GI Drugs Flashcards

0
Q

Proton pump inhibitors
H2-receptor blockers
Sucralfate
Antacids

A

Drugs used in acid-peptic diseases

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1
Q

Drugs used in acid-peptic diseases

A

Proton pump inhibitors
H2-receptor blockers
Sucralfate
Antacids

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2
Q

Proton pump inhibitors

A

Omeprazole
Lansoprazol
Etc

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3
Q

Omeprazole

A

Proton pump inhibitor

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4
Q

Lansoprazol

A

Proton pump inhibitor

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5
Q

Proton pump inhibitors

Mechanism of action

A

Irreversible blockade of H+/K+ATPase pump in active parietal cells of stomach

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6
Q

Irreversible blockade of H+/K+ATPase pump in active parietal cells of stomach

A

Proton pump inhibitors

Mechanism of action

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7
Q

Proton pump inhibitors

Effects

A

Long-lasting reduction of stimulating and nocturnal acid secretion

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8
Q

Long-lasting reduction of stimulating and nocturnal acid secretion

A

Proton pump inhibitors

Effects

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9
Q

Proton pump inhibitors

Clinical applications

A

Peptic ulcer
Gastroesophageal reflux disease
Erosive gastritis

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10
Q

Peptic ulcer
Gastroesophageal reflux disease
Erosive gastritis

A

Proton pump inhibitors

Clinical applications

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11
Q

Proton pump inhibitors

Toxicities

A

Reduction of stomach acid may reduce absorbtion of some drugs and increase that of others

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12
Q

Reduction of stomach acid may reduce absorbtion of some drugs and increase that of others

A

Proton pump inhibitors

Toxicities

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13
Q

H2-receptors blockers

A

Cimetidine

Etc

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14
Q

H2-receptors blockers

A

Cimetidine

Etc

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15
Q

H2-receptors blockers

Effects

A

Effective reduction of nocturnal acid but less effective against stimulated secretion, very safe.

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16
Q

Effective reduction of nocturnal acid but less effective against stimulated secretion, very safe.

A

H2-receptors blockers

Effects

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17
Q

Sucralfate

Effects

A

Polymerizes at site of tissue damage (ulcer bed) and protectsagainst further damage; very insoluble with no systemic effects; must be given 4 times daily

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18
Q

Polymerizes at site of tissue damage (ulcer bed) and protectsagainst further damage; very insoluble with no systemic effects; must be given 4 times daily

A

Sucralfate

Effects

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19
Q

Antacids

Effects

A

Popular OTC medication for symtomatic relief of heartburn; not as usful as PPI and H2 blockers in peptic diseases

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20
Q

Popular OTC medication for symtomatic relief of heartburn; not as usful as PPI and H2 blockers in peptic diseases

A

Antacids

Effects

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21
Q

Drugs stimulating motility

A

Metoclopramid
Domperidone
Cholibomimetics: Neostigmine
Macrolides: Eryhromycin

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22
Q

Metoclopramid
Domperidone
Cholibomimetics: Neostigmine
Macrolides: Eryhromycin

A

Drugs stimulating motility

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23
Q

Drugs stimulating motility
Metoclopramid
Domperidone

Mechanism of action

A

D2-receptor blocker

Removes inhibition of acetylcholine neurons in enteric nervous system

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24
Q

D2-receptor blocker

Removes inhibition of acetylcholine neurons in enteric nervous system

A

Drugs stimulating motility
Metoclopramid
Domperidone

Mechanism of action

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25
Q

Drugs stimulating motility
Metoclopramid
Domperidone

Effects

A

Increases gastric emptying and intestinal mobility

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26
Q

Drugs stimulating motility
Metoclopramid
Domperidone

Effects

A

Increases gastric emptying and intestinal mobility

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27
Q

Drugs stimulating motility
Metoclopramid
Domperidone

Clinical applications

A
Gastric paresis (e.g, in diabetic)
Antiemetic
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28
Q
Gastric paresis (e.g, in diabetic)
Antiemetic
A

Drugs stimulating motility
Metoclopramid
Domperidone

Clinical applications

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29
Q

Drugs stimulating motility
Metoclopramid
Domperidone

Toxicities

A

Parkinsonian symtoms due to block of central nervous system (CNS) D2 receptors

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30
Q

Parkinsonian symtoms due to block of central nervous system (CNS) D2 receptors

A

Drugs stimulating motility
Metoclopramid
Domperidone

Toxicities

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31
Q

Laxatives

A
Magnesium hydroxide, other nonabsorbable salts
Bulk-forming laxatives
Stimulants laxatives
Stool surfactans
Chlorid channal activator
Opioid receptor antagonists
5-HT4 agonists
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32
Q
Magnesium hydroxide, other nonabsorbable salts
Bulk-forming laxatives
Stimulants laxatives
Stool surfactans
Chlorid channal activator
Opioid receptor antagonists
5-HT4 agonists
A

