Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PharmU6 > GI > Flashcards

GI Flashcards

1
Q

What are the 4 substances that stimulate acid production in the stomach?

A

Gastrin–from antrum
Ach–vagal inputs, CNS
Histamine–stimulated by Ach and gastrin
Parietal Cell H+/K+ ATPase–final common pathway of other 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mechanism of action of Histamine for acid production?

A

Increases intracellular adenyl cyclase and cyclic AMP–activate or increase the amount of K/H ATPase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the mechanism of action of Gastrin for acid production?

A

Causes influx of Ca++ which in turn activates the K/H ATPase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What pharmacologic intervention neutralizes acid?

A

Antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What pharmacologic intervention decreases acid production?

A

Anticholinergics–antimuscarinic
Antihistamines
Proton Pump inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What pharmacologic intervention increases mucosal resistance?

A

Prostaglandins
Sucralfate
Bismuth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Reacts slowly with HCl to form calcium chloride and carbonic acid?

A

Calcium carbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the disadvantage of using calcium carbonate for ulcer tx and gerd and how is this fixed?

A

Constipating–use in combination with magnesium compounds which are laxatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the side effects of Calcium carbonate?

A

Milk-alkali syndrome
Nephrocalcinosis
Rebound acidity
Digitalis antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is sodium bicarbonate rarely used for Ulcer tx and GERD?

A

Induces systemic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drug has enhanced affects of amphetamine, quinidine, and cinchophen?

A

Sodium bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the side effects of magnesium hydroxide and magnesium carbonate used for Ulcer Tx and GERD?

A 
Diarrhea
Hypokalemia
Hypermagnesemia
Complexing of enteric iron
Iron deficiency

May cause magnesium toxicity in the presence of renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Combines with HCl to form aluminum chloride and water?

A

Aluminum hydroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What antacid is used in renal failure pts?

A

Aluminum hydroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the major side effects of aluminum hydroxide?

A

Phosphate depletion and sequelae–weakness, anemia, tetany, apnea

Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do anticholinergic agents do to help with the treatment of Ulcers?

A

Vagotomy type effect–reduction of HCl secretion: Spasmolytic effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the side effects of the anticholinergic agents used for ulcer tx?

A 
Dryness of the mouth
Blurred vision
Atony of bladder
Constipation
Drowsiness
Mental confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Anticholinergic agents are contraindicated in pts with…

A

Known pyloric obstruction

Pts with hiatus hernia and peptic esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name the anticholinergic agents used for ulcer tx…

A

Atropine sulfate
Propantheline
Methantheline bromide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When should anticholinergic agents be administered?

A

30 min before a meal and at bedtime–attempt to reduce nocturnal secretion by vagal block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are Histamine (H2) receptor blockers used for?

A

Ulcer tx
Prophylactically for stress ulcers
GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name the Histamine (H2) receptor blockers?

A

Cimetidine
Ranitidine
Famotidine
Nizatidine

Competitive inhibition of the receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the major side effect of the H2 receptor blockers?

A

Rebound acidity if stopped suddenly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the uncommon side effects of the H2 receptor blockers?

A 
Headache
Lethargy
Confusion
Depression
Hallucination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What 2 H2 receptor blockers bind to cytochrome P450 and interferer with the metabolism of drugs such as theophylline, warfarin, dilatin, lidocaine?

A

Cimetidine

Ranitidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Name the H/K ATPase inhibitors

A 
Omeprazole
Lansoprazole
Rabeprazole
Esomeprazole
Pantoprazole
Dexlansoprazole--Essentially lansoprazole with a rapid release and extended release component

Noncompetitive inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is required in order for the proton pump inhibitors to work?

A

Requires acid env. to activate –Dont take with antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the side effect of the proton pump inhibitors?

A

Headache
Gynecomastia
Gastric hyperplasia and carcinoid tumors in rats lon term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the 2 proton pump inhibitors that are used for H. pylori tx?

A

Omeprazole and Lansoprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Omeprazole and Lansoprazole are used in combination with what to tx H. pylori?

A

Tetracycline
Metronidazole
Clarithromycin

31
Q

Which proton pump inhibitor has the most P450 inhibition?

A

Omeprazole

32
Q

What are factors that lead to impaired mucosal defense?

A

NSAIDs
H. pylori
Zollinger-Ellison syndrome–gastrinoma

Smoking
Genetics
Stress

33
Q

What are the 2 drugs that coat ulcer crater and increase mucosal resistance?

A

Bismuth salts

Sucralfate

34
Q

What is the mechanism of action of Bismuth salts?

A

In acid environment it forms crystals that precipitate on the ulcer crater

35
Q

What is the mechanism of action of Sucralfate?

A

An aluminum hydroxide complex of sucrose, binds to ulcerated tissue, activated in acid env.

36
Q

What are the side effects of Bismuth salts and sucralfate?

A

Aluminum toxicity possible in renal failure

Bismuth salts–turn BM black

37
Q

What are Sucralfate and Bismuth salts used for?

A

Ulcer tx

Tx of H. pylori–combination with tetracycline, metronidazole, and clerithromycin

38
Q

What drug is used with pt who are using a lot of NSAIDs, such as RA pts?

