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GI meds Flashcards

1
Q

What is the MOA of osmotic laxatives?

A
  1. Provide osmotic load to draw H2O into gut lumen

2. Lactulose treats hepatic encephalopathy

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2
Q

Medication to control vomiting postoperatively by inhibiting 5-HT

A

Ondansetron

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3
Q

What are the adverse side effects of Osmotic laxatives?

A
  1. Diarrhea

2. Dehydration

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4
Q

What is the clinical use of Ursodiol?

A
  1. Primary Biliary Cirrhosis

2. Gallstone prevention and dissolution

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5
Q

What drug causes hypercalcemia and rebound acid increase? (can chelate and decrease the effectiveness of other drugs)

A

Calcium carbonate (antacid)

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6
Q

What is the adverse effect of the antacid Magnesium hydroxide?

A
  1. Diarrhea
  2. Hyporeflexia
  3. Hypotension
  4. Cardiac Arrest
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7
Q

What is the adverse effect of Senna?

A
  1. Diarrhea

2. Melanosis coli

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8
Q

What is Bismuth not be given with?

hint: requires acidic environment to work

A
  1. H2 Blockers

2. PPI

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9
Q

Medication for post surgery gastroparesis, persistent GERD, antemetic and Diabetes

A

Metoclopramide

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10
Q

What is the mechanism of action of Ursodiol aka Ursodeoxycholic acid?
(NON-TOXIC BILE ACID)

A
  1. Increase bile absorption

2. Decrease cholesterol secretion and reabsorption

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11
Q

Side effects of Odansetron

A

QT prolongation, serotonin syndrome, headache, constipation

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12
Q

What is the mechanism Of Loperamide?

A
  1. Agonist at mu opiod receptors.
  2. Slows gut motility
    (low addictive potential d/t poor CNS penetration)
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13
Q

What the adverse effects of Metoclopramide?

A
  1. Tardive dyskinesia
  2. Increases Parkinsonian effects
  3. Restlessness
  4. Fatigue, Drowsiness, Depression
  5. Drug interaction w/ Digoxin and Diabetic agents
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14
Q

What are the adverse effects of sulfasalazine?

A
  1. Malaise
  2. Nausea
  3. Sulfonamide toxicity
  4. Reversible oligospermia
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15
Q

Side effect of Sulfasalazine

A

Oligospermia, sulfonamide toxicity

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16
Q

What is the mechanism of Proton Pump Inhibitors?

A

Inhibit the H/K-ATPase on parietal cells

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17
Q

What drug/herb is an enteric nerve stimulant –> colonic contraction?

A

Senna

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18
Q

What is the MOA of bulk forming laxatives?

A
  1. Soluble fiber
  2. Draws H2O into gut lumen
  3. Form viscous fluid that promotes peristalsis
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19
Q

Mechanism of Metoclopramide

A
  1. D2 receptor antagonist
  2. Increases:
    a) resting tone,
    b) contractility,
    c) LES tone,
    d) Motility,
    e) gastric emptying
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20
Q

What is the general effects of antacids?

A
  1. Affect absorption
  2. Affect Bioavailability
  3. Affect Urinary excretion of other drugs
  4. Hypokalemia
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21
Q

What are the adverse effects of bulk forming laxatives?

A

Bloating

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22
Q

What are the adverse effects of proton pump inhibitors?

A
  1. Increase risk of C. difficile infection
  2. Pneumonia
  3. Decreased serum Mg2+ w/ chronic-longterm use =
    increased fracture risk in elderly (dec Mg2+ ==> dec
    Ca2+)
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23
Q

Which drug(s) most abused by bulimics?