Laxatives

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33
Q

Magnesium hydroxide, other nonabsorbable salts and sugars

Mechanism of action

A

Osmotic agents increase water content of stool

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34
Q

Osmotic agents increase water content of stool

A

Magnesium hydroxide, other nonabsorbable salts and sugars

Mechanism of action

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35
Q

Magnesium hydroxide, other nonabsorbable salts and sugars

Effects

A

Usally cause evacuation within 4-6 h, sooner in large doses

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36
Q

Usally cause evacuation within 4-6 h, sooner in large doses

A

Magnesium hydroxide, other nonabsorbable salts and sugars

Effects

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37
Q

Magnesium hydroxide, other nonabsorbable salts and sugars

Clinical applications

A

Simple constipation
Bowel prep for endoscopy
(especially PGE solutions)

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38
Q

Simple constipation
Bowel prep for endoscopy
(especially PGE solutions)

A

Magnesium hydroxide, other nonabsorbable salts and sugars

Clinical applications

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39
Q

Magnesium hydroxide, other nonabsorbable salts and sugars

Toxicities

A

Magnesium may be absorbed and cause toxicity in renal imparment

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40
Q

Magnesium may be absorbed and cause toxicity in renal imparment

A

Magnesium hydroxide, other nonabsorbable salts and sugars

Toxicities

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41
Q

Bulk-forming laxatives

A

Methylcellulose
Psyllium
Etc
( increase volume of colon, stimulat evacuation)

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42
Q

Methylcellulose
Psyllium
Etc
( increase volume of colon, stimulat evacuation)

A

Bulk-forming laxatives

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43
Q

Stimulants (laxatives)

A

Senna
Cascara
(Stimulate activity; may cause cramping)

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44
Q

Senna
Cascara
(Stimulate activity; may cause cramping)

A

Stimulants (laxatives)

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45
Q

Stool surfactants

A

Docusate
Mineral oil
(Lubricate stool, ease passage)

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46
Q

Docusate
Mineral oil
(Lubricate stool, ease passage)

A

Stool surfactants

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47
Q

Chloride channal activators (laxatives)

A

Lubiprostone
Prostanoic acid derivate

(Stimulates chloride secration into intestine, increasing fluid content)

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48
Q

Lubiprostone
Prostanoic acid derivate

(Stimulates chloride secration into intestine, increasing fluid content)

A

Chloride channal activators (laxatives)

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49
Q

Opioid receptor antagonists (laxatives)

A

Alvimopan
Methylnaltrexone

(Blocks intestinal U-opioid receptors but do not enter CNS, so analgesia is maintained)

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50
Q

Alvimopan
Methylnaltrexone

(Blocks intestinal U-opioid receptors but do not enter CNS, so analgesia is maintained)

A

Opioid receptor antagonists (laxatives)

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51
Q

5-HT4 agonists (laxatives)

A

Tegaserod

Activates enteric 5-HT4 receptors and increase intestinal mobility

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52
Q

Tegaserod

Activates enteric 5-HT4 receptors and increase intestinal mobility

A

5-HT4 agonists (laxatives)

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53
Q

Antidiarrheal drugs

A

Loperamide
Diphenoxylate
Colloidal bismuth compounds
Kaolin+pectin

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54
Q

Loperamide
Diphenoxylate
Colloidal bismuth compounds
Kaolin+pectin

A

Antidiarrheal drugs

55
Q

Loperamide

Mechanism of action

A

Activates U-opioid receptors in enteric nervous system

56
Q

Activates U-opioid receptors in enteric nervous system

A

Loperamide

Mechanism of action

57
Q

Loperamide

Effects

A

Slows mobility in gut with negliable CNS effects

58
Q

Slows mobility in gut with negliable CNS effects

A

Loperamide

Effects

59
Q

Loperamide

Clinical applications

A

Nonspecific, noninfectious diarrhea

60
Q

Nonspecific, noninfectious diarrhea

A

Loperamide

Clinical applications

61
Q

Loperamide

Toxicities

A

Mild cramping but little or no CNS toxicity

62
Q

Mild cramping but little or no CNS toxicity

A

Loperamide

Toxicities

63
Q

Diphenoxylate

Effects

A

Similar to loperamid, but high doses can cause CNS opioid effects and toxicity

64
Q

Similar to loperamid, but high doses can cause CNS opioid effects and toxicity

A

Diphenoxylate

Effects

65
Q

Colloidal bismuth compounds

A

Subsalicylate and citrate salts available

OTC preparations popular and have some value in travelers’ diarrhea due to adsorption of toxins