A

Misoprostol–Prostaglandin E analog

39
Q

What are the 3 things that misoprostol does?

A

Decrease acid production
Increase mucous secretion
Increase HCO3 secretion

40
Q

Why isn’t Misoprostol very effective

A

Because endogenous prostaglandin levels are already high in duodenal ulcer pts

41
Q

What are the preferred therapies for H. pylori infection?

A

A PPI or Ranitidine Bismuth citrate BID + 2 of: Amoxicillin, Clarithromycin, metronidazole

42
Q

Name the promotility agents used for GERD and gastroparesis?

A

Metochlorpramide–also used as anti-emetic
Cisapride
Domperidone–only used for Gastroparesis

43
Q

Increase motor tone in lower esophageal sphincter and stomach and also a peripheral and CNS dopamine antagonist?

A

Metochlorpramide

44
Q

What is the major side effect of metochlorpramide?

A

Hand tremor and extrapyramidal symptoms

45
Q

Increase motor tone in lower esophageal sphincter and stomach and can cause sudden cardiac death?

A

Cisapride

46
Q

Promotility agent that improves gastric tone and is used for gastroparesis?

A

Domperidone

47
Q

Has probable CNS interaction with dopaminergic receptor-antagonist–> leading to reduction of stimulation in the CRTZ in the medulla—-used as anti-emetic?

A

Prochlorperazine

48
Q

What are the side effects of prochlorperazine?

A

Extra-pyramidal–torticollis

49
Q

Antihistaminic (H1 receptor), anticholinergic used as anti-emetic?

A

Promethazine

50
Q

What is the major side effect of promethazine?

A

Somnolence–especially in elderly

51
Q

Benzamide derivative used as anti-emetic?

A

Trimethobenzamide

52
Q

Suppresses CRTZ by anticholinergic mechanism and is used as anti-emetic and causes the munchies?

A

Tetrahydrocannabinol

53
Q

Name the 3 drugs used as anti-emetics that block serotonin at 5HT3 receptor in central CRTZ?

A

Odansetron
Granesitron
Dolasetron

54
Q

What are the side effects of the 5HT3 receptor antagonists used as anti-emetics?

A

Headache
Dizziness
Somnolence

55
Q

What anti-cholinergic is used for the tx of diarrhea by relaxing all bowel smooth muscle?

A

Atropine sulfate

56
Q

These drugs have less penetration to CNS, stimulates mu receptors in GI tract–increasing rectal tone–disrupting peristalsis–increased absorption time–used for tx of diarrhea (IBS)?

A

Loperamide –opioid agonist
Dipheoxylate–opioid agonist
Codeine sulfate–opioid agonist

57
Q

What two anti-diarrheal meds are contraindicated in chowder–because narcotic will cause respiratory suppression?

A

Dipheoxylate and codeine sulfate

58
Q

What is Lomotil?

A

Diphenoxylate + atropine

59
Q

What drugs absorb water, but don’t precent potential dehydration and are used for the tx of diarrhea?

A

Metamucil–colloid

Bismuth subsalicylate–pectin

60
Q

Name the irritates of the lumen of the colon that causes peristaltic contractions and are used for constipation…

A 
Castor oil
Cascara sagrada
Senna extract
Bisacodyl
Phenolphthalein
61
Q

Name the osmotic cathartics that draw water into the colon and are used for constipation and to clean the bowel prior to colonoscopy…

A 
Magnesium citrate
Magnesium sulfate
Sodium sulfate
Milk of magnesia 
Sodium phosphate
Lactulose
62
Q

Bulk forming hydrophilic colloid used for the tx of constipation…

A

Psyllium seed
Methylcellulose
Sodium carboxymethylcellulose

63
Q

Lubricant and fecal softeners used for the tx of constipation?

A

Mineral oil
Dioctyl sodium sulfo-succinate
Poloxalkol

64
Q

Name the 3 anti-inflammatory agents that work from the lumen to reduce inflammation in pts with acute IBD (UC)…

A

Sulfasalazine
Olsalazine
Mesalamine

65
Q

Which of the 3 anti0inflammatory agents can cause toxicity coming from systemic absorption of sulfapyridine–is used for acute IBD (UC)?

A

Sulfasalazine

66
Q

Which anti-inflammatory used for acute IBD (UC) has a delayed release 5-ASA in order to tx terminal ileum and colon?

A

Mesalamine

67
Q

Purine antimetabolite that interferes with DNA synthesis and is used for the tx of chronic IBD?

A

Azathioprine

68
Q

Drug that suppresses T helper and T suppressor lymphocytes and is used for the tx of chronic IBD?

A

Cyclosporine

69
Q

Monoclonal Ab that binds and neutralizes TNFa and is used for the tx of chronic IBD?

A

Infliximab

70
Q

Anticholingeric agents that block cholinergic action and are used to reduce spasm in IBS?

A

Dicyclomine HCl

Hyoscyamine sulfate

71
Q

Used for the tx of diarrhea seen in irritable bowel syndrome by blocking 5HT3?

A

Alosetron

72
Q

What are the side effects of Alosetron?

A

Ischemic bowel

Constipation

73
Q

Used for the tx of constipation in irritable bowel syndrome by stimulating 5HT4 receptor?

A

Tegaserod maleate

PharmU6 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions