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GI Pathophys > GI Pharma > Flashcards

GI Pharma Flashcards

1
Q

OTC antacids

(a) What are they?
(b) Absorbed?
(c) Onset?
(d) Possible side effect
(e) Example

A 
OTC antacids 
(a) weak bases to neutralize stomach acid
(b) Not absorbed
(c) Rapid onset
(d) possible side effect = constipation
Ex: Tums, Rolaids
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2
Q

TUMS

A

OTC antacid (weak base) to neutralize stomach acid

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3
Q

Zantac

A

H2 receptor blocker- available OTC

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4
Q

Pepsid

A

H2 receptor- available OTC

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5
Q

PPIs- describe process of absorption and activation

A

PPIs ingested as a weak base. Taken up by activated parietal cells (activated by eating) and protonated.

Then protonated PPI can covalently bind and inactivate HK ATPase

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6
Q

2 limitations of PPIs

A
  • doesn’t inhibit nighttime acid secretion (parietal cell inactive) => nocturnal acid breathrough
  • Short half life => long time (3-5 days) until peak onset
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7
Q

Biggest worrisome risk of PPIs

A

-Infections: specifically C. dif and pneumonia

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8
Q

3 ways prostaglandins are protective against acid

A
  • decrease acid secretion
  • increase bicarb and mucous secretion
  • increase musocal bloodflow
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9
Q

When do you take antacids?

A

30-60 minutes before meal (usually right before breakfast) b/c parietal cells get activated upon eating => most drug will be taken up and prootnated

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10
Q

Sucralfate

A

-treat ulcers

Adheres to ulcers and acts as barrier of diffusion of H+ ions and pepsin

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11
Q

Define nauseau

A

subjective, painless feeling that one may vomit

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12
Q

Stimulation of what area causes nausea and vomiting?

A

-4th ventricle of the brain = area postrema

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13
Q

What are some triggers of the area postrema?

A
  • drugs: dopamine agonists
  • toxins
  • metabolic causes: uremia, hypercalcemia
  • radiation exposure
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14
Q

List some antiemetics

A

Antiemetics = anti-nausea

  • Dopamine antagonists
  • Serotonin receptor antagonists
  • Tricyclic anti-depressants
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15
Q

List drugs w/ some antiemetic properties

A

-antihistamines, anticholinergics

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16
Q

Osmotically active laxatives

A
  • increase the water content of stool => bowel distention and increased peristalsis
  • very quick onset: 1-3 hrs

ex: Miralax, Go lightly, MIlk of Magnesia, Epsom Salt

17
Q

Miralax

A

Osmotically activate laxative

18
Q

Bulk Laxatives

A

= Fiber laxatives: insoluble and non-absorbable

  • increase stool volume to trigger stretch receptors => reflex peristalsis to move contents forward
  • must be taken w/ lots of water
  • safest, often first line
19
Q

What do you need to be careful of when taking Metamucil?

A

Metamucil = bulk laxative

-make sure to take w/ lots of water

20
Q

Irritant Laxatives

A
  • causes irritation of the enteric mucosa/nerves => water secretion => soften stool and increased volume => increased peristalsis
  • not first line, don’t want to irritate stuff if you don’t have to
21
Q

Senakot

A

Irritant laxative

22
Q

Lubiprostone/Amitiza

A

activates Cl- channels = new mechanism of laxative

-used in IBS-C pts

23
Q

Lubricant laxatives

A

Retards water absorption to lubricate and soften stool

24
Q

Stool Softener

A

Not effective as a laxative

-decreases surface tension of stool

25
Q

Adsorbants

A

= Antidiarrheals

  • coats the gut wall
  • can bind to stuff (bugs, toxins, but also other drugs) to expedite their excretion
  • can cause tongue to turn black

ex: pepto-bismol, kaopectate

26
Q

Pepti-bismol

A

= Adsorbant = Antidiarrheal

27
Q

Systemic anti-diarrheals

A
  • opiate biased
  • slows GI mobility/peristalsis to allow for increased water absorption

-also can use anticholinergics as systemic antidiarrheal

28
Q

What is the most universal symptom of IBS?

A

Abdominal pain

2nd most common = altered bowel habits

29
Q

Amitripyline

A

= TCA (tricyclic antidepressant)

  • inhibitory effect on the gut
  • used as antiemetic and to reduce sensitivity to pain in IBS
30
Q

Serotonin receptor blockers in IBS

A
  • 5 HT3 and 5 HT4 antagonists previously used to treat IBS but taken off the market b/c of side effects
  • 5 HT3 antagonist => ischemic bowel (but a dif form used as antiemetic)
  • 5 HT4 antagonist => cardiac events
31
Q

What is Ogilvie’s syndrome?

A

= pseudoobstruction = mimics acute large bowel obstruction
-colon distends (most common in cecum) and risk of perforation is high => very high mortality if distends enough
=> if distends to a certain degree use Neostigmine (Ach-ase inhibitor) to cause decompression

32
Q

What can be used to treat pruritis in cholestatic disease?

A
  • bile acid sequestrant

- CHolestyramine = Questran

33
Q

Medication for variceal bleeding

A

Somatostatin mimic = Octreotide = Sandostatin
-inhibits release of many GI hormones (ex: gastrin, CCK etc) => decreases secretion from intestine and pancreas and decreases GI motility

GI Pathophys (4 decks)

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