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Pharm > GI > Flashcards

GI Flashcards

1
Q

What cell secretes acid into the stomach lumen

A

Parietal

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2
Q

What 3 things stimulate the parietal cell

A

Histamine, Ach, and Gastrin

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3
Q

What is the parietal cell negatively regulated by

A

Somatostatin

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4
Q

Chief cells produce

A

Pepsinogen, which is cleaved to make pepsin

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5
Q

What does pepsin do

A

Digests peptide bonds

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6
Q

What is a concern that GERD can lead to in some patients

A

Barrett’s esophagus (precancerous)

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7
Q

In this type of peptic ulcer, the amount of acid production is normal, but the mucosal barrier is weak

A

Benign Peptic Ulcer Disease

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8
Q

In this type of peptic ulcer, there is excessive secretion of gastric acid that overwhelms the mucosal barrier

A

Malignant Peptic Ulcer Disease

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9
Q

What are the 2 main causes for peptic ulcers

A

NSAIDs and H. Pylori

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10
Q

What are the two types of antacids

A

Systemic and Nonsystemic

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11
Q

This is the systemic antacid

A

Sodium Bicarbonate

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12
Q

These two drugs are the nonsystematic antacids

A

Aluminum Hydroxide + Magnesium Hydroxide combinations and Calcium Carbonate

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13
Q

In what type of patients is Aluminum+Magnesium Hydroxide combinations contraindicated

A

Patient with impaired renal function

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14
Q

Magnesium may cause what symptom

A

Diarrhea

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15
Q

Calcium may cause what symptom

A

Constipation

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16
Q

What common suffix do Histamine Receptor Blockers have

A

Tidine

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17
Q

What are the 4 Histamine Receptor blockers

A

Cimetidine, Famotidine, Ranitidine, and Nizatidine

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18
Q

What do Histamine Receptor Blockers do

A

Inhibit the histamine on the parietal cells, which decreases the amount of acid being produced

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19
Q

What is a side effect of cimetidine

A

Inhibits the metabolism of estrogen, therefore en will have feminization due to excess estrogen

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20
Q

How do proton pump inhibitors work

A

They prevent any release of protons (acid)

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21
Q

How long is the course of treatment for proton pump inhibitors

A

4-8 weeks

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22
Q

What kind of patients are proton pump inhibitors contraindicated

A

patients taking clipidogel (Plavix); it can reduce the effectiveness of Plavix

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23
Q

What is a problem with proton pump inhibitors

A

It is overprescribed especially in hospital settings and can significantly increase mortality rate compared to no PPI or even H2 blocker

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24
Q

What are the 5 Proton pump inhibitors

A

Omeprazole, Esomeprazole, Rebeprazole, Lansoprazole, Pantoprazole

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25
Q

This drug is a prostaglandin

A

Misoprostol

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26
Q

You do not want to give this drug to women of childbearing years unless a reliable method of birth control can be DOCUMENTED

A

Misoprostol

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27
Q

Why don’t you want to give misoprostol to women of childbearing years

A

it can cause birth defects and premature birth

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28
Q

You typically use this drug for elderly patients or postmenopausal women when the ulcer is due to NSAIDs bc it helps boost the production of the mucosal barrier

A

Misoprostol

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29
Q

This drug blocks the Ach input on the parietal cells and is a muscarinic acetylcholine receptor antagonist

A

Pirenzipine

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30
Q

What are the side effects of pirenzipine

A

Anticholinergic side effects; at therapeutic levels, it can have antimuscarinic effects in the CNS (blurry vision, constipation, dry mouth, sedation

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31
Q

Name the two mucosal protective agents

A

Sucralfate and Chelated Bismuth

32
Q

This drug forms a sticky polymer in acidic environment and adheres to the ulcer site

A

Sucralfate

33
Q

Why should you take sucralfate 2 hours before or after other drugs

A

because it may bind with other drugs and interfere with absorption

34
Q

This drug protects the ulcer crater and allows healing with some activity against H. pylori

A

Chelated bismuth

35
Q

This drug shouldn’t be used repeatedly or for more than 2 months at a time; it can also cause black stools and constipation

A

Chelated bismuth

36
Q

What kind of therapy can you use for H. pylori

A

triple therapy (proton pump inhibitor + a moderate and strong antibiotic) or quadruple therapy (same as triple but add bismuth)

37
Q

What is included in the therapeutics for IBD

A

Anti-inflammatories and immunosuppressants (mild for mild symptoms and more effective immunosuppressants for chronic symptoms)

38
Q

What are the side effects for IBD therapeutics

A

GI problems, Hepatotoxicity, pancreatitis, pulmonary fibrosis, risk for opportunistic infections; ~20% of patients discontinue treatment due to side effects

