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pharmacology unit 6 > GI drugs II > Flashcards

GI drugs II Flashcards

1
Q

patho of GERD

A

inappropriate relaxation, low resting tone, anatomical alteration of the lower esophageal sphincter. acid hypersecretion especially after meals.

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2
Q

how to treat GERD simple lifestyle

A

elevation of head at bed time, avoidance of liquids or foods 2-3hrs before bed, avoid fatty or spicy food, no cigs or ETOH, weight loss, liquid antacids, pregnancy.

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3
Q

how to treat GERD with persistent symptoms W/O esophagitis

A

alginic antacids, promobility drugs, H2-blockers.

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4
Q

what promobility drugs treat GERD

A

cisapride, metaclopramide

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5
Q

what H2 blockers treat GERd

A

cimetidine, ranitidine, famotidine, nizatidine

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6
Q

how to treat GERD with persistent symptoms with esophagitis

A

H2 blockers double dose, H2 blockers and promobility agent. PPI. antireflux surgery

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7
Q

what PPI for GERD with esophagitis

A

omeprazole, lansoprazole, rabeprazole, esomeprazole, pantoprazole, dexlansoprazole.

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8
Q

metaclopramide

A

peripheral dopamine antagonist

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9
Q

adverse effects of metaclopramide

A

tremor.

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10
Q

what mediates vomiting

A

chemo-receptor trigger zone in the medulla vomiting center.

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11
Q

what stimulates vomiting

A

alcohol, ipecac, infection, inflammation, mass effects, vestibular irritation, headaches, apomorphine, chemotherapy.

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12
Q

how do antiemetics work

A

on the chemoreceptor trigger zone

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13
Q

what are the phenothiazines and agents

A

neuroleptic class of antiemetics -perchlorperazine, promethazine

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14
Q

mechanism of perchlorperazine

A

CNS interaction with the dopamine receptor -antagonistic. adverse affects are largely extrapyramidal

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15
Q

mechanism of promethzine

A

antihistaminic and anticholinergic.

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16
Q

what are the adverse affects of promethazine

A

somnolence

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17
Q

what are the benzamide derivatives

A

unknown effect. trimethobenzamide and metaclopramide

SE not as severe as the phenothiazines

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18
Q

mechanism of metoclopramide

A

CNS and peripheral dopamine receptor antagonism

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19
Q

tetrahydrocannabinol

A

probable anticholinergic mechanism

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20
Q

what are the serotonin antagonists

A

ondansetron, granesitron, dolasetron,

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21
Q

what are the SE of the serotonin antagonists

A

HA, dizziness, somnolence

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22
Q

what is the treatment for gastroparesis

A

promotility drugs.

23
Q

what is gastroparesis

A

obstruction or loss of gastric tone.

24
Q

what are the promobility drugs

A

metaclopramide, cisapride, domperidone

25
Q

what is secretory diarrhea

A

increased secretion or decreased absorption of NaCl

26
Q

what is osmotic diarrhea

A

nonabsorbable molecules in the gut lumen

27
Q

what is inflammatory absoroptive surface diarrhea

A

destruction of the mucosa impaired absorption, outpouring of blood/mucous

28
Q

what happens in decreased absorption diarrhea

A

impaired reabsorption of electrolytes

29
Q

what happens in a motility disorder

A

increased motility with decreased time for absorption of electrolytes and/or nutrients. decreased motility with bacterial overgrowth.

30
Q

5 causes of acute diarrhea

A 
viral/bacterial/parasitic infections
food poisoning
drugs
fecal impaction
heavy metal poisoning
31
Q

travelers diarrhea

A

bacterial infections, viral and parasitic infections

32
Q

what are the bacterial causes of travelers diarrhea

A

mediated by enterotoxins made by e coli. mediated by invasion of the mucosa and inflammation by e coli, shigella, camplobacter. or a combination of both enterotoxins and invasion such as salmonella.

33
Q

causes of chronic/recurrent diarrhea

A

IBS, inflammatory bowel disease, parasitic infections, malabsorption syndrome, drugs, heavy metals.

34
Q

causes of chronic diarrhea of unknown origin

A

surreptious laxative abuse, IBS, unrecognized inflammatory, bile acid malabsorption, other

35
Q

causes of incontinence

A

sphincter malfunction (surgeries, fissures, fistulas, hemorrhoids, episiotomy, anal crohns, diabetic neuropathy, idiopathic)

36
Q

what drug classes treat diarrhea

A

anticholinergics, opioid agonists, colloids and pectins

37
Q

atropine sulfate

A

treatment of diarrhea by relaxing the bowel smooth muscle.

38
Q

loperamide

A

opioid treatment for diarrhea, increases rectal tone and disrupts peristalsis via mu receptor

39
Q

diphenoxylate

A

opioid treatment for diarrhea, usually combined with atropine, mu receptor, contracts the circular muscle causing segmentation. (codeine sulfate works the same)

40
Q

what causes constipation

A

drugs, functional, colonic, rectal, neurologic, metabolic

41
Q

hwo do we treat constipation

A

with laxatives or carthartics

42
Q

antiinflammatories for the treatment of colitis

A

mesalamine, sulfasalazine, olsalazine. corticosteroids and antibiotics.

43
Q

what are the chronic immunosuppressive agents for inflammatory bowel diseases

A

azothioprine, corticosteroids, infliximab, cyclosporine

44
Q

what is the mechanism of azothioprine

A

antimetabolite that interferes with DNA synthesis

45
Q

what is the mechanism for infliximab

A

monoclonal antibody, binds and neutralizes TNF-a

46
Q

what is the mechanism for cyclosporin

A

polypeptide that inhibits T cell helpers and lymphocytes

47
Q

classes of drugs used to treat IBS

A

opioids, bulking agents, antidepressants, anticholinergics, serotonergic agonists and antagonists

48
Q

bulking agents

A

metamucil and fibercon.

49
Q

opioids for IBS

A

loperamide

50
Q

anticholinergics for IBS

A

dicyclomine hydrochloride, hyoscyamine sulfate

51
Q

antidepressants for IBS

A

SSRIs..

52
Q

serotinergic agonists for IBS

A

for when diarrhea predominates. alosetron. constipation or ischemic bowel can occur

53
Q

serotonergic antagonists for IBS

A

constipation predominant tegaserod maleate.

pharmacology unit 6 (45 decks)

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