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Pharmacology > Gastrointestinal Pharmacology -1 > Flashcards

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

19
Q

Triple therapy drugs ??

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

540

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
21
Q

Quadruple therapy ??

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

540

21
Q

Who will get quadruple therapy ??

A

Clarithromycin resistance

540

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

23
Q

Clarithromycin role in PUD ??

500MG

A

Inhibit bacterial protein synthesis

541

24
Q

Amoxicillin role in PUD ??

A

Inhibit bacterial cell wall synthesis

541

25
Q

MetronidaAZOLE role in PUD ??

400 mg

A
  1. Cytotoxic nitro group of M bind with bacterial Proteins & DNA

541

26
Q

K+ competitive acid blocker drug name ??

A

VonoPrazan

541

27
Q

VonoPrazan indications ??

A
  1. PUD
  2. Reflux esophagitis
  3. Drug induced ulcer
28
Q

Vonoprazan mechanism ?

A
  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
Q

Agents those enhance mucosal resistance / ulcer healing >??

A
  1. Sucralfate
  2. PG analog- Misoprostol
  3. Colloidal bismuth compounds

531

30
Q

Sucralfate composition ?

A

Salt of sucrose + Sulfated Al(OH)3

31
Q

Sucralfate indications ??

A
  1. PUD
  2. Prevention of stress related bleeding

542

32
Q

Sucralfate mechanism ?/

A
  1. (-) sucralfate & (+) proteins in the base of ulcer / erosion = it forms physical barrier that restricts caustic damage

542

33
Q

A/E of Sucralfate ??

A
  1. Constipation
  2. Avoided in pt of RF
34
Q

Indications of misoprostol ??

A
  1. NSAID induced ulcer

543

34
Q

Vonoprazan advantages over PPI ??

A
  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
Q

Contraindiaction of Misoprostol ??

A
  1. 🤰
  2. Women of childbearing

543

36
Q

Mechanism of misoprostol ??

A
  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
Q

A/E of misoprostol ??

A
  1. Diarrhoea
  2. Ab pain
  3. Spotted bleeding
  4. Dysmenorrhea

544

38
Q

Limitation of misoprostol ??

A
  1. High A/E
  2. Need for multiple daily dosing

544

39
Q

Colloidal bismuth compounds clinical use ??

A
  1. Dyspepsia
  2. H pylori PUD
  3. Travlers diarrhea
  4. Acute Diarrhea

543

40
Q

A/E of CBC ??

A
  1. Stool- blackening
  2. Tongue- Blackening
  3. Ataxia
  4. Headache
  5. Seizure
  6. Confusion
  7. Salicylate toxicity
  8. Renal insufficiency

543

41
Q

Mechanism of CBC ??

A
  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
Q

GERD drugs ??

A
  1. PPI
  2. H2 RB
  3. Antacids
  4. Domeperidone

545

43
Q

Advice for PUD patient ??

A
  1. Stop smoking
  2. Stop NSAID
  3. Stop alcohol
  4. Take regular meals

544

Pharmacology (16 decks)

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