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Pharmacology > GI Meds COPIED > Flashcards

GI Meds COPIED Flashcards

1
Q

mech of action,

clinical indications,

potential adverse effects
of promethazine

(antihistamine)

A

H1 Antihistamine

treats nausea and vomiting induced by medications, anesthetics, and a wide range of other stimuli.

Rectal suppository or injection.

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2
Q

What is used primarily for the treatment of motion sickness?

A

Scopalamine - muscarinic receptor antagonist similar to atropine.

Been used by astronauts.

Skin patch slow 72 hr release.

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3
Q

Treatment of Crohn’s

A

Control flare-ups

steroids, immunosuppresants (eg. azathioprine)

otherwise biological agents; infliximab (targets TNF)

Surgery

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4
Q

H. Pylori tx

A

Triple therapy

PPI + two or more antimicrobial agents

eg. amoxicillin + clarithromycin

or metronidazole + clarithromycin

5 days + 5 days treatment programme

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5
Q

mech of action,

clinical indications,

potential adverse effects
of metoclopramide

others; prochlorperazine, domperidone

(acts peripherially - prokinetic drug

and acts centrally - antiemetic)

A

Blocks dopamine D2 receptors; this prevents the relaxation of GI smooth muscle produced by dopamine. Also increases acetylcholine from cholinergic motor neurons in the enteric nervous system.

>> tone and motility in the oesophagus and stomach. (therefore opioid induced sickness)

Also >> gastric emptying.

NB> also increases resting pressure of lower oesophageal sphincter, therefore << acid reflux.

Indications: GERD, diabetic gastroparesis, intractable hiccup, also antiemetic.

Adverse effects: CNS reactions. CONTRAINDICATED with px with seizures.

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6
Q

mech of action,

clinical indications,

potential adverse effects
of senna, bisacodyl

(stimulant - secretory laxatives )

A

Alter fluid secretion and stimulates peristalsis

Bisacodyl; used to evacuate the bowel. Can cause cramping and electrolyte/ fluid depletion. SHORT term use only.

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7
Q

mech of action,

clinical indications,

potential adverse effects
of misoprostol,

(cytoprotective drug)

A

Prostaglandin E1 analogue

expensive. Inhibits gastric acid secretion, promotes mucus and bicarbonate.

Primary indication: prevention of gastric and duodenal ulcers with px who take NSAIDs long term.

contraindicated in PREGNANCY (stimulates uterine contractions)

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8
Q

What hormone stimulates the parietal cells?

A

Gastrin

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9
Q

mech of action,

clinical indications,

potential adverse effects
of cimetidine, famotidine, ranitidine

(histamine H2-receptor antagonists)

A

drugs compete with histamine for binding to H2 receptors on gastric parietal cells.

Reduce volume and conc of gastric acid. This also proportionally decreases pepsin. (Gastric acid is the pepsinogen-pepsin catalyst)

cimetidine - weak antiandrogenic activity; can cause gynecomastia in elderly men.

cimetidine - WELL-KNOWN - inhibits P450 enzymes, therefore care with polypharmacy.

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10
Q

mech of action,

clinical indications,

potential adverse effects
of docusate sodium

(stool softener)

A

facilitate movement of water into fatty intestinal material, thus softening stool.

Indicated for hard, dry stool, prevent aggravation of haemorrhoids, helping px avoid straining.

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11
Q

mech of action,

clinical indications,

potential adverse effects
of omeprazole

(proton pump inhibitor)

A

inhibitors of proton-pump, Strong inhibitors of gastric acid

Choice drug for peptic ulcers

Choice drug for GERD

Choice drug for Zollinger-Ellison syndrome

Choice drug for long-term NSAID therapy

hypomagnesemia can occur with long-term PPI therapy.

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12
Q

Diagram of vomiting pathways

A
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13
Q

mech of action,

clinical indications,

potential adverse effects
of dronabinol

(marijuana derivatives)

A

used for cancer chemotherapy induced emesis when other drugs have failed.

Used as an appetite stimulant for anorexic HIV patients

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14
Q

mech of action,

clinical indications,

potential adverse effects
of sucralfate,

(cytoprotective drug)

A

this polysaccharide adhers to ulcer craters , inhibits pepsin-catalyzed hydrolysis of mucosal proteins. Helps form a protective barrier.

Used to treat peptic ulcers, but not so effective as H2blockers or PPIs, so only indicated with patients who can’t tolerate the others.

Take 2 hours between other drugs.

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15
Q

mech of action,

clinical indications,

potential adverse effects
of calcium carbonate

(gastric antiacid)

A

chemically neutralize stomach acid.

Commonly used for acid indigestion and dyspepsia.

Can cause some constipation, can cause rebound acid secretion.

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16
Q

Gastrin and acetylcholine also stimulates the release of ……. from paracrine cells

A

Histamine

17
Q

mech of action,

clinical indications,

potential adverse effects
of milk of magnesia

(osmotic laxative)

A

poorly absorbed salt that osmotically attracts water.

Administer to px to evacuate the bowel in prep for surgery.

Danger> loss of fluids and electrolytes

18
Q

Summary

peptic ulcer meds

A

Histamine H2 receptor antagonists, or a proton pump inhibitor, or a cytoprotective agent

+

antibiotics for H.pylori

19
Q

mech of action,

clinical indications,

potential adverse effects
of psyllium

(bulk forming laxative)

A

Indigestible hydrophilic drug

absorbs water and increases mass of stool. This stimulates mech peristalsis.

Also used to treat diarrhoea

20
Q

What is the relationship between histamine and gastric acid production?

A

histamine stimulates H2 receptors located on parietal cells and provokes acid secretion.

21
Q

What’s the treatment for GERD?

(causing oesophagitis)

A

<< gastric acidity (two main groups previously mentioned)

increase the compromised oesophageal sphincter pressure (metoclopramide)

22
Q

Which cells secrete gastrin?

A

G cells in the stomach’s antrum

23
Q

mech of action,

clinical indications,

potential adverse effects
of ondansetron

(phenothiazines)

A

Selective 5-HT3 receptor antagonist; competitively block 5-HT3 receptors. I.e. blocks stimuli from the chemoreceptor trigger zone.

Acts both peripherally and centrally (vomiting centre)

Indicated for : cancer chemotherapy-induced emesis.

Adverse effects: headache, constipation, and diarrhoa.

24
Q

ranitidine

A

H2 histamine receptor antagonist

blocks histamine and thus decreasing the amount of acid released by cells of the stomach.

25
Q

What is mesalazine used for?

(5-aminosalicyclic acid) 5-ASA

A

treatment of choice for maintenance of mild-to-moderate ulcerative colitis.

(also reduces risk of colorectal cancer)

Also used inconjunction with antibiotics for the treatment of diverticulitis.

26
Q

What is Hyosine used for?

(and MOA)

A

Motion sickness and vesibulocochlear dysfunction.

Targets the vomiting centre and vestibulocochlear nuclei.

27
Q

How does cyclizine work and indications?

A

Histamine (H1) receptor antagonist

Targets the vestibulocochlear nuclei

Labyinthine disorder, vertigo, migraine

Pharmacology (13 decks)

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