A

Osmotic Laxatives

24
Q

Which GI medication causes CONSTIPATION and hypophosphatemia, osteodystrophy, siezures, proximal muscle weakness

A

Aluminum hydroxide

25
What are the clinical uses of proton pump inhibitors?
1. Zollinger-Ellison Syndrome 2. Component of H. pylori treatment 3. Stress Induced Ulcer prophylaxis 4. Peptic ulcer 5. Gastritis 6. Esophageal Reflux
26
What the common osmotic laxatives?
1. Magnesium Hydroxide 2. Magnesium Citrate 3. Polyethylene Glycol 4. Lactulose
27
What is the MOA of Histamine 2 (H2) Blockers?
Reversibly block H2 receptor --> decrease in H+ secretion from parietal cells
28
what is the mechanism of Octreotide?
1. Long acting somatostatin analog, 2. Inhibits secretion of various splachnic vasodilatory hormones
29
What medication is used to treat Acute Variceal Bleeds, acromegaly, VIPOMA, carcinoid tumors?
Octreotide
30
Side effect of Octreotide
1. Increased risk of cholelithiasis due to CCK inhibition 2. Nausea 3. Steatorrhea 4. Cramps
31
What are the main adverse effects of Histamine 2 blockers?
``` Cimetidine: 1. Inhibit P450 - Hepatotoxicity 2. Anti-androgenic effects - Prolactin Release, Decrease libido(men), Impotence, gynecomastia 3. Cross BBB --> CNS effect 4. Cross Placenta 5. Decrease Renal excretion of creatinine = Cimetidine and Ranitidine ```
32
What are the Clinical uses of Histamine 2 (H2) Blockers?
1. Gastritis 2. Peptic Ulcer 3. Mild Esophageal Reflux dz
33
What is the MOA of sulfasalazine?
1. Combination of sulfapyridine and 5-aminosalicylic acid 2. Activated by colonic bacteria (sulfapyridine = antibacteria; 5-AA = anti-inflammatory)
34
What medication is used to treat NSAID-induced peptic ulcer and is used as an off label drug for labor induction (ripens cervix)?
Misoprostol
35
What is the MOA of Orlistat?
Inhibits gastric and pancreatic lipase --> decreased breakdown and absorption of dietary fats
36
What are the adverse effects of Bismuth?
Black tongue and black stool
37
What are the Histamine 2 (H2) Blockers?
1. Cimetidine 2. Ranitidine 3. Famotadine 4. Nizatidine
38
What medication decreases vagal tone and is a powerful central acting antiemetic? Serotonin antagonist
Ondansetron
39
Metoclopramide is contraindicated in patients with
1. Small bowel obstruction, 2. Parkinsons disease (d/t D2 receptor blockade)
40
Mechanism of Misoprostol
PGE1 analog. Increase production and secretion of gastric mucous barrier, decrease acid production
41
Which medication is used to treat Ulcerative Colitis, Crohn disease
Sulfasalazine
42
List the Common Proton Pump Inhibitors | hint: LOPED
1. Lansoprazole 2. Omeprazole 3. Pantoprazole 4. Esomeprazole 5. Dexlansoprazole
43
Which drug(s) binds to ulcer base, provide physical protection and allow HCO3 secretion to reestablish pH gradient of gut mucosa?
Bismuth, sucralfate
44
Side effects of Misoproterol
1. Diarrhea 2. Abortifacient (contraindicated in potential childbearing females)
45
Which medication used for weight loss has an adverse effect of steatorrhea, decrease absorption of fat-soluble vitamins
Orlistat
46
Medication use to treat chemotherapy induced nausea and vomiting
Aprepitant
47
What is Loperamide is used to treat?
Diarrhea
48
What some common bulk forming laxatives?
1. Phyllium | 2. Methylcellulose
49
What is the clinical use of Bismuth?
1. Increase ulcer healing | 2. Traveler's diarrhea
50
What do centrally acting drugs do?
1. Acts on CNS 2. Decrease activity of SNS 3. Dilate BV and decrease BP
51
Mechanism of action of Aprepitant
1. Substance P antagonist. | 2. Blocks NK1 receptors in brain
52
What drug is an emollient, which causes osmotic draw into lumen --> increased H2O absorption by stool --> diarrhea?
Ducosate
53
What medication is used to control vomiting post-operatively and cancer pts undergoing chemo?
Ondansetron
54
List 3 common antacids
1. Aluminium Hydroxide 2. Calcium Carbonate 3. Magnesium Hydroxide
55
What is the adverse effects of Loperamide?
constipation, nausea

SMART 1 (14 decks)

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