Gi

Question 1

Parietal cells

Answer 1

Secrete hydrochloric acid. Proton pump that pumps hydrogen ions into the stomach, do this in response to histamines

Inhibited by prostaglandins

Question 2

Cox1 produce what type of cells

Answer 2

Helpful prostaglandins

Question 3

Cox2 produces what cells?

Answer 3

Harmful prostaglandins

Question 4

Chief or zymogenic cells secrete

Answer 4

Pepsinogen which gets converted to pepsin that breaks down proteins. If Proteins are the cell lining then the whole cell will be digested

Question 5

Mucous cells secrete what

Answer 5

Mucus. Mucus is protective in the gi tract from pepsinogen/pepsin and hcl

Question 6

What is the nerve network in the gi system that release hormones and neurotransmitters that regular basic functions of digestion?

Answer 6

Myenteric plexus

Question 7

What neurotransmitter inhibits cholinergic pns control of peristalsis

Answer 7

Dopamine

Question 8

What hormone enhances gi motility

Answer 8

Motilin

Question 9

Nsaids, gerd, peptic ulcer disease, esophagitis, stress ulcers, gastritis cause this

Answer 9

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

Question 10

Antacids example and moa

Answer 10

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

Question 11

Antacids can bind to what meds?

Answer 11

tetracycline and fluoroquinolone antibiotics, digoxin

Question 12

What is treatment for h pylori

Answer 12

Two antibiotics (amoxicillin/tetracycline) , bismuth (peptobismal) and PPI

Question 13

Where does h pylori live

Answer 13

Gastric glands

Question 14

Bismuth moa

Answer 14

Increases mucus secretion and disrupts bacterial cell wall adhesions to gastric mucosa. Reduces bacterial damage

Question 15

Histamine receptor antagonists moa/examples

Answer 15

Cimetidine , ranitidine

Parietal cell h2 histamine receptor blocker antagonists, blocks activation of proton pump

Question 16

H2 receptor antagonists were recalled why

Answer 16

FDA found trace amounts of ndma. Ndma is a probably human carcinogen

Question 17

Cimetidine is a potent cyp inhibitor. What does that mean

Answer 17

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

Question 18

Proton pump inhibitors ex/moa

Answer 18

Omeprazole and esomeprazole

Inhibit proton pump on parietal cells, slow onset of action

Question 19

People with asthma should be tested for what

Answer 19

Gerd, obesity, OSA

Question 20

Gerd associated asthma is alleviated with what class of medications

Answer 20

PPI

Question 21

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?

Answer 21

PPI’s reduce your calcium absorption

Question 22

Synthetic prostaglandins moa and examples

Answer 22

Misoprostol (cytotec)

Prostaglandin receptor agonist mimics the inhibitory effects of prostaglandins on parietal cells
Good for people taking long-term NSAIDS, may induce miscarriage

Question 23

Loperamide MOA

Answer 23

Opioid receptor agonist along G.I. track mimics inhibitory effects of endorphins. Slow down motility

Not appropriate for infections diarrhea

Question 24

Prokinetic medication’s MMOA and example

Answer 24

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

Question 25

Human guanylin and uroguanlyin
agonist

Answer 25

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

Question 26

Ibs c or d

Answer 26

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

Question 27

Ibs treatment

Answer 27

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

Question 28

inflammatory bowel disease, Crohn’s disease, ulcerative colitis

Answer 28

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