66
Q

Subsalicylate and citrate salts available

OTC preparations popular and have some value in travelers’ diarrhea due to adsorption of toxins

A

Colloidal bismuth compounds

67
Q

Kaolin+pectin

A

Adsorbent compounds available OTC in some contries

68
Q

Adsorbent compounds available OTC in some contries

A

Kaolin+pectin

69
Q

Drugs for irritable bowel syndrome (IBS)

A

Alosetron (5-HT3 antagonist)
Anticholinergics
Chloride channal activators

70
Q

Alosetron (5-HT3 antagonist)
Anticholinergics
Chloride channal activators

A

Drugs for irritable bowel syndrome (IBS)

71
Q

Alosetron

Mechanism of action

A

5-HT3 antagonist of high potency and duration of binding

72
Q

5-HT3 antagonist of high potency and duration of binding

A

Alosetron

Mechanism of action

73
Q

Alosetron

Effects

A

Reduces smooth muscle activity in gut

74
Q

Reduces smooth muscle activity in gut

A

Alosetron

Effects

75
Q

Alosetron

Clinical applications

A

Approved for severe diarrhea-predominant IBS in women

76
Q

Approved for severe diarrhea-predominant IBS in women

A

Alosetron

Clinical applications

77
Q

Alosetron

Toxicities

A

Rare but serious constipation
Ischemic colitis
Infarction

78
Q

Rare but serious constipation
Ischemic colitis
Infarction

A

Alosetron

Toxicities

79
Q

Antiemetic drugs

A
Ondasetron, other 5-HT3 antagonists
Aprepitant
Corticosteroids
Antimuscarinic
Antihistaminics
Phenothizines
Cannabinoids
80
Q
Ondasetron, other 5-HT3 antagonists
Aprepitant
Corticosteroids
Antimuscarinic
Antihistaminics
Phenothizines
Cannabinoids
A

Antiemetic drugs

81
Q

Ondasetron, other 5-HT3 antagonists

Mechanism of action

A

5-HT3 blockade in gut and CNS with shorter duration of binding than alosetron

82
Q

5-HT3 blockade in gut and CNS with shorter duration of binding than alosetron

A

Ondasetron, other 5-HT3 antagonists

Mechanism of action

83
Q

Ondasetron, other 5-HT3 antagonists

Effects

A

Extremely effective in preventing chemotheraphy induced and postoperative nausea and vomiting

84
Q

Extremely effective in preventing chemotheraphy induced and postoperative nausea and vomiting

A

Ondasetron, other 5-HT3 antagonists

Effects

85
Q

Ondasetron, other 5-HT3 antagonists

Clinical applications

A

First-line agents in cancer chemotherapy; also useful for postop emesis

86
Q

First-line agents in cancer chemotherapy; also useful for postop emesis

A

Ondasetron, other 5-HT3 antagonists

Clinical applications

87
Q

Aprepitant

Mechanism of action

A

NK1-receptor blocker in CNS

88
Q

NK1-receptor blocker in CNS

A

Aprepitant

Mechanism of action

89
Q

Aprepitant

Effects

A

Interferes with vomiting reflex

No effect on 5-HT, dopamin or steroid receptors

90
Q

Interferes with vomiting reflex

No effect on 5-HT, dopamin or steroid receptors

A

Aprepitant

Effects

91
Q

Aprepitant

Clinical applications

A

Effective in reducing both early and delayed emesis in cancer chemotherapy

92
Q

Effective in reducing both early and delayed emesis in cancer chemotherapy

A

Aprepitant

Clinical applications

93
Q

Aprepitant

Toxicities

A

Fatigue
Dizziness
Diarrhea
CYP interactions

94
Q

Fatigue
Dizziness
Diarrhea
CYP interactions

A

Aprepitant

Toxicities

95
Q

Antimuscarinic (scopolamine)

A

Effective in emesis due to motion sickness; not other types

96
Q

Effective in emesis due to motion sickness; not other types

A

Antimuscarinic (scopolamine)

97
Q

Antihistaminics ( antiemetic )

