GI II Flashcards
What are the adverse effects seen with sucralfate?
Constipation, impaired drug absorption
What pts should you be careful about administering sucralfate to? Why?
Renal insufficient pts
Al toxicity
What are the common adverse effects of misoprostol?
Cramping, diarrhea
What is the drug name of peptobismol?
Bismuth subsalicylate
What are the severe adverse effects with bismuth subsalicylate?
Salicylate toxicty
What population of pts should not be administered misoprostol? Why?
Pregnant patients
May stimulate uterine contractions
What is the advantage of mucosal protective agents over PPIs?
Do not stop acid secretion, thus will not cause B12 deficiency
What is misoprostol primarily used for?
NSAID induced ulcers
What is the drug of choice for treating H.pylori, travelers diarrhea, and dyspepsia?
Bismuth subsalicylate
What are the two cancers that H.pylori causes?
Gastric lymphoma
Adenocarcinoma
What is the enzyme that allows H/pylori to thrive in the acidic environment?
Urease
Is H.pylori gram negative or positive?
Negative
True or false: most patients with gastric or duodenal ulcers are h.pylori positive
true
How is h.pylori transmitted?
Fecal-oral route
What is the first line defense (triple therapy) against H.pylori?
PPI
Clarithromycin
Amox/metronidazole
True or false: it is okay to combine the triple therapy that treats h.pylori infection, with bismuth subsalocylate
True
What role does serotonin play in the enteric nervous system?
Induces the release of ACh in gastric smooth muscle
senation from the GI system
What role does dopamine play in the GI tract?
decreases the firing of ENS neurons, decreasing gastric motility
What is the receptor that induces gastric motility?
M3
What is motilin, and what is its effect on the GI tract?
Hormone that promotes gastric motility through ativation of GI smooth muscle
What is the MOA of metoclopramide? What is it used for?
D2 antagonist
dyspepsia/GERD
Antiemetic
What are the adverse effects of metoclopramide?
Parkinson like symptoms
What is the MOA of bethanochol? Use?
M3 agonist
GERD/gastroparesis
What is the MOA of neostigamine? Use?
AchE inhibitor
urinary retention
What is the MOA of erythromycin? Use?
Motilin receptor agonist
Gastroparesis
What is the trade name of metoclopramide?
Reglan
What is the MOA of bulk forming laxatives?
Plants cell wall resistant to degradation (fiber) helps retain water in the GI lumen
What do you need to ingest with bulk-forming laxatievs?
Water
What is the MOA of stool softeners?
Coats/penetrates stool with oil
What type of laxative is glycerin?
Stool softener
What type of laxative is mineral oil?
Stool softener
What is the MOA of osmotic laxatives?
Pull water into the GI tract using salts
What type of laxative is MgOH (milk of magnesia)?
Osmotic agent
What type of laxative is lactulose?
Osmotic agent
What type of laxative is polyethylene glycol?
Osmotic agent
What is the MOA of stimulant laxatives? (3)
Stimulation of the ENS induces gastric motility
Induce leaky mucosa
Inhibit Na uptake
What type of laxative is senna?
Stimulant
What type of laxative is methylcellulose?
Fiber (bulk forming)
What are the adverse effects of methylcellulose?
gas/bloating
What are the adverse effects of glycerin?
Nutrient malabsorption
What are the adverse effects of laculose?
Electrolye imbalance
What is the adverse effect of senna?
GI irritation
Activation of what neurotransmitter receptors will result in increase ENS motility?
5HT-4
What are the two MOA of serotonin receptors in the GI tract?
Stimulate Ach release
Block pain signals
What is the drug that stimulate 5HT-4 receptors?
Tegaserod
What is the MOA of cloride channel activation laxatives?
Increase Cl in the gut lumen, water follows
What is the Cl ion channel that can be targeted to promote gastric motility?
CIC-2
Activation of mu-opioid receptors causes what?
Constipation
What is the MOA of mu-opioid receptor antagonists?
Block the mu-opioid receptors, to prevent constipation
Why is it important that mu-opioid receptor antagonists cannot cross into the CNS?
Allows for opioid action in the CNS