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Pharmacology > Gastrointestinal Pharmacology > Flashcards

Gastrointestinal Pharmacology Flashcards

1
Q

At least 98% of PUD occurs in which part of the GIT?

A

Stomach and first portion of the duodenum

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2
Q

What are other types of antacids aside from MgAlOH3?

A

Calcium carbonate

Sodium bicarbonate

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3
Q

What is the MOA of antacids?

A

React with protons —> neutralize stomach acid

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4
Q

What are the side effects of sodium bicarbonate?

A

Fluid retention
Belching
Metabolic alkalosis

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5
Q

What are the side effects of calcium carbonate?

A

Hypercalcemia
Renal insufficiency
Milk alkali syndrome (Metabolic alkalosis)

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6
Q

MgAlOH3 impairs absorption of what drugs?

A

Fluoroquinolones
Itraconazole
Tetracyclines
Iron

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7
Q

Why are Aluminum and Magnesium given together?

A

They cancel out each other’s adverse effects
Mg: diarrhea
Al: constipation

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8
Q

What are the available H2 recepor antagonists?

A 
F-R-C-N
Famotidine
Ranitidine
Cimetidine
Nizetidine
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9
Q

H2-receptor agonists are highly effective when?

A

Highly effective in noctural acid secretion

Modest effect on meal-stimulated secretion

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10
Q

What are the available proton pump inhibitors

A 
P-R-O-L-E
Pantoprazole
Rabeprazole
Omeprazole
Lansoprazole
Esomeprazole
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11
Q

What is the MOA of PPIs?

A

Irreversible blockade of H/K/ATPase in gastric parietal cells -> long-lasting reduction in meal-stimulated and nocturnal acid secretion

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12
Q

What is a noted adverse effect of chronic PPIs use?

A

Vitamin B12 deficiency

Malabsorption

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13
Q

What are the available mucosal protective agents?

A

Sucralfate
Misprostol
Bismuth salicylate

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14
Q

What is the MOA of sucralfate?

A

Binds to injured tissues
Forms a protective covering
Accelerates healing of peptic ulcers
Prevents recurrence

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15
Q

What is the MOA of Misoprostol?

A

Binds to EP receptors
Promotes HCO and mucus secretion

Also causes uterine contraction
Prevents NSAID-induced gastric mucosal injury

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16
Q

What is the MOA of bismuth salicylate?

A

Protecting coating on ulcerated tissue
Antimicrobial effects
Enterotoxin sequestration
Reduces stool frequency and liquidity in infectious diarrhea

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17
Q

What are the SE of bismuth salicylate?

A

Black stool
Darkening of the tongue
Encephalopathy

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18
Q

What are the available triple regimen therapy for H.pylori infection?

A

Tetracycline 500mg QID
Metronidazole 250mg QID
Bismuth salicylate 2tabs QID

Ranitidine bismuth citrate 400mg BID
Tetracycline 500mg BID
Clarithromycin/Metronidazole 500mg BID

Clarithromycin 250mg/500mg BID
Omeprazole/Lansoprazole 20mg/30mg BID
Metronidazole 500mg/Amoxicillin 1g BID

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19
Q

What are the available prokinetic agents for the upper GI?

A

M-E-D
Metoclopramide
Erythromycin
Domperidone

20
Q

What is the MOA of prokinetic agents?

A

Metoclopramide and Domeridone: block D2 receptors

Erythromycin: stimulates motilin receptors

21
Q

Your prokinetic agents are the drug of choice for what condition?

A

Diabetic gastroparesis

22
Q

Which prokinetic agent does not cross the BBB?

A

Domperidone

23
Q

What are the mechanisms of action of laxatives?

A

B-I-L-S
Bulk-forming action —> reflex contraction of the bowel
Irritant/Stimulant on the bowel wall
Lubricating action —> easy passing of stool
Softening action on hard/impacted stool

24
Q

What are the available bulk-forming laxatives?

A

Psyllium
Polycarbophil
Maltodextrin
Methylcellulose

25
Q

What is the MOA of bulk-forming laxatives?

A

Indigestive, hydrophilic colloids that absorb water
Form bulky, emollient gel that distends the colon
Promotes peristalsis

26
Q

What are the available stool softening laxatives?

A

G-D-M
Glycerine suppository
Docusate
Mineral oil

27
Q

What are the available stool-softening laxatives?

