Gi Flashcards
Parietal cells
Secrete hydrochloric acid. Proton pump that pumps hydrogen ions into the stomach, do this in response to histamines
Inhibited by prostaglandins
Cox1 produce what type of cells
Helpful prostaglandins
Cox2 produces what cells?
Harmful prostaglandins
Chief or zymogenic cells secrete
Pepsinogen which gets converted to pepsin that breaks down proteins. If Proteins are the cell lining then the whole cell will be digested
Mucous cells secrete what
Mucus. Mucus is protective in the gi tract from pepsinogen/pepsin and hcl
What is the nerve network in the gi system that release hormones and neurotransmitters that regular basic functions of digestion?
Myenteric plexus
What neurotransmitter inhibits cholinergic pns control of peristalsis
Dopamine
What hormone enhances gi motility
Motilin
Nsaids, gerd, peptic ulcer disease, esophagitis, stress ulcers, gastritis cause this
Inflammation/ulcers, hemorrhage, irritation, pain in any part of gi system. Caused by pepsinogen converting to Pepsin and breaking down proteins in cell walls causing exposure to hcl
Antacids example and moa
Mag oxide/hydroxide, aluminum oxide, calcium carbonate
Buffering and neutralizing gastric acids and decrease ph dependent conversion of pepsinogen to pepsin (increasing gastric ph to above 3.5 reduced proteolysis catalyzed by pepsin. Reduces gastric damage to mucosal lining
Antacids can bind to what meds?
tetracycline and fluoroquinolone antibiotics, digoxin
What is treatment for h pylori
Two antibiotics (amoxicillin/tetracycline) , bismuth (peptobismal) and PPI
Where does h pylori live
Gastric glands
Bismuth moa
Increases mucus secretion and disrupts bacterial cell wall adhesions to gastric mucosa. Reduces bacterial damage
Histamine receptor antagonists moa/examples
Cimetidine , ranitidine
Parietal cell h2 histamine receptor blocker antagonists, blocks activation of proton pump
H2 receptor antagonists were recalled why
FDA found trace amounts of ndma. Ndma is a probably human carcinogen
Cimetidine is a potent cyp inhibitor. What does that mean
Means you may need less drug for a starting dose because the drug is metabolized slower and may lead to toxic effects in the body
Proton pump inhibitors ex/moa
Omeprazole and esomeprazole
Inhibit proton pump on parietal cells, slow onset of action
People with asthma should be tested for what
Gerd, obesity, OSA
Gerd associated asthma is alleviated with what class of medications
PPI
When taking a proton pump inhibitor why might it be a good clinical strategy to monitor the bone density of a patient who is at risk the development of osteoporosis?
PPI’s reduce your calcium absorption
Synthetic prostaglandins moa and examples
Misoprostol (cytotec)
Prostaglandin receptor agonist mimics the inhibitory effects of prostaglandins on parietal cells
Good for people taking long-term NSAIDS, may induce miscarriage
Loperamide MOA
Opioid receptor agonist along G.I. track mimics inhibitory effects of endorphins. Slow down motility
Not appropriate for infections diarrhea
Prokinetic medication’s MMOA and example
Metoclopramide and erythromycin
Metoclopramide is a D2 receptor antagonist that suppresses the inhibitory effects of dopamine on cholinergic smooth muscle contractions along the G.I. tract. Long term use not recommended no more then 6 months // used for delayed gastric emptying like diabetic gastroperesis
Motin receptor agonist that triggers, smooth muscle contractions along the G.I. Tract // promote gastric emptying before endoscopy * potent cyp inhibitor , may cause delayed metabolism of med leading to toxic effects, may need to use lower dose of other medicines
Human guanylin and uroguanlyin
agonist
Linaclotide (linzess) regulates electrolyte and water transport into the lumen of the intestine to bulk stool with water and loosen it
Binds to gc-c receptor to make cGMP, that binds to Cftcr (cystic fibrosis transmembrane conductance regulator) allows chloride and bicarb into lumen of intestine and sodium and water passively follow to bulk stool with water and loosen it
Should be taking on empty stomach. Used for IBS-C not IBS-D
Ibs c or d
Constipation or diarrhea. Condition that causes abdominal pain and bowel movement changes and spasms.
Different then inflammatory bowel disease that is associated with chronic inflammation of the colon
Ibs treatment
Low FODMAP (no gas making foods, garlic) anticholinergics, chloride channel activators, rifamycins, serotonin agonists anticholinergic/barbiturate combo, anticholinergic/benzo
Dicyclomine (Bentyl)- muscarinic cholinergic, receptor antagonist, and G.I. systems, suppresses, peristalsis and spasm
inflammatory bowel disease, Crohn’s disease, ulcerative colitis
Autoimmune disorder where antibodies produced against the digestive system, inflammatory mediators and tumor necrosis factor which result in inflammation and tissue damage
Infliximab (remicade) infusion- anti TNF (tumor necrosis factor)antibody. Can cause secondary infection, anemia, hypotension. MUST TEST FOR TB