39
Q

When should laxatives be used for constipation

A

only if dietary modification fails

40
Q

what is the number one cause of constipation

A

laxatives

41
Q

What do laxatives do to the intestinal lumen

A

it stretches it and turns on peristalsis

42
Q

This type of laxative increases bowel content volume which triggers the stretch receptor and causes peristalsis that propels the bowel content forward

A

Bulk laxatives

43
Q

Name the 3 bulk laxatives

A

Psylliun, bran, and methyl cellulose

44
Q

what do bulk laxatives need to be taken with

A

lots of water

45
Q

what is the most rapid acting laxative

A

Saline and osmotic laxatives

46
Q

In this laxative, fluid is drawn into the bowel by osmotic force, increasing volume and triggering peristalsis

A

saline and osmotic laxatives

47
Q

Name the two non digestible sugars and alcohols in saline and osmotic laxatives

A

Lactulose and prunes (sorbitol)

48
Q

Name the 5 salts that are saline and osmotic laxatives

A

Milk of magnesia, epsom salt, glauber’s salt, sodium phosphates, and sodium citrate

49
Q

This saline and osmotic laxative is used in children

A

polyethylene glycol

50
Q

Name the 3 stool softeners - Emollients

A

Docusate sodium (surfactant and stimulant), Liquid paraffin (oral solo), and glycerin suppositories

51
Q

What are stool softeners used for

A

impacted stool or megacolon; helps lubricate for the stool to come out

52
Q

This type of laxative increases intestinal motility by irritating the GI mucosal and pulling water into the lumen

A

Irratant/stimulant laxative- cathartics

53
Q

This laxative works in 6-8 hours; its a gentle overnight laxative

A

irritant/ stimulant laxative-cathartics

54
Q

Name the 4 irritant/stimlant laxatives

A

castor oil, senna, bisacodyl, and lubiprostone

55
Q

How do anti-diarrheal agents work

A

reduce peristalsis by stimulating opioid receptors in the bowel and allow time for more water to be absorbedly the gut

56
Q

Name the 4 anti-diarrheal agents

A

Morphine, codeine, diphenoxylate, loperamide

57
Q

What does diphenoxylate combine with

A

atropine

58
Q

This anti-diarrheal is 40-50x more potent than morphine and doesn’t cross the BBB

A

Looperamide

59
Q

What are the contraindications for antidiarrheals

A

Toxic materials, microorganisms, or antibiotic associated

60
Q

This is a major cause of diarrhea and colitis in patients exposed to antibiotics (~20%)

A

C. Diff

61
Q

What is the route of transmission for C. diff

A

Fecal-oral

62
Q

What is the most preventative way for C. diff

A

washing the hands

63
Q

What are the 3 pharmacological treatments for C. diff

A

discontinue offending antibiotic, metronidazole (not for liver or renal impairment), and vancomyocin (not for renal impairment)

64
Q

This antiflatulant alters elasticity of mucus-coated bubbles, causing them to pass easier; but has limited data regarding effectiveness

A

Simethicone

65
Q

Which part of the brain senses motion sickness

A

vestibular apparatus in the ear

66
Q

Which part of the brain promotes emesis after seeing something repulsive

A

cortex

67
Q

This syrup induces emesis and is good to have if you live in a rural area and can’t get to the ER within an hour

A

Syrup of ipecac emetic

68
Q

This muscararinic receptor antagonist is an antiemetic therapeutic and is given as patches

A

scopolamine

69
Q

This histamine and dopamine receptor antagonist is an antiemetic therapeutic that is widely used today

A

Phenothiazine

70
Q

what is the side effect of phenothiazines

A

blurred vision, dry mouth, seizures, extrapyramidal effects (tar dive dyskinesia)

71
Q

These two antiemetic therapeutics are serotonin receptor antagonists that are excellent for chemotherapy induced N/V

A

Ondansetron and granisetron

72
Q

where do the serotonin receptor antagonists for antiemetic therapeutics work

A

in the vomiting center, CTZ, and GI

73
Q

This is the first antiemetic derived from marijuana

A

Dronabinol

74
Q

In what type of patients is dronabinol used in

A

cancer/aids patients

75
Q

What is the current theory for dronabinol

A

activation of the presynaptic CB1 receptors inhibits serotonin release onto the 5-HT3 receptors on the brainstem

76
Q

This drug is also called substance P antagonist or SPA is the only NK1 antagonist for post-operative N/V and is approved in combo with 5-HT3 antagonist for highly emetic chemotherapy

A

Aprepitant

77
Q

What is the side effect of aprepitant

A

headache, elevated liver enzymes, hypotension

Pharm (8 decks)

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