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Pharma > GI drugs > Flashcards

GI drugs Flashcards

1
Q

Disorder involving erosion or ulceration of mucosal lining of GI tract

A

Acid Peptic Disease

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2
Q

Drug that reduces nausea and vomiting

A

Anti emetics

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3
Q

Esophageal irritation or inflammation due to reflux of stomach acid

A

GERD

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4
Q

Paralysis of muscle of stomach and GI due to nerve or muscle damage

Common in DM and PD

A

Gastroparesis

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5
Q

Inflammatory disease involving irritation and ulceration of COLON and RECTUM

A

Ulcerative colitis

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6
Q

Inflammatory disorder involving colon plus proximal parts of GI tract

A

Crohn’s dse

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7
Q

Disease of unknown origin manifesting as episodes of abdominal discomfort and abnormal bowel dysfunction

A

Irritable bowel syndrome

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8
Q

Drug that promotes GI motility

A

Prokinetic

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9
Q

Uses energy of ATP to secrete protons into stomach

Common target of drugs that suppress acid secretion

A

Proton Pump H/K ATPase in Parietal Cell

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10
Q

Weak bases that neutralize stomach acid by reacting with protons in the lumen

A

Antacids

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11
Q

PROTECTIVE FUNCTION of gastric mucosa

A

Antacids

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12
Q

Difference in antacids

A

Absorption and stool consistency

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13
Q

Aluminum hydroxide causes

A

Constipation

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14
Q

Magnesium hydroxide causes

A

Diarrhea

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15
Q

Less commonly used bec are completely absorbed and with more SE

A

Sodium bicarbonate Calcium carbonate

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16
Q

Two classes of GI drugs

A

1 reduce intragastric acidity

2 promote mucosal defense

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17
Q

Inhibit basal acid production by parietal cells

Inhibits binding of histamine at H2 receptor and preventing HKATPase pump

A

H2 antagonist

Cimetidine
Ranitidine
Famotidine
Nizatidine

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18
Q

Inhibit prandial acid release

A

H2 agonist

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19
Q

Cimetidine

A

1st H2 blocker
CYP450 inhibitor (inc Warfarin effect)
Inc metabolism of estrodiol - gynecomastia

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20
Q

Cimetidine endocrine effects (4)

A

Alopecia
Loss of libido
Impotence
Irregular menstruation

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21
Q

Most used H2 receptor blocker

A

Ranitidine

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22
Q

H2 receptor blocker other SE

A

Abdominal discomfort
NDV
Give BID PO

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23
Q

Proton Pump Inhibitors are Lipophilic weak bases that irreversibly inactivate the final common pathway of H secretion

A

H+/K+ ATPase

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24
Q

PPIs are metabolized in the

And have a half life of

A

Liver

1-2h

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25
Q

PPIs have a duration of action of

and

Require days of treatment to achieve effectiveness

A

24 h

3-4 days of treatmenr

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26
Q

Most bioavailable of PPIs

A

Lansoprazole

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27
Q

Lansoprazole is excreted via

the rest are via renal

A

biliary tract

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28
Q

PPIs can inhibit percentage of 24h acid secretion

SE

A

90-98%

C difficile 
Pneumonia 
Dec absorption of Ca, Mg and Fe cations
Osteoporosis (dec Ca absorption)
Hypomagnesemia
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29
Q

Least bioavailable PPI

A

Omeprazole

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30
Q

PGE analog increasing mucus and bicarbonate

A

Misoprostol

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31
Q

Misoprostol increases

and inhibits

A

mucosal protection

acid secretion

32
Q

Misoprostol CI

A

pregnant

33
Q

Sucrose complex with sulfatef aluminum hydroxide

A

Sucralfate

34
Q

Sucralfate MOA

A

polymerizes in acid environment of stomach

35
Q

Sucralfate SE

A

constipation

36
Q

Reduces stool frequency and liquidity in infectious diarrhea

A

Bismuth salt

37
Q

Bismuth SE

A

stool and tongue blackening

38
Q

Bismuth toxicity (5)

A 
Encephalopathy
Ataxia
Headache
Confusion
Seizure
39
Q

D2 antagonist that can cross BBB and has antiemetic effect at CTZ

A

Metaclopromide

40
Q

Metaclopromide SE

A

EPS and endocrine

41
Q

Does not cross BBB, not anti enetic but for stimulation of Post Partum Lactation

A

Domperidone

42
Q

Macrolide that promotes Motilin release

A

Erythromycin Parenteral

43
Q

Erythromycin se

A

Diarrhea

44
Q

Used in constipation, prevention of straining, preparation of diagnostic examination, removal of poison or toxin, antihelminth

A

Laxative

45
Q

Laxatives are CI in

A

Appendicitis
Diverticulitis
Ulcerative colitis

46
Q

Laxative SE

A 
Diarrhea
Abdominal cramping
Nausea
Fluid and electrolyte imbalance
Sympathetic reactions
CATHARTIC dependence
47
Q

