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Pharmacology > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

PPIs- PKs?

A

Omeprazole is a prodrug activated by stomach acid!

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2
Q

PPIs- ADRs?

A

GI disturbance, headache, rash, osteoporosis

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3
Q

PPIs- DDIs?

A

CYP inhibitor- increase MTX, decrease clopidogrel (reduced activation by CYP!)

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4
Q

H2 antagonists- mechanism?

A

Antagonise H2 receptors -> decrease acid secretion, acts immediately and has short half life so take 2 x day

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5
Q

H2 antagonists- ADRs?

A

GI disturbance, headache, gynaecomastia, hypotension

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6
Q

H2 antagonists- DDIs?

A

Cimetidine is CYP inhibitor- increase AEDs, aminophylline, decrease clopidogrel

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7
Q

PPIs- mechanism?

A

Inhibit H+/K+ ATPase (omeprazole IRREVERSIBLY inhibits!) -> decrease acid secretion! Takes days to have full effect (take out all pumps!)

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8
Q

Domperidone- mechanism?

A

Dopamine (D2) antagonist -> inhibits vomiting response from trigger centre in 4th ventricle (postrema) ALSO increase rate of stomach emptying

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9
Q

Domperidone- uses?

A

Acute N&V esp in parkinsons (caused by L-dopa)

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10
Q

Ondansteron -mechanism?

A

Serotonin antagonist -> Inhibits postrema in 4th ventricle, inhibits vagal vomiting signals from GI tract

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11
Q

Domperidone- ADRs?

A

Increased prolactin-> galactorrhoea, dystonia

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12
Q

Ondansteron - uses?

A

Iatrogenic vomiting- chemotherapy and post op nausea

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13
Q

Ondansteron- ADRs

A

Headache, constipation, flushing

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14
Q

Hyoscine - mechanism?

A

ACh antagonist in vestibular apparatus -> stops MOTION SICKNESS

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15
Q

Hyoscine ADRs

A

Anti-cholinergic effects plus bradycardia (unexpected!!)

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16
Q

Cyclizine- mechanism?

A

Histamine (H1) antagonist -> inhibits vomiting centre in medulla and vestibular apparatus

17
Q

Cyclizine- uses?

A

Acute N&V

18
Q

Cyclizine- ADRs

A

Long QT, sedation

19
Q

Metoclopramide- mechanism?

A

D2 antagonist, anti-cholinergic AND serotonin antagonist

20
Q

Metoclopramide- uses?

A

GI causes of N&V, migraine, post op nausea

21
Q

Metoclopramide- ADRs

A

Galactorrhoea, dystonia, extra pyramidal signs (avoid in parkinsons)

22
Q

Drugs for hard faeces constipation?

A

Bulk forming, faecal softeners, osmotic laxatives

23
Q

Soft faeces constipation?

A

Stimulant laxatives e.g. Senna

24
Q

Bulk forming laxatives mechanism?

A

E.g isphaghula, indigestible vegetable fibre!! (Yum)

25
Q

When don’t use bulk laxatives?

A

Ulceration/adhesions -> obstruction!!

26
Q

Faecal softeners- example, mechanism, uses?

A

E.g. Arachis oil, glycerol -> lubricate and soften stool, use in adhesions (no obstruction risk!), haemorrhoids and anal fissures

27
Q

Osmotic laxatives- Mg/Na salts mechanism, example, uses?

A

E.g. Phosphate enema -> Increase water retention -> increase peristalsis, quick acting! Use in resistant constipation for urgent relief!!

28
Q

Osmotic laxatives - lactulose mechanism, uses?

A

Galactose and fructose, bacteria FERMENT it -> acetic and latic acid -> osmotic effect, use in LIVER FAILURE (decreased ammonia)

29
Q

Stimulant laxatives- example, mechanism?

A

Senna -> excite sensory nerves -> increase water and electrolyte retention -> increase peristalsis!

30
Q

Stimulant laxatives- ADRs and contra indications

A

Abdo cramps, colonic atony, hypokalaemia DONT use in OBSTRUCTION

31
Q

Anti motility drugs- example, mechanism?

A

Loperamide (opiate analogue) -> opioid receptors in bowel -> decrease motility, increase time for water and salt resorption, increase anal tone, decrease defecation reflex

32
Q

Loperamide- indications and contraindications

A

Use in chronic diarrhoea NOT in IBD as -> toxic megacolon

33
Q

Anti-spasmodics- example, mechanism, uses?

A

Meberavine, anti-muscarinic-> decrease spasms and painful cramps, maintain motility, use with bulk forming agent to treat IBS!

Pharmacology (13 decks)

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