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Pharmacology > GI drugs > Flashcards

GI drugs Flashcards

1
Q

what is the area is the area that receives vomiting relays?

A

nucleus tractus soltarius

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2
Q

What are the 3 areas that relay information to the nucleus tractus solitarius?

A

GI tract
vestibular system
area postrema

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3
Q

How does the GI tract trigger emesis?

A

stomach release 5HT3 that bin to vagal efferents that cause emesis

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4
Q

how does the vestibular system cause emesis?

A

CN VIII communicates with NTS–> emesis

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5
Q

How does the area postrema cause emesis?

A

its located to the NTS outside the BBB in the 4th ventricle ;responds to emtogenic substances

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6
Q

Ondanseton

A

antagonizes 5HT 3 receptors on the vagal afferent of GI tract

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7
Q

What are the side effects of ondansetron?

A 
constipation 
headache
dizziness 
QT prolongation--> torsade de pointes 
serotonin syndrome
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8
Q

What are the receptors located in the vestibular system ?

A

H1 receptors

and Muscarinic receptors

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9
Q

Antihistamines & scopolamine

A

tx: motion sickness

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10
Q

What are the side effects of antihistamines

A

antimuscarinc
sedation
mydriasis

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11
Q

What is the receptor in the area postrema ?

A

D2 receptors

NK 1 receptors

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12
Q

Metochlopramide

A

antagonize D2 receptors in area postrema

pro kinetics –> increased gastric emptying

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13
Q

What are the side effects of metochlopramide?

A 
contraindicated in small bowel obstruction 
diarrhea
drowsiness 
depression 
extrapyramidal effects 
Tar dive dyskinesia 
Neuroleptic malignant syndrome 
increase prolactin levels 
torsade de pointes
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14
Q

What activated NK1 receptors in area postrema?

A

substance P

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15
Q

Aprepitant

A

antagonizes NK1 receptors in area postrema

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16
Q

Ranitidine, Cimetidine, famotidine

A

H2 antagonist
“tidine”
tx: GERD
gastric & duodenal ulcers

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17
Q

Omeprazole, lanoprazole

A 
"prazole"
proton pump inhibitors 
tx:GERD
NSAID induced ulcers
H.pylori 
Gastrinomas
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18
Q

What are the side effects of proton pump inhibitors

A 
increased clostridium difficile 
increase osteoporosis
increased respiratory infections 
decreased Ca,Fe, Mg, absorption 
hypomagnesium
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19
Q

Octreotide

A

Somatostain anolog
inhibit G cells from releasing gastrin
decrease release of histamine by ECL cells

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20
Q

Rifaximin

A

decrease the ammonia produce by intestinal bacteria

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21
Q

Psyllium

A

gulf forming laxative

22
Q

Decussate , Enema

A

stool softners

23
Q

Senna

A

stimulates laxative

can cause melanosis coli

24
Q

loperamide , diphenoxylate

A

active mu receptors decrease bowel movements

25
Q

What type of cancers can octreotide be given for?

A

VIPoma

carcinoid tumors

26
Q

Gluisine, Aspart, lispro

A

short acting

tx; post prandial meals

27
Q

Regular insulin, NPH insulin

A

intermediate acting
given IV
tx: diabetic ketoacidosis
hyperkalemia

28
Q

Detemir, Glargine

A

allows for steady level of insulin

can cause hypoglycaemia

29
Q

Tolbutamine , chlorpropamide

A

1st generation sulfonylureas

bind to ATP dependent K channels–> depolarization–> ca influx –> insulin release

30
Q

glyburide, glimepriride, glipizide

A

2nd generation sulfonylureas

glipizide is short acting

31
Q

ropaglinide, nateglinide

A

'’glide”
bind K channels
no sulfa interaction

32
Q

What is the side effects of sulfonylureas and glinides?

A

increased risk of hypoglycaemia
increase weight gain
disulfram reaction with alcohol

33
Q

eventide, liraglutide

A

act on GLP-1 receptors

increase insulin , decrease glucagon, decrease gastric emptying– satiety

34
Q

Sitagliptin, saxagliptin, linagliptin

A

“gliptin”

prevent the breakdown of GLP-1

35
Q

What are the side effects of DDP4

A

nasopharyngitis

upper respiratory infections

36
Q

Metformin

A

inhibit mitochondrial enzyme glycerophosphate dehydrogenase–> decrease hepatic gluconogenesis

activates AMPK–> decreases gluconeogenesis

37
Q

What is the side effects of metformin

A 
lactic acidosis 
contraindicated with renal insufficiency 
GI effects (anorexia, vomiting)
38
Q

Rosiglitazone, Pioglitazone

A

increase glucose use
is a ligand of PPAR-gamma –> unregulated adiponectin
increased adipocytes –> decreased TGs
unregulated glut 4

39
Q

What are the side effects of thiazolidinediones

A

fluid retention & peripheral edema
weight gain
exacerbate HF
decrease bone mineralization –> fractures

40
Q

Amylin

A

decrease glucagon , gastric emptying & appetite

tx : type 1 &2 hypoglycaemia

41
Q

Acarbose & miglotol

A

Alpha glucosidase inhibitor
decrease conversion of disaccharides to absorbable monosaccharides
located in brush border

42
Q

What are the side effects of alpha glucosidase inhibitors

A

diarrhea, flatulence, abdominal pain

43
Q

Canagloflozin, dapagloflozin

A

SGLT2 inhibitors

decrease reabsorption of glucose in PCT

44
Q

What are the side effects of SGLT2 inhibitors

A

increase UTI due to glucose concentration in urine
candidiasis (genital)
hypotension
contraindicated in renal insufficiency

45
Q

Alendronate, pamidronate, zoledronate

A

1st line tx
attach to hydroxyapatite in bone –> osteoclast binding to bisphosphonates instead of bone –> decrease activity

induce osteoclast apoptosis
decrease the development & recruitment of osteoclast precursors

tx; hypercalcemia, hypercalcemia malignancy
paget disease

46
Q

What are the effects of bisphosphonates

A 
GI effects 
esophagitis 
esophageal ulcers 
acid reflux 
osteonecrosis of the jaw 
hypocalcemia 
increase risk of breast cancer
taken with a lot of water
47
Q

What is the effects of estrogen on bone?

A

inhibit differentiation of osteoclast precursors

48
Q

Raloxifene

A

SERM
agonist in bone: antagonist in breast and uterus
tx; prevention of postmenopausal osteoporosis

49
Q

What is the action of PTH on bone ?

A

stimulates osteoblast to express RANKL

RANKL binds to RANK to increase osteoclast activity

50
Q

Denosumab

A

directly inhibit osteoclast
promote Ca excretion from the kidney
tx: paget
hypercalcemia of malignancy

Pharmacology (15 decks)

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