Surfactant which facilitate mixing of water and oily material

A

Stool softeners/Emollients

48
Q

Drugs with 5 aminisalicylic acid (5-ASA) for topical therapy in IBD

These inhibit synthesis of prostaglandin and inflammatory leukotrienes hence no cytokines

A

Aminosalicylate

49
Q

Inhibits cAMP and blocks cytosol Ca
Inhibits GH, glucagon, insulin, gastrin

Used in treatment of esophageal varices, acromegaly, carcinoid, glucagonoma, gastrinoma)

A

Somatostatin

50
Q

Long acting somatostatin synthetic analog

Acromegaly, carcinoid, gastrinoma, glucagonoma

A

Ocreotide

51
Q

Ocreotide side effects

A

GI
gallstones
Bradycardia, conduction anomaly

52
Q

Agonist at V1 and V2 ADH
Activates insertion of aquaporin in water channels in collecting tubule

Decreases water excretion
Vasoconstriction

Used for varices, pituitary diabetes insipidus

A

Desmopressin

Vasopressin

53
Q

Desmopressin
Vasopressin

side effect

A

Hyponatremia

Hypertension

54
Q

Promotility agents

A

Erythromycin 250
Metaclopromide D2 antagonist 10
Domperidone D2 antagonist

55
Q

D2 dompamine receptor antagonist against area postrema but

Prokinetic promoting upper GI intestinal motility

D2 receptor blocking action in the area postrema of value in preventing emesis after surgical anesthesia and cancer chemotherapeutic drugs

A

Metaclopromide

Domperidone

56
Q

Metaclopromide SE

A 
Parkinsonism
EPS 
Tardive dyskinesia 
Hyperprolactinemia
Upper GI prokinetic 
Diarrhea because of D2 receptor blockade
Drowsiness 
Depression 
Neuroleptic malignant syndrome bec of D2 blockade (fever, rigidity, msc, autonomic instability, rhabdomyolysis) 
QT prolongation Torsade de pointes
57
Q

D2 antagonist that does not cross BBB so less CNS

A

Domperidone

58
Q

Promotes motility by stimulating motilin receptors

A

Erythromycin

59
Q

Interferes with activity of T lymphocytes , decreased inflammation

Metabolized to sulfapyridine and 5 ASA

Compete with p-aminobenzoic acid (PABA)

Inhibits dihydropteroate synthase

A

Sulfasalazine

60
Q

Calcineurin inhibitor
Inhibits trascription of IL - 2 and cytokines involved in T cell activation

Used in severe UC refractory to IV corticosteroids

A

Cyclosporine

61
Q

Activates u opiod receptor and slows motility with negligible CNS effects

A

Loperamide

Similar:
Diphenoxylate greater CNS opiod

62
Q

5HT3 receptor antagonist of high potency and duration of binding

Reduces smooth muscle activity in GI tract

Severe diarrhea predominant IBS in women

A

Alosetron

63
Q

Alosetrone 5HT3 antagonist SE

A

ischemic colitis
bowel infarct
constipation

64
Q

Chloride channel activator useful in constipation-predominant IBS

A

Lubiprostone

65
Q

Selective 5HT3 receptor block on vagal afferents of GI and CNS

Prevention of chemotherapy-induced and postoperative nausea and vomiting

May slow colonic transit
constipation

A

Ondansetron

similar:
Dolasetron
Granisetron
Palonosetron

66
Q

GI irritation due to infection, chemotherapy and distention cause release of

A

serotonin activating 5HT3 receptors of vagus nerve relaying impulse at vomiting centers hence emesis

67
Q

Vestibular system also communicates directly to vomiting center hence

A

vestibular nausea

68
Q

5HT3 antagonists like ondansentron alarming SE

A 
Prolong QT interval 
Torsade 
Serotonin syndrome (rigidity, tremor, hyperthermia and confusion)
69
Q

Vestibular system receptors for vomiting and emesis

A

H1 histamine receptor coupled to Gq

M1 muscarinic receptors

70
Q

Treat vestibular nausea and motion sickness

A

1st gen antihistamine receptors
Diphenhydramine
Meclizine

SE: sedation, antimuscarinic

71
Q

Muscarinic agonist that treats motion sickness (M1 blockade)

A

Scopolamine

72
Q

Area postrema receptors

A

D2 receptors

Neurokinin NK1 receptors activated by Substance P

73
Q

Metaclopromide CI

A

Small bowel obstruction

74
Q

Antagonizes NK1 receptors in area postrema

Treats chemotherapy induced vomiting

No effect on serotonin, dopamine and muscarinic receptors

Limited adverse effects

A

Aprepitant

75
Q

Inhibits both gastrin and histamine by ECL cells

Tones down gastric acid production even on gastrinomas

A

Somatostatin

Ocreotide long acting SST analog useful on Zollinger Ellison

Pharma (26 decks)

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