A

G-D-M
Glycerine suppository
Docusate
Mineral oil

28
Q

What are the available osmotic laxatives?

A 
MS-PLMS
Magnesium oxide
Sorbitol
Polyethylene glycol
Lactulose
Magnesium citrate
Sodium phosphate
29
Q

What are the available stimulant/cathartic laxatives?

A 
ABS-CC
Aloe
Bisacodyl
Senna
Cascara
Castor oil
30
Q

What is a known side effect of cathartic laxatives?

A

Melanosis coli

-results from lipofucsin pigment accumulation in macrophages from intake of anthraquinone-containing laxatives

31
Q

What are the available antidiarrheal agents?

A 
CLD DK
Diphenoxylate
Difenoxin
Colloidal bismuth
Loperamide
Kaolin + Pectin
32
Q

What is the mode of action of antidiarrheal agents?

A

Activate opioid receptors in the ENS -> slows motility

33
Q

Why are antidiarrheal agents not given in children less than 4yo?
What is used to reverse this SE?

A

Paralytic ileus

Betanechol to reverse paralytic ileus

34
Q

What are the available antiemetics?

A 
P-A-T-D-O-G
Palosetron
Alosetron
Tropisetron
Dolasetron
Ondansetron
Granisetron
35
Q

Antiemetics belong to what class?

What is its MOA?

A

5-HT3 receptor antagonist

36
Q

What are the available immunomodulators for inflammatory bowel disease?

A 
M-M-B-O-S
Mesalamine
Mesalazine
Balsalazine
Olsalazine
Sulfasalazine
37
Q

What is the MOA of immunomodulators

A

Unknown.
Inhibits production of eicosanoid inflammatory mediators
Not used for acute flare-ups of disease

38
Q

What are the available therapy for mild, moderate, and severe IBS?

A

Mild: Antibiotics, Budesonide, Corticosteroids (topical), 5-aminosalicylates

Moderate: Azathioprine/6-mercaptopurine, Methotrexate, TNF antagonist/, Corticosteroids (oral)

Severe: Cyclosporine, Natalizumab, Surgery, TNF antagonist, Corticosteroids IV

39
Q

What are the effects of ursodeoxycholic acid?

A
  • decreases CE secrection -> decreased CE content in bile
  • dec endogenous BA conc + inhibits immune-mediated hepatocyte destruction -> stabilization of hepatocyte canalicular membranes
40
Q

What are the uses of UDCA

A

Nonsurgical therapy for cholelithiasis
Prevent gallstone formation in obese patients undergoing rapid weight loss
Reduce liver function abnormalities in early stage primary biliary cirrhosis

41
Q

What is the MOA of rebamipide?

A

Enhances mucosal defense by scavenging free radicals and temporarily activating COX-2 genes

42
Q

This is a prokinetic benzamide derivative that inhibits dopamine and acetylcholinesterase

A

Itopride

43
Q

What is the MOA of simethicone?

A

Changes surface tension of gas bubbles -> collapse of foam bubbles -> easier passage of gas and preventing gas pockets in GIT

44
Q

What is the MOA of racecadotril?

A

Inhibits enkephalinase -> increases endogenous opioids (enkephalins) -> inhibits adenylate cycles -> increased Cl- absortion

Antisecretory effect: reduces secretion of water and electrolytes reducing frequency and duration of acute diarrhea

45
Q

This probiotic has produces antimicrobial substances that are active against G(+) bacteria. What bacteria?

A

Bacillus clausii

  • S.aureus
  • E.facium
  • C.difficile
46
Q

What are uses and MOA of silymarin?

A

Hepatoprotectant, anti-inflammatory, anti-carcinogenic

  • Antioxidant, scavenger and regulator of intracellular glutathione
  • CM stabilizer and permeability regulator
  • Promote rRNA synthesis
  • Inhibits transformation of stellate hepatocytes into myofibroblasts
47
Q

What are the available anorectal preparations available and their corresponding uses?

A

DAFLON: Diosmin+Hesperidin

  • potent venotropic drug for venous insufficiency
  • improves lymph drainage and protects microcirculation
  • decreases PGE2 and TxA2 synthesis -> dec infammation

FAKTU: Policresulen + Cinchocaine

  • arrests bleeding by coagulation and vascular contraction
  • antimicrobial action by coagulation properties and acidic pH

Cinchocaine: local anesthetic action, relieve pain and itching

Pharmacology (8 decks)

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