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OP: PASS PCOL!!! > GI Motility And Water Reflux, Emesis, And Biliary And Pancreatic Disease > Flashcards

GI Motility And Water Reflux, Emesis, And Biliary And Pancreatic Disease Flashcards

1
Q

Most important regulator of physiological gut function

A

Enteric Nervous System

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2
Q

ENS is an extensive collection of nerves that constitute the _ of the ANS

A

Third Division

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3
Q

ENS lies within the wall of the ___

A

GI tract

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4
Q

Nerve fiber found between the circular and longitudinal muscle layers

A

Myenteric/Auerbach’ Plexus

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5
Q

Nerve fiber located within the submucosa

A

Submucosal/Meissner’s

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6
Q

What is the primary neurotransmitter of the excitatory motor neuron?

A

Acetylcholine (Ach)

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7
Q

Principal neurotransmitter in the inhibitory motor neurons

A

Nitric Oxide (NO)

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8
Q

Cells scattered throughout the epithelium of the intestine

A

Enterochromaffin Cells

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9
Q

Enterochromaffin cells secrete ______

A

Serotonin (5-HT)

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10
Q

Impaired relaxation of the lower oesophagal sphincter associated with defective oesophagal peristalsis that results in dysphagia and regurgitation

A

Achalasia of the esophagus

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11
Q

Delayed gastric emptying

A

Gastroparesis

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12
Q

Presentin in the GI tract and has several inhibitory effects involving motility, reduce lower esophageal sphincter and intragastric pressure

A

Dopamine

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13
Q

ACh is released from ___

A

Myenteric Motor Neurons

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14
Q

Half life of metoclopramide domperidone

A

4-6 hours

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15
Q

Metoclopramide undergoes___ and ____

A

Sulfation and Glucoronide Conjugation

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16
Q

Used as an adjunctive measure in medical or diagnostic procedures

A

Metoclopramide injection

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17
Q

Used for the treatment of persistent hiccups

A

Metoclopramide

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18
Q

When is metoclopramide administered?

A

30 mins. before meal and at bedtime

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19
Q

Metoclopramide onset of action after an ORAL dose

A

30-60 minutes

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20
Q

Metoclopramide onset of action if given INTRAMUSCULARLY

A

10-15 mins

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21
Q

Metoclopramide onset of action after given INTRAVENOUSLY

A

1-3 minutes

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22
Q

It predominantly antagonizes the D2 receptors without the major involvement of other receptors

