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GI Exam > GI Pharmacology 2 > Flashcards

GI Pharmacology 2 Flashcards

1
Q

drug classes for inflammatory bowel disease

A

*aminosalicylates
*immune modulators:
-glucocorticoids
-purine analogs
-tofacitinib
*monoclonal antibodies

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2
Q

aminosalicylates (5-ASA) - MOA

A

*local anti-inflammatory effects
*act topically (not systemically) in the intestine

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3
Q

aminosalicylates (5-ASA) - specific drugs

A

*sulfasalazine
*olsalazine
*pentasa
*asacol
*apriso
*lialda

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4
Q

aminosalicylates - uses

A

*Crohn’s disease
*ulcerative colitis

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5
Q

aminosalicylates - ADEs

A

ADEs of sulfasalazine:
-GI upset
-headaches
-arthralgias
-bone marrow suppression
-allergic reactions
*impairment of folate absorption (supplement recommended)

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6
Q

aminosalicylates - unique facts

A

*if using sulfasalazine, supplement folate

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7
Q

glucocorticoids for IBD - MOA

A

*suppress production of inflammatory mediators (cytokines & chemokines)

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8
Q

glucocorticoids - specific drugs

A

*prednisone
*methyl prednisolone
*budesonide
*hydrocortisone rectal products

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9
Q

glucocorticoids - GI uses

A

*Crohn’s disease
*ulcerative colitis

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10
Q

budesonide

A

*a glucocorticoid
*high first-pass hepatic metabolism (decreased systemic absorption)
*pH controlled delayed release
*watch out for drug interactions (CYP3A4)
*used to tx moderate to severe active disease in UC and Crohn’s

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11
Q

purine anti-metabolites - MOA

A

*alters purine nucleotide synthesis which affects DNA synthesis & function
*helps in Crohn’s and UC

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12
Q

azothioprine - drug class & MOA

A

*purine antimetabolite
*immunosuppressive (suppresses T-cells and has anti-inflammatory properties)

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13
Q

purine anti-metabolites - specific drugs

A

*azothioprine
*6-mercaptopurine

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14
Q

purine anti-metabolites (azothioprine) - GI uses

A

*Crohn’s disease
*ulcerative colitis
*autoimmune hepatitis

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15
Q

purine anti-metabolites - ADEs

A

*leukopenia
*pancreatitis

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16
Q

tofacitinib - drug class

A

JAK inhibitor

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17
Q

tofacitinib - MOA

A

*inhibits JAK-STAT pathway -> decreased synthesis of inflammatory cytokines

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18
Q

tofacitinib - uses

A

*treatment and maintenance of ulcerative colitis
*some rheumatology diseases

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19
Q

tofacitinib - ADEs

A

*increased risk of infections
*reactivation of infections (TB, shingles)

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20
Q

tofacitinib - unique facts

A

*some CYP3A4 drug interactions

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21
Q

anti-TNF monoclonal antibodies - specific drug

A

*infliximab

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22
Q

infliximab - target

A

TNF receptor (anti-TNF monoclonal antibody)

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23
Q

anti-TNF monoclonal antibodies (infliximab) - MOA

A

*blocks pro-inflammatory actions of TNF (tumor necrosis factor)

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24
Q

anti-TNF monoclonal antibodies (infliximab) - uses

A

*Crohn’s disease
*ulcerative colitis
*some rheum diseases

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25
Q

anti-TNF monoclonal antibodies (infliximab) - ADEs

A

*increased risk of acquiring or reactivating infections
*increased risk of skin cancers & lymphoma

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26
Q

anti-integrin monoclonal antibodies - specific drug

A

vedolizumab

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27
Q

vedolizumab - target

A

anti-integrin monoclonal antibody (inhibits mucosal WBC adhesion & migration)

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28
Q

anti-integrin monoclonal antibodies (vedolizumab) - MOA

A

*inhibits mucosal WBC adhesion & migration

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29
Q

anti-integrin monoclonal antibodies (vedolizumab) - uses

A

*2nd line drug for Crohn’s disease & ulcerative colitis

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30
Q

anti-integrin monoclonal antibodies (vedolizumab) - ADEs

A

*infection
*arthralgia

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31
Q

anti-integrin monoclonal antibodies (vedolizumab) - unique facts

A

less risk of PML than natalizumab

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32
Q

anti-IL12/23 monoclonal antibodies - specific drug

A

ustekinumab

33
Q

ustekinumab - target

A

*anti IL12 and IL-23 antibody (inhibits cell-mediated inflammation by blocking cell signaling, cytokine production, and gene activation)

34
Q

anti-IL12/23 monoclonal antibodies (ustekinumab) - MOA

A

inhibits cell-mediated inflammation by blocking cell signaling, cytokine production, and gene activation

35
Q

anti-IL12/23 monoclonal antibodies (ustekinumab) - uses

A

*Crohn’s
*ulcerative colitis

36
Q

anti-IL12/23 monoclonal antibodies (ustekinumab) - ADEs

A

*allergic reactions
*increased infections
*headache

37
Q

bulk-forming laxatives - MOA

A

*indigestible, hydrophilic colloid
*distends colon & promotes peristalsis

38
Q

bulk-forming laxatives - specific drugs

A

*psyllium
*methyl cellulose
*polycarbophil

39
Q

bulk-forming laxatives - ADEs

A

*bloating
*flatus

40
Q

bulk-forming laxatives - uses

A

constipation

41
Q

osmotic laxatives - MOA

A

non-absorbable compounds that increase fecal fluid

42
Q

osmotic laxatives - specific drugs

A

*polyethylene glycol (most commonly used)
*Mg salts
*Mg citrate & sulfate
*sorbitol
*lactulose

