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DEMS > GI/Liver Pharmacology > Flashcards

GI/Liver Pharmacology Flashcards

1
Q

H2 Antagonists vs. PPIs - pharmacodynamics

A

H2 are less effective, but ARE good at NOCTURNAL acidity; more rapidly absorped and less protein bound.

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2
Q

Hereditary Hemochormatosis tx

A

Phelbotomy

chelation with Deferasirox, deferoxamine, deferiprone

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3
Q

Triple Theraty

A

PPI + Clarithrymycin + Amoxicillin

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4
Q

Adalimumab

A

TNF-alpha antagonist used to tx IBD

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5
Q

Wilson Dz treamtnt

A

Copper chelation with D-penicillamine, trientine

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6
Q

Area Postrema

A

area outside of BBB that is acted on my cancer drugs

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7
Q

Uses of PPI

A

First line: GERD, PUD, H Pylori triple therapy
NSAID ulcers: Tx and prevention
Prevention of stress gastritis
ZE syndrome

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8
Q

Bidacodyl - ADRs

A

Dangerous electrolyte and fluid imbalances
most widely abused
interpatient variation

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9
Q

ADRS of PPIs

A

Very safe
minor side effects of HA, Abdominal pain, N, C, Diarrhea
Increased risk of C diff infection or pneumonia.
Rebound acidity with discontinuation

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10
Q

Cimetidine - type

A

H2 Receptor antagonist - Anti-acid medication

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11
Q

Pharmacokinetics of PPIs

A

best if taken before a meal
short half life, but long acting
metabolized by CYP450, dosage reduction required with severe hepatic disease only

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12
Q

Magnesium hydroxide uses and ADRs

A

used to create osmotic diarrhea to counteract Al and Ca side effects.
Avoid in renal diseases due to retention of Mg

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13
Q

Sulfasalazine

A

5- Aminosalicylate used to tx IBD

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14
Q

Bidacodyl uses

A

Constipation that fails fiber and osmotically active.

Opiod constipation

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15
Q

Pharmacodynamics of PPis

A

prodrug administered into systemic circulation that diffuses into parietalc ells and is activated to sulfanamide and trapped.
Only inactivates ACTIVE pumps - sso delayed effect

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16
Q

Loperamide

A

Mu opioid agonist that decreases intestinal motility and secretion.
used for travelers diarrhea
ADRS; low addiciton, overdose can cause CNS depression, cardiotoxicity (QT prolongation),

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17
Q

Milk of Magnesia

A

Used for mild to moderate constipation and opioid constipation.
ADRS: avoid with renal dysfunction due to hypermagnesium

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18
Q

Adsorbent antidiarrheals

A

Kaolin, pectin, bismuth
used for mild/mod diarrhea - promote formed stool, but little effect on volume secretion.
Avoid subsalicylate in children under 12

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19
Q

Lansoprazole - mechanism and Type

A

PPI - irreversibly inactivates H/K ATPase pump on Apical side of Parietal cells to decrease Acid secretion

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20
Q

Cisapride ADRs

A

QT prolongation, life threatening arrythmias

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21
Q

Tegaserod/Cisapride uses

A

Diabetic Gastroparesis
IBS constipation
IBS- reduced bloating

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22
Q

Mesalamine

A

5- Aminosalicylate used to tx IBD

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23
Q

Omeprazole - Mechanism and Type

A

PPI - irreversibly inactivates H/K ATPase pump on Apical side of Parietal cells to decrease Acid secretion

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24
Q

Cisapraide - type

A

Promotility - agonist of 5HT4 R on ENS ACh.

