Brainscape's Knowledge GenomeTM

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


See full index

PCM Exam 4 > GI Drugs 2 > Flashcards

GI Drugs 2 Flashcards

1
Q

what is the function of somatostatin?

A
  • Decrease gastric acid and pepsinogen secretion
  • Decrease pancreatic and small intestine fluid secretion
  • Decrease gallbladder contraction
  • Decrease insulin and glucagon release
  • Decreases GI hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what type of drug is docusate?

A

it is a stool softener; dont give with mineral oil because then the effects will cancel out

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

a child with constipation predominant IBS is most often prescribed ______

A

poly-ethylene glycol because lubiprostone cannot be used in kids

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

which amino glycoside is well tolerated because the 5-ASA in that is linked to an inert unabsorbed carrier molecule? and thus works mainly int he ______

A
  • balsalazide; terminal ileum and colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

methylcellulose and other ________ (type of laxative) should not be given to ____ and ______

A

bulk forming laxatives (psyllium and bran) should not be given to immobile patients or those on long term opioid therapy

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

lubiprostone stimulates __________ of the SI and thus ↑ intestinal motility;
what is a contraindication of lubiprostone?

A

type 2 chloride channels → ↑ secretion of chloride

CANNOT be used in kids

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

______ is a synthetic form of somatostatin and is used to treat _______ diarrhea

A

octreotide is used to treat secretory diarrhea (neuroendocrine tumors/ VIPoma) and diarrhea caused by vagotomy, dumping syndrome and short bowel syndrome

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

5-ASA is almost completely absorbed in the ______

A

jejunum; thus no therapeutic effect in the distal ileum, colon and rectum

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

__________ (amino glycoside) has the largest anatomic distribution of areas of the GI that it is effective

A

mesalamine (delayed response capsules specially but also pH sensitive)

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

constipation is defend as stool frequency less than ___ / week

A

< 3 /week

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

methotrexate inhibits _______ and ↓ the inflammatory actions of _____

A

dihydrofolate reductase; IL-1

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

________ type of renal stones are an AE of taking pancrelipase to treat pancreatic insufficiency

A

uric acid

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

does alvimopan and methylnaltrexone reverse the analgesic effects of opioids because they antagonize the mu receptors?

A

NO because these drugs do not cross the blood brain barrier and thus only act at the level of the gut to maintain normal motility

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

suppression of Th___ activity is an adverse effect of anti TNA alpha drugs

A

TH1 activity → severe infection and reactivation of latent tb

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

which of the glucocortocoids is preferred for long term use in patients?

A

budesonide because ↓ adverse effects because it has a rapid first pass metabolism so it has low systemic availability
glucocorticoids are usually never used for long term

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

what drugs are used for the most severe IBD’s?

A
  • anti TNF α drugs: infliximab and adalimumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

________ (glucocorticoid) is given via enema for sigmoid and rectal IBD flares

A

hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MOA of lubricant laxatives such as______

A

mineral oil; they coat the fecal material and PREVENTS water reabsorption so it should not be given with docusate

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

what are the 3 bulk forming laxatives?

A
  • methylcellulose
  • psyllium
  • bran
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

inhibition of the activity of nuclear factor kB (NF-kB) is the MOA of _______

A

aminosalicylates

21
Q

most of the side effects of sulfasalazine is due to _______

A

systemic absorption of sulfapyridine group;

side effects: nausea, GI upset, headaches, myalgia, bone marrow suppression and HS reactions

22
Q

natalizumab is indicated in treatment of ________

A

moderate to severe, unresponsive Crohn’s disease

23
Q

_____, ______, and ____ are cathartics (stimulant laxatives)
which one is safer for use in pregnant patients

A
  • castor oil, Senna, and bisacodyl

bisacodyl is more safe to pregnant patient beaucse it has minimal systemic absorption

24
Q

which drug is an osmotic laxative that can be used for long term control?