43
Q

osmotic laxatives - uses

A

*constipation
*bowel prep

44
Q

osmotic laxatives - ADEs

A

*diarrhea
*bloating
*cramps

45
Q

stimulant laxatives - MOA

A

directly stimulates enteric nervous system

46
Q

stimulant laxatives - specific drugs

A

*senna
*bisacodyl

47
Q

stimulant laxatives - uses

A

*constipation
*bowel prep

48
Q

stimulant laxatives - ADEs

A

*diarrhea
*bloating
*cramps
*nausea

49
Q

lubiprostone - drug class

A

chloride secretion activator

50
Q

lubiprostone - MOA

A

stimulates type-2 chloride channel in small intestine (increases Cl in intestine, leading to increased intestinal motility to tx constipation)

51
Q

lubiprostone - uses

A

*chronic constipation
*IBS-C

52
Q

lubiprostone - ADEs

A

nausea

53
Q

linaclotide - drug class

A

chloride secretion activators

54
Q

linaclotide - MOA

A

activates guanylate cyclase-C on luminal surface of intestine

55
Q

linaclotide - uses

A

*chronic constipation
*IBS-C

56
Q

linaclotide - ADEs

A

*diarrhea
*nausea
*dizziness

57
Q

dicyclomine - drug class

A

anticholinergic (for IBS-D)

58
Q

dicyclomine - MOA

A

*M1 cholinergic receptor antagonist (block M1 Ach receptors)
*decreases smooth muscle contractility & GI motility (to tx IBS-D)

59
Q

dicyclomine - GI uses

A

*IBS-D
*GI antispasmodic

60
Q

dicyclomine - ADEs

A

dry mouth, constipation, dry eyes, other anticholinergic side effects

61
Q

alosetron - drug class

A

5-HT3 antagonist

62
Q

alosetron - MOA

A

decreases afferent signaling from GI tract (by inhibiting GI 5-HT3 receptors)

63
Q

alosetron - uses

A

*severe IBS-D in women who have not responded to other therapies

64
Q

alosetron - ADEs

A

*severe constipation
*ischemic colitis

note - much worse ADEs than other 5-HT3 antagonists

65
Q

peppermint oil for GI uses

A

*drug class = menthol
*MOA = kappa-opioid & 5-HT3 antagonist
*uses = IBS-D
*ADEs = GERD, nausea

66
Q

loperamide - drug class

A

*opioid agonist (alternative = diphenoxylate)

note - the STANDARD anti-diarrheal drug

67
Q

loperamide - MOA

A

*mu-opiod agonist in GI tract

note - the STANDARD anti-diarrheal drug

68
Q

loperamide - uses

A

*IBS-D
*OTC treatment of diarrhea

note - the STANDARD anti-diarrheal drug

69
Q

loperamide - ADEs

A

*constipation
*nausea
*somnolence
*abuse of high doses?

70
Q

amitriptyline - drug class

A

tricyclic antidepressant

71
Q

amitriptyline - MOA

A

*acts on 5-HT, NE, H1, & Ach in CNS & enteric nervous system (inhibiting 5-HT and NE reuptake like SNRIs)
*decreases visceral pain perception & GI motility

72
Q

amitriptyline - GI uses

A

*IBS-D
*diabetic neuropathy
*pain disorders

73
Q

amitriptyline - ADEs

A

lots (sedation, anticholinergic, sedation, weight gain, cardiac, serotonin-related)

74
Q

SSRIs for GI uses

A

*sertraline, citalopram, escitalopram
*MOA = blocks 5-HT reuptake
*GI uses = IBS-D
*ADEs = sexual dysfunction, headache, weight gain

75
Q

albendazole & mebendazole

A

*drug class: anti-helminth
*uses: tapeworm, cysticercosis, roundworm, pinworm, hookworm
*ADEs: abdominal pain, nausea, vomiting

76
Q

thiabendazole

A

*drug class: anti-helminth
*uses: cutaneous larva migrans, strongyloides, trichinosis
*ADEs: nausea, vomiting, dizziness

77
Q

ivermectin

A

*drug class: anti-helminth
*uses: strongyloides!!
*ADEs: dizziness, rash/pruritus, peripheral edema, tachycardia

78
Q

nitazoxanide

A

*drug class: anti-protozoan
*uses: cryptosporidiosis, giardiasis
*ADEs: abdominal pain, nausea, headache

79
Q

trimethoprim-sulfamethoxazole (TMP/SMX)

A

*drug class: antibiotic anti-protozoan
*MOA: INTERRUPT FOLIC ACID SYNTEHSIS
*uses: protozoa (Cystoisospora belli & Cyclospora); lots of bacterial infections
*ADEs: hypersensitivity, bone marrow suppression, hyperkalemia

GI Exam (54 decks)

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