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Gastrointestinal Pharmacology -1 Flashcards

H2 Receptor Blocker

1
Q

H2 receptor antagonists name ??

535

A
  1. RaniTidine
  2. CimeTidine
  3. FamoTidine
  4. NizaTidine

535

TIDINE

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2
Q

Indications of H2 receptors blockers ??

A
  1. GERD
  2. PUD
  3. Non ulcer dyspepsia
  4. Bleeding from stress ulcer

536

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3
Q

Mechanism of H2 channel blockers ??

Figure to whole process >??

A

=Ranitidine block H2 receptors in parietal cell
=Histamine released from ECL cell cannot bind
=No production of cAMP
=No activation of protein kinase
=No H+ from H+K+ATPase Proton pump

535

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4
Q

Receptors of parietal cells ??

A
  1. Gastrin
  2. Histamine
  3. Ach

534

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5
Q

Ach & gastrin receptor mechanism ?

A
  1. Vagus-Ach & G cells- Gastrin
  2. Ach–M3 & Gastrin – CCKB
  3. Ca2+ production
  4. Ca2+ —- Protein kinase
  5. Protein kinase – H+ ( H+ k+ ATPase Pump )

534

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6
Q

Endocrine A/E of ranitidine ?/

A
  1. Gynecomastia
  2. Galactorrhea
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7
Q

A/E OF H2 receptor blockers ??

A
  1. Diarrhea
  2. Constipation
  3. Headache
  4. Myalgia
  5. Fatigue
  6. Gynecomastia
  7. Galactorrhea
  8. Hypotension
  9. Bradycardia

536

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8
Q

What Tx if ranitidine fails ??

A

H pylori infection
Triple/Quadruple therapy

536

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9
Q

Warfarin + Cimetidine = ??

Drug interaction

A

=Cimetidine inhibit cyt-P450 enzyme
=dec metabolism of drugs
=prolonged Half life of the drugs

Warfarin toxicity = Bleeding

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10
Q

For GERD which drug preferable ??

A

PPI

536

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11
Q

Proton pump inhibitors name ??

537

A
  1. OmePrazole
  2. Esome
  3. Lanso
  4. Panto
  5. Rabe

PRAZOLE

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12
Q

PPI active form ??

A

Thiophilic sulfonamide cation

537

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13
Q

PPI mechanism ??

From figure

A
  1. PPI – TSC
  2. TSC reacts with proton pump
  3. Irreversible inactivation of the proton pump
  4. Counter transport blocked
  5. No H+ by the parietal cells

537

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14
Q

Indication of PPI ??

537

A
  1. GERD
  2. PUD
  3. Non ulcer dyspepsia
  4. Stress related mucosal bleeding
  5. Zollinger ellison syndrome

538

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15
Q

Prevention of rebreeding from PUD ??

A

80mg IV bolus followed by dose of 8mg/h in IV infusion for 3-5 days

538

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16
Q

PUD indication of PPI ??

A
  1. H pylori PUD
  2. NSAID PUD
  3. Perforation of bleeding PUD

538

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16
Q

A/E of PPI ??

A
  1. Diarrhea
  2. Headache
  3. Ab pain
  4. Subnormal B12 level
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17
Q

Prolonged use of PPI ?? A/E ?

A
  1. Gastric atrophy
  2. Intestinal metaplasia

538

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18
Q

Triple therapy for which disease ??

A

PUD

540

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19
Q

Triple therapy drugs ??

A
  1. PPI
  2. Amoxicillin
  3. Clarithromycin
  4. Metronidazole

540

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20
Q

Drugs doses of Triple therapy?”

A
  1. PPI- 12hr - 7days
  2. Amoxicillin - 1g - 12hr
  3. Metronidazole - 400mg - 12hr - 7day
  4. Clarithromycin - 500mg - 12hr - 7day
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21
Q

Quadruple therapy ??

A
  1. Bismuth subsalicylate 524 mg
  2. Metronidazole 500mg
  3. Tetracycline 500mg
  4. PPI twice a day&raquo_space;»

540

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21
Q

Who will get quadruple therapy ??

A

Clarithromycin resistance

540

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22
Q

Role of PPI in PUD ???

