GI pharma

Question 1

6 classes of gi drugs

Answer 1

antacids
laxatives
antidia
prokinetics
antiemtics
anti-inflammatory

Question 2

MOA of antacids

Answer 2

weak bases that neutralize HCl

Question 3

indications for antacids

Answer 3

GERD, dyspepsia

Question 4

examples of antacids

Answer 4

systemic - sodium bicarb (alka selzer)

local - mag. hydroxide, aluminium hydroxide

Question 5

MOA of H2-r antags

Answer 5

reversible inhib. of H2 receptos

- partial acid supression for 24 hrs

Question 6

indications for H2

Answer 6

GERD
dyspepsia
no role in acute bleed

Question 7

MOA of PPI

Answer 7

prodrug activated in adicic canaliculi

• irrev. inhib of K/H atpase
• 95% supression for 24 hrs

Question 8

4 indications for PPI

Answer 8

gerd
pud
acute bleed
zollinger-ellison

Question 9

4 risks of PPI

Answer 9

1. enteric infection
2. pneumonia
3. path. fracture
4. drug interactions

Question 10

MOA of systemic mucosal protective agents

Answer 10

prostaglandins

• increase mucus
• decrease acid

Question 11

indication

Answer 11

prevntion of NSAID injury

Question 12

2 examples of topical

Answer 12

1. sulcralfate - binds mucosa and form a barrier

2. bismuth (pepto) - ulcer healing, antidiarrhea, antimivrobial

Question 13

2 keys to h pylori infection treatment

Answer 13

1. PPI - incr. pH, and lower minimal inhib. conc. for bact. irradication
2. antimicrobial

Question 14

5 classes of laxatives

Answer 14

1. bulking agents
2. osmotic
3. stimulant
4. emolient
5. secretagogue

Question 15

2 types of bulk

Answer 15

soluble - psylium and methycellulose

insoluble - bran

Question 16

mech of bulking agents

Answer 16

non-digestiblem pushes sides and engages muscles

Question 17

2 types of osmotic laxatives

Answer 17

1. non-absorbable - lactulose, polyglycol (bowel prep)

2. salts - milk of magnesia, magnesium sulfate

Question 18

MOA od stimulants

Answer 18

local mucosal irritants

• alter water and lyte secretion
• stim peristalsis

Question 19

MOA of emmolients (stool softeners)

Answer 19

reduce surface tension of oil-water interface of poop - water goes in

Question 20

MOA and one secretagogue

Answer 20

linaclotide

- stims CFTR to pump lytes into lumen

Question 21

3 contraindications to poo drugs

Answer 21

1. active IBD
2. enteric infectios
3. surgical.acute abdo

Question 22

4 types of diarrhea and what they mean

Answer 22

1. watery - osmotic or secretory
2. malabsorbative - fat
3. exudative - inflamed mucosa
4. motility - rapid transit, low abs

Question 23

4 types of antidiarrhea

Answer 23

1. opiod agonists - loperamide
2. bismuth
3. bile salt resins
4. octreotide - low gut hormones

Question 24

what is role of 5HT in gut

Answer 24

can be excitatory or inhib depending on interaction with 5HT3 or 4 receptor

Question 25

drugs that affect serotonin

Answer 25

5HT4 agonist - increase transit, more stool water, more gatric emptying

Question 26

MOA of D2 antags.

Answer 26

block inhibition of D2 receptor and increase Ach

Question 27

effects of 2 different D2 antags

Answer 27

1. domperidone - no BBB - prokinetic - faster eso and gastric emptying 2. metoclopramide - antiemetic - crosses BBB

Question 28

what is MOA of motilin analogue

Answer 28

macrolide AB - peptide hormone - stims migrating motor complex - increases gsatric emptying

Question 29

see prokinetic table

Answer 29

do ir

Question 30

4 classes of antispasmodics

Answer 30

1. Ca channel antags - inhib of Ca2 influx 2. nitro - converts to NO inhibing smooth muscle contraction 3. anti-cholinergics - muscarinic receptor inhib. - blocks stim effects of ach on smooth muscle cells

Question 31

5 agents for IBD

Answer 31

1. 5-ASA 2. corticosteroids 3. immunosuppressants 4. immunobiologics 5. ABs