A

Moderate efficacy in motion sickness and chemotherapy-induced emesis

98
Q

Moderate efficacy in motion sickness and chemotherapy-induced emesis

A

Antihistaminics ( antiemetic )

99
Q

Phenothiazines ( antiemetic )

A

Act primary through block of D2 and muscarinic receptors

100
Q

Act primary through block of D2 and muscarinic receptors

A

Phenothiazines ( antiemetic )

101
Q

Cannabinoids

A

Dronabinol is available for use in chemotherapy- induced nausea and vomiting, but associated with CNS marijuana effects

102
Q

Dronabinol is available for use in chemotherapy- induced nausea and vomiting, but associated with CNS marijuana effects

A

Cannabinoids

103
Q

Drugs used in inflammatory bowel disease (IBD)

A

5-Aminosalicylates, eg mesalamine
Sulfasalazine
Purine analogs, eg, 6-mercaptopurine, methtrexate
Anti-TNF antibodies, eg infliximab, others
Corticosteroids

104
Q

5-Aminosalicylates, eg mesalamine
Sulfasalazine
Purine analogs, eg, 6-mercaptopurine, methtrexate
Anti-TNF antibodies, eg infliximab, others
Corticosteroids

A

Drugs used in inflammatory bowel disease (IBD)

105
Q

5-Aminosalicylates

A

Mesalamine

106
Q

Mesalamine

A

5-Aminosalicylates

107
Q

Mesalamine

Mechanism of action

A

Mechanism uncertain

May be inhibition of eicosanoid inflammatory mediators

108
Q

Mechanism uncertain

May be inhibition of eicosanoid inflammatory mediators

A

Mesalamine

Mechanism of action

109
Q

Mesalamine

Clinical applications

A

Mild to moderately severe Crohn’s disease and ulcerative colitis

110
Q

Mild to moderately severe Crohn’s disease and ulcerative colitis

A

Mesalamine

Clinical applications

111
Q

Anti-TNF antibodies

A

Infliximab

Others

112
Q

Infliximab

Others

A

Anti-TNF antibodies

113
Q

Infliximab

Mechanism of action

A

Bind tumor necrosis factor and prevents it from binding to its receptors

114
Q

Bind tumor necrosis factor and prevents it from binding to its receptors

A

Infliximab

Mechanism of action

115
Q

Infliximab

Effects

A

Suppression of several aspects of immune function, especially TH1 lymphocytes

116
Q

Suppression of several aspects of immune function, especially TH1 lymphocytes

A

Infliximab

Effects

117
Q

Infliximab

Clinical applications

A

Moderately severe to severe Crohn’s disease and ulcerative colitis

118
Q

Moderately severe to severe Crohn’s disease and ulcerative colitis

A

Infliximab

Clinical applications

119
Q

Pancreatic supplements

A

Pancrelipase

Pancreatin

120
Q

Pancrelipase

A

Pancreatic supplements

121
Q

Pancrelipase

Mechanism of actions

A

Replacement enzymes from animal pancreatic extracts

122
Q

Replacement enzymes from animal pancreatic extracts

A

Pancrelipase

Mechanism of actions

123
Q

Pancrelipase

Effects

A

Improves digestion of dietary fat, protein, and carbohydrate

124
Q

Pancrelipase

Effects

A

Improves digestion of dietary fat, protein, and carbohydrate

125
Q

Pancrelipase

Clinical applications

A

Pancreatic insufficiency due to cystic fibrosis, pancreatitis, pancreatectomy

126
Q

Pancreatic insufficiency due to cystic fibrosis, pancreatitis, pancreatectomy

A

Pancrelipase

Clinical applications

127
Q

Bile acid therapy for gallstones

A

Ursodiol

128
Q

Ursodiol

A

Bile acid therapy for gallstones

129
Q

Ursodiol

Mechanism of action

A

Reduces cholesterol secretion into bile

130
Q

Reduces cholesterol secretion into bile

A

Ursodiol

Mechanism of action

131
Q

Ursodiol

Effects

A

Dissolves gallstones

132
Q

Dissolves gallstones

A

Ursodiol

Effects

133
Q

Ursodiol

Clinical applications

A

Gallstones in patients refusing or not eligible for surgery

134
Q

Gallstones in patients refusing or not eligible for surgery

A

Ursodiol

Clinical applications

135
Q

Orlistat

A

Non-amphetamine drug for treatment of obesity

136
Q

Non-amphetamine drug for treatment of obesity

A

Orlistat