A
  • polyethylene glycol (PEG); it is common used for complete bowel preparation before GI endoscopy
25
Q

_______ is the preferred drug to be used in constipation predominant IBS; what is its MOA?

A

lubiprostone; stimulates type 2 chloride channels → ↑ secretion of chloride

26
Q

what is the MOA of bismuth subsalicylate (Pepto-Bismol)

A
  • coats the enteric tract that ↓ fluid secretion

- cAMP dependent inhibition of GI fluid secretion

27
Q

sulfasalazine consists of 5- ASA linked to _______ by a ______ bond which allows it to ↓ the absorption of the 5 ASA in the jejunum

A

sulfapyridine linked by a azo bond

28
Q

_______ is the preferred opioid diarrheal agonist

A

loperamide

29
Q

use of _______ (stimulant laxative) can cause brown pigmentation of the colonic mucosa.

A

Senna; melanosis coli and it had NO ↑ risk for colon cancer

30
Q

what are some AE of dioxyphenolate

A
  • higher doses can have CNS effects and lead to opioid dependence
  • it is an opioid agonist use as an anti diarrheal drug
31
Q

what are 4 MOA of aminosalicylates

A
  1. modulation of both cyclooxyrgenase and lipoxygenase pathways
  2. inhibition of NF-kB
  3. inhibitor of cellular immunity mechanism
  4. scavenges reactive oxygen metabolites
32
Q

in the absence of an underlying medical condition, what are the first line strategies for constipation?

A
  • ↑ dietary fiber

- physical activity

33
Q

allopurinol should not be coadmisntered with ______ because it can predicate life threatening leucopenia

A

6-MP;

allopurinol reduces xanthine oxidase and xanthine oxidase breaks down 6 MP

34
Q

what 3 types of drugs can be given to treat diarrhea predominant IBS?

A
  1. opioid agonists: loperamide
  2. 5HT 3 antagonist: alosetron which ↓ noxious visceral sensations such as nausea, bloating and pain
  3. anticholinergics: hyoscyamine, dicylomine, glyocpyrrolate and methoscopolamine (not preferred anymore)
35
Q

what drugs are opioid AGONISTS given as anti-diarrhea drugs

A
  • loperamide

- diphenoxylate

36
Q

dronabintol stimulates the _____ receptors

A

CB1 (cannabinoid)

37
Q

what two drugs are stool softeners?

A

docusate and glycerin

38
Q

when do you give infiliximab?

A

for moderate to severe colitis when patients are not response to mesalamine or corticosteroids

anti TNF α drug

39
Q

________ targets integrins

A

natalizumab

40
Q

what is the MOA of natalizumab?

A

monoclonal antibodies that targets integrins on circulating inflammatory cells and thus disrupt the leukocyte vascular wall adhesion and transmigration

41
Q

__________ (class of drugs) are used for long term MAINTENANCE of IBD remission

A

aminosalicylates (all have a ‘sal’ in the name)

  • sulfasalazine
  • balsalazide
  • mesalamine
42
Q

opioid induced constipation is due to activation of _____ receptor in the bowel. what are some drugs that are antagonists to this receptor?

A

mu-opioid receptor;

antagonists: alvimopan and methylnaltrexone

43
Q

polyethylene glycol, ________, and _______ are osmotic laxatives

A

magnesium salts/hydroxide, and lactulose;

they exert and osmotic pull to retain water in the intestinal lumen

44
Q

therapeutic approach to IBD is based on _____

A

severity

45
Q

what are some AE’s of octreotide

A

octreotide is a synthetic form of somatostatin

  • steatorrhea (↓ pancreatic exocrine function where there is ↓ lipolysis)
  • gallstones (inhibition of gallbladder contractility)
46
Q

activation of the mu opioid receptors in the gut ↑ / ↓ gut motility

A

↓ gut motility because they inhibit Ach release from the enteric nervous system

47
Q

_______ or _______ are given specially for opioid induced constipation

A
  • alvimopan

- methylnaltrexone

48
Q

________ are used to induce remission of ACUTE exacerbation of IBD

A

glucocorticoids: prednisolone, prednisone and budesonide

PCM Exam 4 (44 decks)

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