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GASTROINTESTINAL > GASTROINTESTINAL-Pharmacology > Flashcards

GASTROINTESTINAL-Pharmacology Flashcards

1
Q

H2 blockers

A

Cimetidine, ranitidine, famotidine, nizatidine

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2
Q

Mechanism of action for H2 blockers

A

Reversible block of histamine H2 receptors → ↓ H+ secretion by parietal cells

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3
Q

Clinical use for H2 blockers

A

Peptic ulcer, gastritis, mild esophageal reflux

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4
Q

Toxic effects of Cimetidine

A

Potent inhibitor of cytochrome P-450 (multiple drug interactions); antiandrogenic effects; can cross blood brain barrier and placenta

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5
Q

Which antiandrogenic efects does cimetidine has?

A

Prolactin release, gynecomastia, impotence, ↓ libido in males

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6
Q

Which common toxic effect does cimetidine and ranitide have?

A

↓ renal excretion of creatinine

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7
Q

Proton pump inhibitors

A

Omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole

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8
Q

Proton pump inhibitors mechanism of action

A

Irreversibly inhibit H+/K+ ATPase in stomach in parietal cells

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9
Q

Clinical use for proton pump inhibitors

A

Peptic ulcer, gastritis, esophageal refluxm Zollinger Ellison syndorme

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10
Q

Toxic effects of Proton pump inhibitors

A

Increased risf of C. difficile infection, pneumonia. Hip fracture, ↓ serum Mg2+ with long term use

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11
Q

Mechanism of action of Bismuth and sucralfate

A

Binds to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer

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12
Q

Clinical use for Bismuth and sucralfate

A

↑ ulcer healing, travelers’ diarrhea

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13
Q

What family is Misoprostol?

A

A PGE1 analog

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14
Q

Mechanism of action of Misoprostol

A

Increases production and secretion of gastric mucous barrier, ↓ acid production

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15
Q

Clinical use for Misoprostol

A

Prevention of NSAID- induced peptic ulcers
Maintenance of a Patent Ductus arteriosus
Also used to induce labor (ripens cervix)

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16
Q

How does misoprostol prevents NSAID- induced peptic ulcers?

A

NSAIDs block PGE1 production

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17
Q

Secondary effects of Misoprostol

A

Diarrhea

Contraindicated in women of childbearing potential (abortifacent)

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18
Q

How does Ocreotide works?

A

Long acting somatostatin analog

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19
Q

Clinical use for Ocreotide

A

Acute variceal bleeds, acromegaly, VIPoma, and carcinoid tumors

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20
Q

Toxic effecs Ocreotide

A

Nause, cramps, steatorrhea

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21
Q

Antacid examples

A

Aluminum hydroxide
Calcium carbonate
Magnesium hydroxide

22
Q

Side effects of Antacid use

A

Can affect absorption, bioavailability, or urinary excretion of other drugs
All can cause hypokalemia

23
Q

How does antacids affect affect absorption, bioavailability, or urinary excretion of other drugs?

A

By altering gastric and urinary pH or by delaying gastric emptying

24
Q

Toxic effects of Aluminum hydroxide

A

Constipation and hypophosphatemia: proximal weakness, osteodystrophy, seizures

25
Q

Calcium carbonate side effects

A

Hypercalcemia, rebound acid increased

26
Q

Which drugs are mainly affected by calcium carbonate?

A

Can chelate and ↓ effectiveness of other drugs (eg. tetracycline)

27
Q

Side effects of Magnesium hydroxide?

A

Diarrhea, hyporeflexia, hypotension, cardiac arrest

28
Q

Side effects of Magnesium hydroxide?

A

Diarrhea, hyporeflexia, hypotension, cardiac arrest

29
Q

Osmotic laxatives

A

Magnesium hydroxide, magnesium citrate, polyethilene glycol, lactulose

30
Q

Mechanism of action of Osmotic laxatives

A

Provide osmotic load to draw water out

31
Q

Which other benefit does lactulose has?

A

Also treats hepatic encephalopathy

32
Q

How does lactulose treat hepatic encephalopathy?

A

Since gut flora degrade it into metabolites (lactic acid and acetic acid) that promote nitrogen excretion as NH4+

33
Q

Clinical use foe Osmotic laxative

A

Constipation

34
Q

Toxic effects of Osmotic laxative

A

Diarrhea, dehydrarion; may be abused by bulimics

35
Q

What is Infliximab?

A

Monoclonal antibody to TNF-α

36
Q

Clinical use for Infliximab

A

Crohn disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriasis

37
Q

Toxic effects caused by Infliximab

A

Infection (including reactivation of latent TB), fever, hypotension

38
Q

How is Sulfazalasine composed?

A

Combination of sulfapyridine (antibacterial) and 5 aminoslicylic acid (anti- inflammatory)

39
Q

What activates Sulfasalazine?

A

Colonic bacteria

40
Q

Clinical use for Sulfasalazine

A

Ulcerative Colitis, Crohn disease

41
Q

Secondary effects of Sulfasalazine

A

Malaise, nauseam sulfonamide toxicity, reversible oligospermia

42
Q

Mechanism of action of Ondansetron

A

5 HT3 antagonist; ↓ vagal stimulation

43
Q

How is Ondansetron consider?

A

Powerful central acting antiemetic

44
Q

Clinical use for Ondansetron

A

Control vomiting postoperatively and in patients undergoing cencer chemotherapy

45
Q

Side effects of Ondansetron

A

Headache, constipation

46
Q

D2 receptor antagonist

A

Metoclopramide

47
Q

Mechanism of action of Metoclopramide

A

↑ resting tone, contractility, LES tone, motility

48
Q

Does Metoclopramide influence colon transport time?

A

No

49
Q

Clinical use for Metoclopramide

A

Diabetic and post surgery gastroparesis, antiemetic

50
Q

Toxic effects of Metoclopramide

A

↑ parkinsonian effects.

Restlessness, drowsiness, fatigue, depression, nauseam diarrhea

51
Q

Which drugs interact with Metoclopramide?

A

Drug interaction with digoxin and diabetic agents

52
Q

When is Metoclopramide contraindicated?

A

In patients with small bowel obstruction or Parkinson disease (D1 receptor blockade)

GASTROINTESTINAL (5 decks)

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