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MBChB 3 Drug Database > Gastrointestinal Drugs > Flashcards

Gastrointestinal Drugs Flashcards

1
Q

Give 3 examples of PPIs?

A

Omeprazole
Lansoprazole
Pantoprazole

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2
Q

What is the MoA for PPIs?

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

What are the indications for a PPI?

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

List some side effects of PPIs:

A 
Nausea
Vomiting
Insomnia
Vertigo
Headaches
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5
Q

What is important clinically regarding pharmaco-kinetics/dynamics for PPIs?

A

Omeprazole is an inhibitor of cytochrome P450 enzymes

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6
Q

what info should be given to a patient before starting a PPI?

A

Avoid alcohol

Take 30-60mins before food

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7
Q

Give 4 examples of H2 receptor antagonists

A

Ranitidine
Cimetidine
Famotidine
Nizatidine

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8
Q

What is the MoA for H2 receptor antagonists?

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

What are the indications for a H2 receptor antagonist?

A

Peptic ulcer
Gastro-oesophageal reflux disease
Zollinger-Ellison syndrome

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10
Q

List some side effects of H2 receptor antagonists:

A 
Headache
Dizziness
Diarrhoea
Reduced B12 absorption
Gynaecomastia
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11
Q

What is important clinically regarding pharmaco-kinetics/dynamics for H2 receptor antagonists?

A

Cimetidine is an inhibitor of cytochrome P450 enzymes.

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12
Q

What info should be given to patient before starting a H2 receptor antagonist?

A

Avoid high protein diet

Take without regard to meals

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13
Q

What are 2 examples of laxatives?

A

lactulose

senna

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14
Q

what is the MoA for senna and lactulose?

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

what are the indications for a laxative?

A

pregnancy
constipation
prophylaxis in opiate analgesic use

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16
Q

list some side effects of laxatives:

A

Dehydration
Salt loss
Abdominal cramps
Fatigue

17
Q

What is important clinically regarding pharmaco-kinetics/dynamics for laxatives?

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

What info should be given to patient before starting a laxative?

A

take liberally without regard to meals

19
Q

give examples of the different types of laxatives:

A

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

Stool softeners – adds more water and fat into the stool

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

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

20
Q

what is the MoA forCyclizine?

A

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

21
Q

what are the indications for Cyclizine?

A

Nausea and vomiting
Motion sickness
Vertigo and dizziness
Prophylaxis alongside chemotherapy and opiate analgesic use

22
Q

List some side effects of Cyclizine:

A

Headache
Sedation
Diarrhoea

23
Q

What is important clinically regarding pharmaco-kinetics/dynamics for Cyclizine?

A

It can also be a central nervous system depressant

24
Q

what info should be given to the patient before starting Cyclizine?

A

Avoid alcohol
Food may reduce irritation
Take without regard to meals

25
Q

Give 5 examples of the different types of anti-emetics

A

Anti-cholinergics (Hyoscine hydrobromide)
Blocks acetylcholine neurotransmitters in the CNS and the PNS

Anti-histamines (Cyclizine)
H1 histamine receptor antagonist

Serotonin antagonists (Ondansetron)
Block serotonin receptors in the CNS and the GIT

Phenothiazines (Prochlorperazine)
Dopamine receptor antagonist (D2 receptor antagonist)

Motility stimulants (Metoclorpramide)
Dopamine  receptor antagonist (D2 receptor antagonist)
26
Q

What is the MoA for metoclopramide?

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

27
Q

what are the indications for metoclopramide?

A

Nausea
Vomiting
To increase gastric emptying

28
Q

list the side effects of metoclopramide:

A 
Dystonia (due to dopamine antagonism)
Confusion
Dizziness
Diarrhoea
Parkinsonism with long term use
29
Q

What is important clinically regarding pharmaco-kinetics/dynamics for metoclopramide?

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

30
Q

what info should be given to patient before starting metoclopramide?

A

avoid alcohol

Take 30 mins before meal

31
Q

what is the MoA for Prochlorperazine?

A

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

32
Q

what are the indications for Prochlorperazine?

A

Nausea and vomiting

Used as an adjunct in some psychotic disorders

33
Q

what are the side effects of Prochlorperazine?

A

Dry mouth
Tachycardia
Restlessness
Drowsiness

34
Q

What is important clinically regarding pharmaco-kinetics/dynamics for Prochlorperazine?

A

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

35
Q

what info should be given to patient before starting Prochlorperazine?

A

Avoid alcohol and caffeine

Take with food along with a full glass of water

MBChB 3 Drug Database (10 decks)

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