Clients with HF or hypertension should use ____ antacids

A

Low sodium

62
Q

Most medications should be given how many hours before antacids?

A

1 to 2 hours

63
Q

Antacids may cause premature dissolving of

A

EC medications

64
Q

Administer antacids with

A

At least 240 mL of water to enhance dispersion

65
Q

Caffeine, alcohol, harsh spices and black pepper may do what

A

Aggregate an underlying GI condition

66
Q

Other agents that protect the mucosa

A

Sucralafate and misoprostol

67
Q

Sucralfate

A

Binds directly to ulcer surface

68
Q

Misoprostol

A

Prostaglandin agent

69
Q

What type of agent is sucralfate

A

Cytoprotective agent

70
Q

MOA of sucralfate

A

-Forms gel with mucus in low pH
-attracted to and binds to the base of ulcers and erosions = protective barrier
-inhibits pepsin

71
Q

Indications of sucralfate

A

Intestinal erosions

72
Q

Sucralfate has little

A

Absorption from the gut

73
Q

Sucralfate adverse effects

A

May cause constipation, nausea, dry mouth, and impair absorption of other drugs

74
Q

Sucralfate binds with

A

Phosphate
-may be used in chronic renal failure to reduce phosphate levels

75
Q

Misoprostol MOA

A

Does the job of endogenous PGs
-12 and E2

76
Q

Prostaglandins have cytoprotective activity

A

-production of mucus and bicarbonate
-reduce acid secretion
-promote local cell regeneration
-help to maintain mucosal blood flow

77
Q

Misoprostol indications

A

Reduce gastric effects of NSAIDs

78
Q

Misoprostol is never used

A

In pregnancy
-can be used to terminate pregnancy

Pharmacology (37 decks)

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