A

Domperidone

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23
Q

Dosage of Domperidone

A

10-20 mg 3x a day

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24
Q

T or F. Domperidone does not readily cross the blood-brain barrier

A

True

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25
It plays an important role in the normal motor and secretory function of the gut.
5-HT / Serotonin
26
How many percent of total 5-HT in the body exists in the GI tract
>90%
27
What specialized cell produces 5-HT?
Enterochromaffin Cells
28
5-HT triggers peristaltic reflex by stimulating intrinsic sensory neurons in the myenteric plexus via which receptors?
5-HT1p and 5-HT4 receptors
29
5-HT triggers peristaltic reflex by stimulating extrinsic vagal and spinal sensory neurons via which receptor?
5-HT3 receptors
30
It is a benzofuran derivative and a specific 5-HT4-receptor agonist that facilitates cholinergic neurotransmission
Prucalopride
31
Prucalopride acts throughout the length of the ____ increasing _____ and _____ without affecting gastric emptying in healthy volunteers
intestine; oral-cecal transit; colonic transit
32
It is a potent contractile agent of the upper GI tract
Motilin
33
Motilin is a ____ peptide hormone found in the GI ___ and in some _______ of the ______
22-amino acid; M cells; enterochromffin cells; upper small bowel
34
Motilin levels ___ in association wiih the migrating motor complex
Fluctuates
35
Motilin appears to be responsible for the amplification, if not the actual induction of ______
Phase 3 activity
36
Motilin receptors are found on _____ and ____
Smooth muscle cells and Enteric neurons
37
It mimics the effects of motilin
Erythromycin
38
Motilin-like effects are most pronounced at higher doses of ___
250-500 mg
39
The best established use of erythromycin as a prokinetic agent is in patients with _____, where it can improve _____ in short term
Diabetic gastroparesis; gastric emptying
40
Erythromycin induces ____ migrating motor complex in dogs and increases ______
phase 3; smooth muscle contractility
41
Multiple effects if erythromycin on upper GI motility (Enumerate the 2)
1. Increasing lower esophageal pressure 2. Stimulating gastric and small-bowel contractility
42
Erythromycin has little or no effect on __
Colonic motility
43
Intravenous standard dose of erythromycin for gastric stimulation
3 mg/kg
44
Standard dose for gastric stimulation of erythromycin for ORAL administration
200-250 mg every 8 hours
45
A macrolide nonantibiotic that shows promise for the treatment of gastroparesis
Mitemcinal (GM-611)
46
Decreased stool frequency
Constipation
47
Useful for the treatment of chronic constipation
Prucalopride
48
Synthetic prostaglandin analog primarily used for protection against gastric ulcers resulting from the use of NSAIDs
Misoprostol
49
Microtubule formation inhibitor used for gout
Colchicine
50
Prostanoid activator of Cl channels
Lubiprostone (Amitiza)
51
14-amino acid peptide agonist of granulated cyclase C that stimulates secretion and motility
Linaclotide
52
This compound shows promise in the treatment of IBS-C and chronic constipation
Linaclotide
53
Its promising strategy is the prevention of opioid-induced constipation with peripherally acting MOR antagonist
Lubiprostone
54
It was the approved treatment of opioid induced in 2008
Methylnaltrexone
55
Approved treatment of opioid-induced constipation in adult patients with chronic noncancer pain
Naldemedine
56
Oral Dosage of Naldemedine
0.2 mg/day
57
Approved treatment for opioid-induced constipation in adults
Naloxegol
58
Dosage of Naloxegol for ORAL admnistration
1.25 or 25 mg once per day
59
Drug given for post operative ileus
Alvimopan
60
Alvimpoan is given ___ prior to surgery and then twice daily for up to maximum of ___ days or until discharge, not exceeding __ doses
30 mins. to 5 h; 7 days; 15
61
Excessive fluid weight, with 200 g per day
Diarrhea
62
Stool weight is determined by ___
Stool water
63
Most cases of diarrhea result from disorders of ____ and ____
Intestinal water; electrolyte transport
64
These drugs absorb water and increase stool bulk. They are used for constipation but are sometimes useful in acute episodic diarrhea and in mild chronic diarrhea in patients suffering with IBS
Carboxymethyl Cellulose and Calcium Polycarbophil
65
These drugs bind water avidly and also may bind enterotoxins
Clays (Kaolin) and Silicates (Attapulgite)
66
This drug absorbs 8x its weight in water
Attapulgite
67
These agents are best avoided within 2-3 hours of taking other medications
Clays and other Silicates
68
Bile acid sequestration (Name 3)
1. Cholestyramine 2. Cholestipol 3. Colesevalam
69
It is useful in the treatment of bile salt-induced diarrhea, as in patients with resection of the distal ileum
Cholestyramine
70
It is helpful for the relief of pruritus associated with partial biliary obstruction and in conditions such as primary biliary cirrhosis
Cholestyramine
71
These drugs are widely used in the treatment of diarrhea
Opioids
72
Mechanisms of Opoids include effects on intestinal motility ____, intestinal secretion ___ or absorption _____
µ receptors; δ receptors; µ and δ receptors
73
It is a piperidine bhtyramide derivative with µ receptor activity, and is an orally active anti-diarrheal agent
Loperamide
74
Loperamide is a______ derivative
Piperidine butyramide derivative
75
Loperamide is ____ times more potent than morphine as an anti-diarrheal agent and penetrate the CNS __
40-50x; poorly
76
These are piperidine derivatives that are related structurally to meperidine
Diphenoxylate and Difenoxin
77
An octapeptide analog of somatostatin (SST) that is effective in inhibiting the severe secretory diarrhea brought about by hormone secreting tumors of the pancreas and the GI tract
Octreotide and Somatostatin
78
The mechanism of action of Octreotide and Somatostatin appears to involve inhibition of hormone secretion, including ____ and other various ____
5-HT; GI peptides

OP: PASS PCOL!!! (2 decks)

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