Acts as Class III antiarrhthmic by blocking K channels

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25
Bidacodyl
Stimulant/irritative laxative | Increases peristalsis by low grade inflammation to promote water accumulation by activating PG, NO, cGMP
26
Sucralfate - pharmacokinetics
inactive- but activated by pH <4 - best on empty stomach.
27
Sequential therapy
PPI + Amox for 7 days | PPI + clarithromycin + Metronidazole 7 days
28
Calcium Carbonate - type and mechanism
Gastric antacid that raise stomach pH
29
Prochlorperazine ADRs
Extrampyramidal SE
30
Magnesium Hydroxide - type and mechansim
gastric antacid by being osmotic agent.
31
Tegaserod
Serotonin 5HT3 agonist to promote gastric emptying and motility. Renal and hepatic metabolism - contraindicated in renal and liver failure used for women under 55 with constipation assoc. IBS ADRs: Diarrhea, MI, stroke, unstable angina
32
H2 Antagonists - excretion
renal - requires dosage adjustment for renal failure
33
Tx of autoimmune heptatitis
Azathloprine - t cel inhbitor
34
Sodium Bicarbonate - type
Gastric antacid Contraindicated for prolonged use due to systemic effects - Na overload and alkalosis. avoid if pregnant, CHF, HTN, edema, renal fialure
35
ADRs for sucralfate
constipation
36
Misprostol - type and mechansim
Cytoprotective prostaglandin analogue that protects against stomach acid. binds to BL membrane and decreases cAMP to indirectly inhibit K/H ATPase increases bicarbonate and mucus foramtion
37
Uses of H2 Antagonists
Second line treatment: GERD, PUD | Stress Gastritis
38
Prochlorperazine - mechanism
D2 Receptor angatonist in the CTZ | Antiemetic
39
6-Mercaptopurine
immunomodulator used to tx IBD - UC
40
Scopalamine
Transdermial Anticholinergic used for motion sickness prevention and post op emesis
41
Ranitidine - mechanism and type
H2 Receptor antagonist that is a reversible, competitive block on H2 Receptor of BL membrane of Parietal cell. Decreases cAMP to decrease activation of K/H ATPase. Less complete block because gastrin and ACh still act to increase H/K ATPase
42
Octreotide - mechanism and use
Somatostatin Analog that inhibits G cells | Used for ZE syndrome
43
Treatment of PBC
Ursodeoxycholic acid
44
ADRs of antihistamine (antiemetics)
sedation, anti muscarinic SE
45
Polycarbophil
absorbs water and prevents fecal dsiccation | Diarrhea and constipation treatment!
46
Methotrexate
immunomodulator used to tx IBD
47
Meclizine
H1R antagonist that crosses BBB to become antiemetic
48
Quadruple Therapy
PPI + Tetracycline + Bismuth + metronidazole
49
Diphenylhydramine
Antihistamine - antiemetic h1R atagonist
50
tx for acalasia
Sildenafil, Nitrate, Ca Channel block
51
ADRs of misprostol
Diarrhea | Uterine stimulation - contraindicated in pregancy
52
what category are PPIs compared to H2 Receptor antagonists?
PPI: anti-secretory H2: anti secretory
53
Olsalazine
5- Aminosalicylate used to tx IBD
54
Metoclopramide ADRS
``` Extrapyramidal side effects - dystonic rxn, tradive dyskinesia, QT prolongation depression, Fatigue Neuroepileptic malignancy Hyperprolactinemia ```
55
Calcium Carbonate uses and ADRs
calcium supplement, reflux - not chronic use. | Constipation, renal calculi
56
ADRs with H2 Antagonists
well tolerated Minor: mental status changes, gynecomastia with cimetidine, galactorrhea, impotence DDIs: Inhibitor of CYP450 so toxic for warfarin.
57
Uses of Misprostol
NSAID induced ulceration - not used anymore
58
Uses and ADRs of Aluminum hydroxide/carbonate
CKD | can cause constipation and CNS toxicity with long term use
59
Lactulose
Osmotic active laxative by adding non-digestable sugars used for acute constipation in elderly and cirrhosis hepatic encephalopathy ADRs: flatulence and cramps
60
Side Effects of Ondanstron
QT prolongation Constipation Serotonin Syndrome
61
Ducosate
surfactant stool wetting lacative that facilitate mixing with acqesous and fat used: primarily prevention of constipation, when initiating opioids,
62
Balsalazide
5- Aminosalicylate used to tx IBD
63
Use of Ondansetron
Most effective antiemetic Use with chemo drugs, post op use of opioids N/V of pregnancy (hospitalization)
64
Sildenafil
inhibit PDE-5 to increase cGMP in smooth muscle | used to treat acalasia - not too effective
65
Doxylamine
H1Angatonist used with pryidoxine for morning sickness
66
Pyridoxine
Vitamin B6 - first line with Doxylamine for morning sickenss
67
Metoclopramide - uses
Diabetic gastroparesis (not with obstruction) N/V of chemo Post-Op emesis 3rd line for pregnancy associated N/V
68
Osmotically active laxatives
Milk of Magnasia (Mg OH), Polyethylene glycol, lactulose | Osmotic retention of water leading to peristalsis
69
Polyethelyene Glycol Solution
osmotic active laxative used for bowel cleaning for colonoscopy or for very difficult constipation.
70
Aluminum hydroxide- type and mechanism
gastric antacid that raises stomach acid by binding to phosphate in gut
71
tegaserod ADRs
QT prolongation, D, HA, stroke, MI agina
72
Azathioprine
immunomodulator used to tx IBD - Crohns
73
Ondansetron - type and mechanism
Antiemetic | 5HT3 antagonists that block receptors in CTZ, STN and visceral afferents
74
Absorbent antidiarrheal - mechanisms
absorb toxin material that cause irritation
75
Uses of Antihistamines H1
antiemetic - useful for motion sickness | post op emesis
76
Sucralfate type and mechanism
mucosal protective anti-acid sulfated disaccharide aluminum salt binds to necrotic tissue to protect from pepsin and H binds to Pepsin in bile acids
77
Natalixumab
TNF-alpha antagonist used to tx IBD
78
Infliximab
TNF-alpha antagonist used to tx IBD both
79
Alosetron
Serotonin 5HT3 antagonist to reduce pain and inhibit motility. P450 metabolism Used with severe diarrhea of IBS ADRS: constipation, ischemic colitis
80
Tegaserod - type
Promotility - agonist of 5HT4 R on ENS ACh to create corrdianted contraction in stomach, esophagus, SI, ascending colon Acts as Class III antiarrhthmic by blocking K channels
81
Metoclopramide - type and mechanism
Promotility and Antiemetic Antagonist at presynaptic D2 receptor to inhibit ACh release to create coordianted contraction to enhance transit time. blocks D2 receptor in CTZ Weak 5HT3 antagonists in CTZ

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