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Pharmacology > GI Drugs II > Flashcards

GI Drugs II Flashcards

1
Q

what are neostigmine and bethanechol used for

A

neostigmine: colonic pseudo obstruction in hospitalized patient
bethanechol: bowel and bladder retention post op

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2
Q

mechanism and use of erythromycin

A

acts on motilin receptors of GIT –> used for GI emptying before upper GI procedure

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3
Q

major categories of anti emetics

A

5 ABCCD HN

5HT3 antagonists
Antimuscarinics
Benzodiazepines
Corticosteroids
Cannabinoids
D2 antagonists
H1 antagonists
NK1 antagonist
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4
Q

what are the 5-HT3 blockers used as anti emetics

A

Ondansetron

Granisetron

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5
Q

when are 5 HT3 blockers anti emetics used?

A

chemo induced emesis

post op nausea and vomiting

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6
Q

what are the H1 blockers and Antimuscarinic anti emetics used and when used?

A

H1 blocker: Diphenhydramine, Meclizine, Cyclizine for motion sickness and chemo

Antimuscarinics: scopolamine for motion sickness

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7
Q

what are the NK1 blockers used for anti emetics

A

Aprepitant

Fosaprepitant

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8
Q

adverse effects of NK1 antagonists (name them again)

A

aprepitant and fosaprepitant

dizziness, fatigue, diarrhea, CYP inhibition

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9
Q

corticosteroids anti emetics

A

Dexamethasone

Methylprednisolone

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10
Q

D2 receptor antagonist anti emetics

A

PPD

Prochlorperazine
Promethazine
Droperidol

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11
Q

adverse effects of prochlorperazine

A

extrapyramidal symptoms, hypotension, sedation

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12
Q

benzodiazepines anti emetics

A

LAD
Lorazepam
Alprazolam
Diazepam

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13
Q

benzos do not work too well as anti emetics so what then is their significant uses

A

sedative, anxiolytic, and amnesic properties

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14
Q

cannabinoid anti emetic and what it works on

A

Dronabinol - CB1 receptor agonist

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15
Q

what are the antidiarrheal drugs

A

SOB i shit my pants

Somatostatin analogs - Octreotide
Opioid agonist - Loperamide and Diphenoxylate
Bismuth compounds - Bismuth Subsalicylate

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16
Q

how do the opioid agonist anti diarrheals work (name them)

A

Loperamide and Diphenoxylate

-slow down gut motility by acting on GI mu-opioid receptor –> inhibition of acetylcholine release and decreased peristalsis

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17
Q

adverse effect of opioid agonists antidiarrheals (name them)

A

Loperamide and Diphenoxylate

  • toxic megacolon in those with severe colitis
  • Diphenoxylate is formulated with atropine to reduce abuse potential but high doses can cause CNS effects
18
Q

mechanism of the somatostain antidiarrheal (name it) and types of pts that use it

A

Octreotide

potent inhibitor of GH, glucagon, and insulin

diarrhea and flushing in carcinoid syndrome and diarrhea in VIPoma

19
Q

what is bismuth subsalicylate used for

A
  • mucosal lining protectant (antacid)
  • antidiarrheal
  • decrease inflammation binds to toxins (E coli)
20
Q

classify the laxatives by their mechanisms of action

A 
-BOSCOS
Bulk forming
Osmotic
Stimulants
Chloride channel activator
Opioid antagonist
Softeners
21
Q

what are the stimulant laxatives and their adverse effects

A

CBS
Castor oil, Bisacodyl, Senna

cause cramping and chronic use leads to perceived need for laxative

22
Q

what are the bulk forming laxatives and their mechanism

A

BPM
Bran, Psyllium, Methylcellulose

non soluble compounds that increase water retention leading to bulky stool –> distention of the bowel –> peristaltic stimulation of gut

23
Q

What are the osmotic laxatives

A

PLOMM

Polyethylene Glycol
Lactulose
Osmotic
Magnesium Hydroxide
Magnesium Salts
24
Q

how do the osmotic laxatives work

A

they pull water into lumen of GIT –> stimulates motility

25
Q

uses of Lactulose

A
  • as an osmotic laxative by forming lactic acid and acetic acid which increases osmotic effect
  • treatment of hepatic encephalopathy –> converts ammonia to ammonium so it can be excreted from body and prevent hyperammonia
26
Q

when is polyethylene glycol used

A

endoscopic and radiological procedures

27
Q

what are the softener laxatives

A

DoMGS

Docusate
Mineral oil
Glycerine
Softeners

28
Q

use of glycerine and side effect

A

used for enema and can cause irritate anal mucosa

29
Q

how do you treat opioid induced constipation

A

Senna and decusate

30
Q

chloride channel activator laxative and mechanism

A

Lubiprostone –> increases secretion into GI –> increases fluid content

31
Q

opioid receptor antagonist laxative

A

Alvimopan

Methylnaltrexone

32
Q

drugs used in Inflammatory Bowel Disease (Ulcerative Colitis and Crohns)

A

AAGI

Anti TNFalpha drugs
Anti Integrins
Aminosalicylates
Glucocorticoids
Immunosuppressants
33
Q

what are the aminosalicylates and their mechanism

A

BAMS

Balsalazide
Aminosalicylates
Mesalamaine
Sulfasalazine

inhibit pro inflammatory mediators IL-1 and TNFalpha

34
Q

in the GIT, what is released by sulfasalazine by colonic bacteria

A
  • sulfapyridine (antibacterial)

- 5 aminosalicyclic acid (5 ASA) (anti-inflamm)

35
Q

adverse effects of sulfasalazine

A

HeRS

Hypersensitivity to sulfa
Reversible Oligospermia
Suppression of bone marrow (related to the sulfapyridine)

36
Q

mechanism of balsalazide

A

releases mesalamine (5 ASA) in large intestine at site of ulcerative colitis

37
Q

glucocorticoids used in IBD and mechanism

A

Hydrocortisone
Prednisolone
Prednisone
Budesonide

inhibit IL-1, IL-8, and TNFalpha

38
Q

immunosuppressant used in IBD and mechanism

A

Methotrexate (MTX)
Azathioprine (prodrug of 6-MP)
Mercaptopurine (6-MP)

39
Q

mechanism of immunosuppressant used in IBD (name them)

A

MTX, Azathioprine, 6-MP

6-MP promotes apoptosis of immune response
MTX blocks dihydrofolate reductase (DHFR)

40
Q

adverse effects of immunosuppressants of IBD (name them)

A

MTX, Azathioprine, 6-MP

GI mucositis, myelosuppression, hepatotoxicity (6-MP)

Pharmacology (79 decks)

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