A
  1. Direct antimicrobial properties
  2. rise intragastric pH
  3. Low minimal inhibitory conc of antibiotics against H pylori

541

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23
Clarithromycin role in PUD ?? | 500MG
Inhibit bacterial protein synthesis | 541
24
Amoxicillin role in PUD ??
Inhibit bacterial cell wall synthesis | 541
25
MetronidaAZOLE role in PUD ?? | 400 mg
1. Cytotoxic nitro group of M bind with bacterial Proteins & DNA | 541
26
K+ competitive acid blocker drug name ??
VonoPrazan | 541
27
VonoPrazan indications ??
1. PUD 2. Reflux esophagitis 3. Drug induced ulcer
28
Vonoprazan mechanism ?
1. acts on the key enzyme H+/K+ ATPase in the final step of gastric acid secretion 2. Competitively inhibits the binding of K+ TO proton pump | 541
29
Agents those enhance mucosal resistance / ulcer healing >??
1. Sucralfate 2. PG analog- Misoprostol 3. Colloidal bismuth compounds | 531
30
Sucralfate composition ?
Salt of sucrose + Sulfated Al(OH)3
31
Sucralfate indications ??
1. PUD 2. Prevention of stress related bleeding | 542
32
Sucralfate mechanism ?/
1. (-) sucralfate & (+) proteins in the base of ulcer / erosion = it forms physical barrier that restricts caustic damage | 542
33
A/E of Sucralfate ??
1. Constipation 2. Avoided in pt of RF
34
Indications of misoprostol ??
1. NSAID induced ulcer | 543
34
Vonoprazan advantages over PPI ??
1. action rapid 2. efficacy not effected by meals 3. peack conc reached rapidly 4. does not require enteric coating 5. more potent 6. prolonged acid suppressing effects | 542
35
Contraindiaction of Misoprostol ??
1. 🤰 2. Women of childbearing | 543
36
Mechanism of misoprostol ??
1. Stimulate mucus & bicarbonate secretion 2. Enhance mucosal blood flow 3. dec Histamine stimulated cAMP production in parietal cells 4. prevents luminal H+ from diffusing into the mucosa 5. inc cell replication in mucosa | 543
37
A/E of misoprostol ??
1. Diarrhoea 2. Ab pain 3. Spotted bleeding 4. Dysmenorrhea | 544
38
Limitation of misoprostol ??
1. High A/E 2. Need for multiple daily dosing | 544
39
Colloidal bismuth compounds clinical use ??
1. Dyspepsia 2. H pylori PUD 3. Travlers diarrhea 4. Acute Diarrhea | 543
40
A/E of CBC ??
1. Stool- blackening 2. Tongue- Blackening 3. Ataxia 4. Headache 5. Seizure 6. Confusion 7. Salicylate toxicity 8. Renal insufficiency | 543
41
Mechanism of CBC ??
1. Bismuth coats ulcer & erosions 2. protective layer against acid & pepsin 3. Direct antimicrobial effects 4. dec stool frequency 5. inc secretion of mucus pg bicarbonate | 542
42
GERD drugs ??
1. PPI 2. H2 RB 3. Antacids 4. Domeperidone | 545
43
Advice for PUD patient ??
1. Stop smoking 2. Stop NSAID 3. Stop alcohol 4. Take regular meals | 544
44
H2 blocker kothay kaj kore ?
h2 receptor of parietal cell
45
long time PPI effect ?
prolonges hypochlorhydria inc gastric bacterial growth risk of respiratory infection
46
amra to PPI onek shomoy dhore use kortesi tao effect pai na keno ??
due to some sparing receptors
47
Misoprostol er sathe khabar er ki relationship?
take this drug with food to prevent Diarrhe nausea stomach cramp
48
proton pump name ?
Na K ATPase pump
49
what kind of inactivation of proton pump ?
irreversible
50
what to do after complete of triple therapy ?
once daily for 4-6 nweeks for complete ulcer healing 540
51
which PPI used in Triple therapy ?
Rabeprazole lansiprazole
52
other use of triple therapy ?
Duodenal ulcer 8.11AM 13.4.2025
53
Antacid + Tetracycline ?
A should not be given within 2 hours of doses of T - as it hampers the absoption of other medications - or by increasing intragastric pH
54
Management of D ?
558
55
loperamide indication ?
persistent diarhhea ?
56
💩Persistent Diarrhea ??
💩Persistent Diarrhea = ⏱ >14d but <30d 📆Acute: <14d 📆Chronic: >30d
57
non-infecrive D ?
diphenoxylate 593
58
infective D >
561
59
what will happen if loperamide is used in acute diarhhea ?
🚫**Loperamide in Acute Diarrhea**—Use w/ CAUTION❗ ✅Safe: *Non-invasive*, no fever/blood ⛔Danger: Invasive/Inflammatory diarrhea → 🦠Shigella, Salmonella, EHEC, C. diff ⚠️Risks: – ↓GI motility → toxin retention – ↑ risk of *toxic megacolon* – Worsen systemic absorption of toxins – CI in kids <2y (CNS/ileus risk) 📌Use only if afebrile, no blood, mild-mod symptoms @usmlereviews
60
best combo of ANtacid ??
Al & Mg (OH) 2
61
why combo in antacid ?
Mg - Osmotic D Al - Constipation antgonism 533

Pharmacology-PROF (38 decks)

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