GI Pharm Flashcards

1
Q

Goals of GI Pharmacology

A

Food digestion, nutrition and water absorption, gastric acid control and secretion, manage excessive GI motility (diarrhea), manage inadequate bowel evacuation (constipation), manage problems with digestion and vomiting (emesis).

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2
Q

Main GI disorders treated

A

Ulcers, GERD, diarrhea, constipation, emesis.

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3
Q

Role of gastric acid

A

Essential for digestion, can cause peptic ulcers and GERD if uncontrolled.

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4
Q

Peptic ulcers and GERD

A

Peptic ulcers: ulceration of the mucosal lining. GERD: gastroesophageal reflux disease, caused by leaking of gastric acid.

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5
Q

Antacids - Goal

A

Neutralize stomach acids by combining with excess H+ to increase gastric pH.

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6
Q

Antacids - Specific agents

A

Various OTC trade names (TUMS, Pepto-Bismol).

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7
Q

Antacids - Adverse effects

A

Constipation (Al-containing), diarrhea (Mg-containing), electrolyte imbalances, altered pharmacokinetics of medications.

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8
Q

H2 Receptor Blockers - Role of histamine

A

Stimulates H2 receptors in stomach to increase gastric acid secretion.

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9
Q

H2 Receptor Blockers - Goal

A

Bind to H2 receptors to avoid activation and prevent histamine-activated release of gastric acid.

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10
Q

H2 Receptor Blockers - Specific agents

A

Famotidine (Pepcid), Cimetidine (Tagamet), Nizatidine (Axid), Ranitidine (Zantac).

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11
Q

H2 Receptor Blockers - Adverse effects

A

Headache, dizziness, mild GI problems (nausea, diarrhea, constipation), acid-rebound phenomenon.

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12
Q

Proton Pump Inhibitors - Goal

A

Inhibit enzyme (proton pump) involved in secretion of acid from gastric cells.

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13
Q

Proton Pump Inhibitors - Specific agents

A

Omeprazole (Prilosec), Pantroprazole (Protonix), Esomeprazole (Nexium), Lansoprazole (Prevacid), Dexlansoprazole (Kapidex).

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14
Q

Proton Pump Inhibitors - Adverse effects

A

Acid rebound, gastric polyps (long-term use), decrease nutrient absorption, kidney problems.

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15
Q

Anticholinergics

A

Blocks effects of acetylcholine and decrease gastric acid release, examples: Atropine, pirenzepine, telenzepine.

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16
Q

Metoclopramide (Reglan)

A

Dopamine receptor antagonist, stimulates motility in upper GI and decreases GERD.

17
Q

Prostaglandins

A

Inhibit gastric secretion, no advantages over other drugs such as PPI.

18
Q

Sucralfate (Carafate)

A

Disaccharide with protective effects on stomach mucosa, forms a protective gel that shields the stomach lining.

19
Q

Antidiarrheal Agents - Goal

A

Decrease GI motility to reduce fluid loss.

20
Q

Antidiarrheal Agents - Specific agents

A

Opium Tincture (laudanum), camphorated opium tincture (paregoric), Diphenoxylate (Lomotil), Loperamide (Imodium).

21
Q

Antidiarrheal Agents - Adverse effects

A

Nausea, abdominal discomfort, constipation, drowsiness, fatigue, dizziness, smaller risk of tolerance and addiction with small doses.

22
Q

Bismuth Salicylate

A

Stimulates water and electrolyte absorption in lower GI, decreases secretions, antibacterial effects.

23
Q

Bile-sequestering agents

A

Sequester and bind bile acids within GI tract, examples: Cholestyramine (Questran), Colestipol (Colestid), Colesevelam (Welchol).

24
Q

Clonidine (Catapres)

A

Stimulates alpha-2 receptors in GI tract, increases absorption and normal GI movement.

25
Q

Laxatives and Cathartics - Overview and goals

A

Promote evacuation of bowel and defecation when normal bowel movements are impaired, cathartics promote lower GI evacuation more rapidly than standard laxatives.

26
Q

Bulk-forming laxatives

A

Absorb water and swell within GI tract, stretches the bowel and stimulates intestinal movement.

27
Q

Stimulant laxatives

A

Increase fluid accumulation within the small intestine or activate peristalsis, examples: Bisacodyl (Dulcolax), Castor Oil, Senna (Senokot).

28
Q

Hyperosmotic laxatives

A

Produce gradient that draws water into the bowel and small intestine, stimulates peristalsis, examples: Methylcellulose (Citrucel), Polycarbophil (Fiber Lax), Psyllium (Metamucil).

29
Q

Lubricants and stool softeners

A

Facilitate entry of water into the fecal mass, softens the stool for easier defecation, examples: Docusate (Colace), Mineral Oil (Fleet Mineral Oil).

30
Q

Adverse effects of laxatives

A

GI disturbances, nausea, cramps, GI irritation, spastic colitis, long-term use can cause fluid and electrolyte abnormalities, dehydration, acid-base imbalances, laxative dependence.

31
Q

Digestants

A

Aid in digestion of food, examples: Pancreatic enzymes (amylase, trypsin, lipase), bile salts.

32
Q

Emetics

A

Induce vomiting to empty stomach of poisons or ingested toxins, examples: Apomorphine, Ipecac.

33
Q

Antiemetics

A

Decrease nausea and vomiting, examples: Antihistamines, anticholinergics, used for motion sickness, surgery recovery, chemo/radiation.

34
Q

Cholelitholytic agents

A

Dissolve types of gallstones by decreasing cholesterol content of bile.

35
Q

Rehabilitation considerations - Common issues

A

Common among critically ill patients, stress-related damage, stress ulcerations, inactivity causes adverse GI effects.

36
Q

Rehabilitation considerations - Impact on rehabilitation

A

Overall should not impair rehabilitation, some dizziness and fatigue, resolve uncomfortable symptoms to increase participation.

37
Q

Rehabilitation considerations - Encouragement of use

A

Encourage use if symptoms occur.