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Pharm > GI > Flashcards

GI Flashcards

1
Q

H2 blockers includ

A

cimetidine, ranitidine, famotidine, nizatidine

Take H2 blockers before you dine. Think table for 2 to remeber H2

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2
Q

Mechanism of H2 blockers:

A

reversible block of histamine H2 receptors: decraease H+ secretion by pareital cells

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3
Q

Use of h2 blockers

A

peptic ulcer, gastritis, mild esophageal reflux

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4
Q

H2 blocker that is potent inhibiotr of cytochrome p450

A

cimetidine

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5
Q

SE of of cimetiddine

A

antiandrrogenic effects (prolactin release, gynecomastia, impotence), decrease libido in males; cross BBB (confusion, dizziness, headaches) and placenta

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6
Q

These two h2 blockers decrease renal excretion of creatinine

A

cimetidine and ranitidine

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7
Q

Proton pump inhibitors

A

omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole

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8
Q

mechanism of PPI

A

irrevsrisbily inhibits H+/K+ ATPase in stomach parietal cells

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9
Q

Use of PPI

A

peptic ucler, esophageal reflux, ZES syndrome, component tof therapy for H. pylori, stress ulcer prophylaxis

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10
Q

SE of PPI

A

Increase risk of C. difficile infection, pneumonia,
Decrease serum Mg+ w long term use
increase risk of osteoporotic fractures

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11
Q

Antacid use

A

aluminum hydroxide, calcium carbonate (tums), magnesium hydroxide

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12
Q

can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying

A

Antacid use

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13
Q

all antacid use can cause

A

hypokalemia

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14
Q

constipation and hypophsophatemia; proximal muscle weakness, osteodystrophy, seizures

A

aluminum hydroxide

aluMINIMUM amout of feces

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15
Q

hypercalcemia (milk-alkali syndrome), rebound acid increase

A

calcium carbonate

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16
Q

diarrhea, hyporeflexia, hypotension, cardiac arrest

A

Magensium hydroxide

Mg2+ = must go to the bathroom

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17
Q

bismuth, sucralfate mechanism

A

bind to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in mucous layer.

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18
Q

require acidic environemnt

A

bismuth; sucralfate;

usually not given with PPIs/H2 blockers

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19
Q

use of bismuth sucralfate

A

increase ulcer healing

travelers’ diarrhea

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20
Q

misoprostol mechanism

A

PGE1 analog;
Increase production and secretion of gastric mucous barrier
Decrease acid production

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21
Q

use of misoprostol

A

prevention of NSAID induced peptic ulcers (NSAIDS block PGE1 producftion
also used off label for induction of labor (ripens cervix)

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22
Q

misoprostol SE

A

diarrhea, Contraindicated in women of childbearing potential (abortifacient)

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23
Q

Octreotide mechanism

A

long acting somatostatin analog; inhibits secretion of various splanchnic vasodilatory hormones

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24
Q

use of octreotide

A

acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
also decrease gut motility, blood flow, and endocrine/exocrine pancreatic function (decrease of secretion of pancreatic enzymes into intestine and therefore could aggravate pt’s malabsorptive diarrhea)

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25
Q

SE of octreotide

A

nausea, cramps, steatorrhea

increase risk of cholelithiasis due to CCK inhibition

26
Q

Sulfasalazine mechanism

A

mechanism: combination of sulfapyridien (antibacterial) and 5-aminosalicylic acid (anti-inflammatory)
activated by colonic bacteria
inhibiting cytokine, PG, leukotriene synthesis during inflammation

27
Q

Use of sulfasalazine

A

Ulcerative colitis, Crohn disease (colitis component)

28
Q

SE of sulfasalazine

A

malaise, nausea, sulfonamide toxicity, reversible oligospermia

29
Q

Loperamide mechanism

A

agonist at mu opiod receptors; slows gut motility. poor CNS penetration (low addictive potentiaL)

30
Q

loperamide use

A

didarrhea: decrease volume by slowing intestinal transit time and allowing greater net fluid resorption

31
Q

SE of loperamide

A

constipation, nausea

32
Q

which hormone increases cholesterol secretion

A

estrogen

33
Q

ewhich hormone decreases bile acid secretion

A

progestorne

34
Q

5Ht3 antagnoist; decreases vagal stimulation: powerful central acting antiemetic

A

Ondansetron

35
Q

Use of ondansetron (like granisetron

A

control vomiting postop and in pt’s undergoing cancer chemotherapy

36
Q

SE of ondansetron

A

headache, constipation, QT interval prolongation, serotonin syndrome

37
Q

because ondansetron is a 5ht3 receptor antagonist, increases serotoing

A

serotoniin sydnorme

38
Q

Metoclopramide use

A

diabetic and postsurgery gastroparesis, antiemetic, persistent GERD; acute migraines

39
Q

mechanism of metoclopramide

A

D2 receptor antagonist. increase resting tone, contractility, LES tone, motility, promotes gastric emptying. Does not influence colon transport time

40
Q

SE of metoclopramide

A

increase parkinsonian effects, tardive dyskinesia
restlessness, drowsiness, fatigue, depression, diarrhea.
drug interaction w digoxin and diabetic agents. Contraindicated in pt’s w small bowel obstruction or Parkinson disease (due to D2 receptor blockade)

41
Q

orlistat mechanism

A

inhibits gastric and pancreatic lipase: decrease breakdown and absorption of dietary fats

42
Q

use of orlistat

A

weight loss

43
Q

SE of orlistat

A

Steatorrhea, decreaes absorption of fat soluble vitamines

44
Q

indicated for constipation or patients on opiates requiring a bowel regimen

A

laxatives

45
Q

Bulk forming laxatives

A

psyllium , methylcellulose

46
Q

mechanism of bulk forming laxatives

A

soluble fibers; draw water into gut lumen; forming a viscous liquid that promotes peristalsis

47
Q

SE of bulk forming laxatives

A

bloating

48
Q

Osmotic laxatives

A

magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose

49
Q

mechanism of osmotic laxatives

A

provide osmotic load to draw water into GI lumen; distending intesitnal wall and increase piristalsis

50
Q

treats hepatic encephalopathy bc gut flora degrade it into metabolites (alctic acid, acetic acid) that promote nitrogen excretion as NH4+

A

lactulose

51
Q

SE of osmotic laxatives

A

diarrhea, dehydration; may be abused by bulimics

52
Q

Stimulants (laxatives)

A

senna

53
Q

mechanism of senna:

A

enteric nerve stimulation: colonic contraction

54
Q

SE of senna

A

diarrhea, melanosis coli

55
Q

emollients

A

docusate

56
Q

mechanism of docusate

A

osmotic draw into lumen : increase water absoprtion by stool

57
Q

SE of docusate

A

diarrhea

58
Q

mechanism of aprepitant (like fosaprepitant)

A

substance P antagnoist. blocks NK1 (neurokin receptors in brain)

59
Q

aprepitant use

A

antiemetic for chemotherapy induced nausea and vomiting.

60
Q

antimuscarinics and anti histamines are used in what antiemetic scenario

A

motion sickness

hyperemesis gravidarum

61
Q

chemotehrapy induced emesis; use what drugs

A

5ht3r antagnoists, dopamaine receptor antagonist

neurokinin 1 recetpro antagnoists

Pharm (13 decks)

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