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0. Clinical Pharmacology > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

Give 3 examples of PPIs.

A

Omeprazole
Lansoprazole
Pantoprazole

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2
Q

Describe the mechanism of action of PPIs. (2)

A
  1. Bind to the H+/K+ ATPase pump on gastric parietal cells
  2. Reduces HCl production
    a. Therefore decreases gastric acidity
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3
Q

List 5 indications for PPIs.

A 
Peptic ulcers
Gastro-oesophageal reflux disease (GORD)
H. pylori infection
Prophylaxis in long term NSAID use
Zollinger Ellison syndrome
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4
Q

List 5 side effects of PPIs.

A 
Nausea
Vomiting
Insomnia
Vertigo
Headaches
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5
Q

Describe the important pharmacokinetics/dynamics of PPIs. (1)

What would you tell the patient when prescribing them? (2)

A

PHARMA:
Omeprazole is a cytochrome P450

PATIENT INFO:
Avoid alcohol
Take 30-60 mins before food

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6
Q

Give 4 examples of H2 receptor antagonists.

A

Ranitidine
Cimetidine
Famotidine
Nizatidine

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7
Q

Describe the mechanism of action of H2 receptor antagonists. (2)

A
  1. Histamine binds to H2 receptors on gastric parietal cells, which stimulates gastric acid secretion
  2. H2 receptor antagonists block the H2 receptor
    a. This causes reduced cAMP levels
    b. This causes reduced activity of the H+/K+ ATPase pump
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8
Q

List 3 indications for H2 receptor antagonists.

A

Peptic ulcer
Gastro-oesophageal reflux disease (GORD)
Zollinger Ellison syndrome

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9
Q

List 5 side effects of H2 receptor antagonists.

A 
Headache
Dizziness
Diarrhoea
Reduced B12 absorption
Gynaecomastia
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10
Q

Describe the important pharmacokinetics/dynamics of H2 receptor antagonists. (1)

What would you tell the patient when prescribing these? (2)

A

PHARMA:
Cimetidine is a CYP450 inhibitor

PATIENT INFO:
Avoid high protein diet
Take without regard to meals

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11
Q

Give 2 examples of laxatives.

A

Lactulose

Senna

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12
Q

Describe the mechanism of action of 2 types of laxatives. Consider:

a) Lactulose (2)
b) Senna (1)

A

LACTULOSE:
1. Reduces water reabsorption in intestine

  1. Pulls water into bowel
    a. This promotes distension and bowel movement

SENNA:
1. Stimulant/irritant agent

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13
Q

List 3 indications for laxatives.

A

Constipation
Pregnancy
Prophylaxis in opiate analgesic use

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14
Q

List 4 side effects of laxatives.

A

Dehydration
Salt loss
Abdominal cramps
Fatigue

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15
Q

Describe the important pharmakinetics/dynamics of lactulose. (2)

Same for senna. (2)

A

LACTULOSE:
Consists of monosaccharides (fructose and galactose)
Colonic bacteria break this down to create osmotic pressure

SENNA
Short term use only
Risk of organ failure with long term use/abuse

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16
Q

What would you tell the patient when prescribing laxatives? (1)

A

Take liberally without regard to meals

17
Q

List the 4 types of laxative.

A

Bulk producing agent (lactulose)
Stool softeners
Stimulant or irritant (senna)
Hydrating agents (milk of magnesia)

18
Q

What are the 3 main anti-emetic drugs?

A

Cyclizine
Metoclopramide
Prochlorperazine

19
Q

Describe the mechanism of action of cyclizine. (3)

A
  1. Histamine H1 receptor antagonist
  2. Acts on the vomiting center in the medullary region
  3. Mild anti-cholinergic and anti-muscarinic effects
20
Q

List 4 indications for cyclizine.

A

Nausea and vomiting
Motion sickness
Vertigo and dizziness
Prophylaxis with chemotherapy and opiates

21
Q

List 3 side effects of cyclizine.

A

Headache
Sedation
Diarrhoea

22
Q

Describe the important pharmacokinetics/dynamics of cyclizine. (1)

What would you tell the patient when prescribing this? (3)

A

PHARMA:
Can also be a CNS depressant

PATIENT INFO:
Avoid alcohol
Food may reduce irritation
Take without regard to meals

23
Q

What are the 5 types of anti-emetics?

Give an example of each.

A

Anti-cholinergics (Hyoscine hydrobromide)

Anti-histamines (cyclizine)

Serotonin antagonists (ondansetron)

Phenothiazines (prochlorperazine)

Motility stimulants (metoclopramide)

24
Q

Describe the mechanism of action of metoclopramide. (4)

A
  1. Dopamine (D2) receptor antagonist (a motility stimulant)
  2. Raises activity in the chemoreceptor trigger zone
    a. This reduces input from afferent visceral nerves
  3. Also increases gastric emptying and intestinal transit
  4. Also causes reduced oesphageal reflux
25
Q

List 3 indications for metaclopramide.

A

Nausea
Vomiting
To increase gastric emptying

26
Q

List 5 side effects of metaclopramide.

A 
Dystonia
Confusion
Dizziness
Diarrhoea
Parkinsonism with long term use
27
Q

Describe the important pharmacokinetics/dynamics of metaclopramide. (2)

What would you tell the patient when prescribing? (2)

A

PHARMA:
Admin: oral or parenteral
Dystonia/movement disorders are more common at the extremes of age

PATIENT INFO:
Avoid alcohol
Take 30 mins before meals

28
Q

Describe the mechanism of action of prochlorperazine. (2)

A
  1. A type of penothiazine anti-psychotic used as an anti-emetic
  2. Dopamine (D2) receptor antagonist
    a. Causes increased dopamine turnover (in the mesolimbic and chemoreceptor trigger zone)
29
Q

List 2 indications for prochlorperazine.

A

Nausea and vomiting

Adjunct in some psychotic disorders

30
Q

List 4 side effects of prochlorperazine.

A

Dry mouth
Tachycardia
Restlessness
Drowsiness

31
Q

Describe the important pharmacokinetics/dynamics of prochlorperazine. (2)

What would you tell the patient when prescribing it? (2)

A

PHARMA:
Sedation, muscle relaxation and hypotension caused by anticholinergic/anti-alpha-adrenergic effects

PATIENT INFO:
Avoid alcohol/caffeine
Take with food and a full glass of water

0. Clinical Pharmacology (14 decks)

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