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Gastrointestinal Block > GI Pharmacology > Flashcards

GI Pharmacology Flashcards

1
Q

Strength of ___ wave determines escape of chyme through ____

A

antral, pyloric sphincter

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2
Q

Gastric factors that determine stomach emptying?

A

DISTENSION

  • STRETCH promotes motility of smooth muscle
  • Simulates activity of INTRINSIC NERVE PLEXUSES
  • Simulates VAGUS NERVE activity
  • Stimulates GASTRIN release
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3
Q

Rate of emptying is proportional to?

A

Volume and consistency of chyme (causes distension)

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4
Q

Enterogastrones ____ contractile forces of stomach

A

decrease

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5
Q

Examples of enterogastrones?

A

Cholycystkinene, secretinin, gastric inhibitory peptides

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6
Q

Enterogastrones released inresponse to?

A

fatty hypertonic acidic chyme in duodenum

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7
Q

fatty hypertonic acidic chyme in duodenum will stimulate…

A

1) duodenal enterendocrine cells
2) chemoreceptors and stretch receptors (activate enteric neurones, inc. SNS activity dec. PNS activity)

These will inhibit contractile force and rate of emptying in stomach

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8
Q

D cells secrete ____ , this ____ HCL secretion. D cells are found in the ______ of the ______

A

SOMATOSTATIN, inhibits, mucosa, pyloric gland area

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9
Q

G cells secrete ____ , this ____ HCL secretion. G cells are found in the ______ of the ______

A

Gastrin, inhibits, mucosa, pyloric gland area

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10
Q

Enterochromaffin-like cells secrete ____ , this ____ HCL secretion. Enterochromaffin-like cells are found in the ______ of the ______

A

Histamine, stimulates, OXYNTIC MUCOSA, fundus and body

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11
Q

Parietal cells secrete ____ & _____. Parietal cells are found in the ______ of the ______

A

Hydrocholric acid, intrinsic factor, OXYNTIC MUCOSA, fundus and body

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12
Q

Chief cells secrete ____ . chief cells are found in the ______ of the ______

A

pepsinogen, OXYNTIC MUCOSA, fundus and body

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13
Q

What does intrinsic factor do?

A

Binds to vitamin B12 allowing it to be absorbed in terminal ileum

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14
Q

What does pepsinogen do?

A

Precursor of pepsin - an enzyme that breaks down proteins

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15
Q

What does HCL do?

A

Activates pepsinogen to pepsin
Denatures protein
Kills most (not all) micro-organisms ingested with food

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16
Q

What does oxyntic mean

A

secretory cells which produce hydrochloric acid in the main part of the stomach, or the glands which they compose.

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17
Q

How is HCL secreted from gasrtic parietal cells?

A

Water and C02 makes carbonic acid.
Carbonic acid breaks down releasing one H+ ion and hydrogen carbonate.
H+ leaves the cell via an antiporter which transfers K+ into the cell
hydrogen carbonate goes into an antiporter.
Antiporter allows entry of Cl- into cell
Cl- diffuses out of cell into lumen of gastric pit
H+ and Cl- become HCL

18
Q

Which pumps are involbed in HCL secretion?

A 
K+ channel
Cl- channel
Cl-/hydrogen carbonate antiporter
H+/K+ ATPase (PROTON PUMP)
Na+/K+ ATPASE
19
Q

How is secretion of HCL regulated? Which receptors?

A
  • Gastrin (CCk2) receptor - expressed on enterochromaffin like cell and parietal cells
  • Muscarininc M1 or M3 Ach receptor expressed enterochromaffin like cell and PARIETAL CELLS
  • Histamine H2 receptor expressed on PARIETAL CELLS
20
Q

GASTRIN ACTS ON

A

Gastrin CCK receptor expressed on enterochromaffin like cell and parietal cells

21
Q

Ach from postganglionic parasympathetics acts on

A

Muscarininc M1 or M3 Ach receptor expressed enterochromaffin like cell and PARIETAL CELLS

22
Q

Histamine from ____ cells acts on ____, expressed on _____

A

enterochromaffin like, H2 receptor on parietal cells

23
Q

T/F

Somatostatin inhibits gastrin sceretion between meals. This has the ffect of increasing HCL secretion

A

F

Somatostatin DOES inhibit gastrin sceretion between meals. This has the ffect of DECREASING HCL secretion

24
Q

Prostaglandin inhibits ..?

A

The effect of stimulating Gastrin CCK2 receptors, M1, M3 and H2 receptors on parietal cells

25
Receptors M1,M2.H2 and G on parietal cells specifically stimulate the ____
K+/H+ antiporter!
26
Secretion from M1,M2.H2 and G on parietal cells results in (detail)
- Extended microvilli in cannaculi of pRIETAL CELL - Release of protein kinases - Protein kinases cause TRAFFICKING of K+/H+ antiporter from INSIDE cell to the surface of the extended microvillus
27
What are the three phases of gastric secretion?
- cephalic : sight/smell vagal stimulation acting on Parietal cells and G cells - Gastric : mechanical and chemical factors (distensin and digestion products) - Intestinal
28
Intestinal phase gastric secretion?
- less distension , less stimuli for secretion - secretion of somatostatin resumes between miles - factors from intestine switch off acid secretion
29
NSAIDS block _____, this is ____ binding, this ____ acid secretion
Cyclooxygenase ( stops creation of prostaglandin), | irreversible, increases
30
Ranitidine is a ____, it blocks _____ | this is ____ binding, this ____ acid secretion
Histamine receptor antagonist, H2 receptor | competitive, decreases
31
Pirenzepine is a ____, it blocks _____ | this is ____ binding, this ____ acid secretion
Muscarinic receptor anatgonis, M1 m3, | competitive, decreases
32
Omeprazole is a ____, it binds to _____ | via ____ , this ____ acid secretion
proton pump (H+/K+) inhibitor, proton pump, covalent modification, decreases
33
Localle produced prostaglandins protect the mucosa from attack by HCl and pepsin by..
reduce acid secretion increase mucus and bicarbonate secretion increase mucosal blood flow
34
Gastric damage due to longterm NSAID use can be prevented with...
a stable PGE analogue - stimulates PGE receptors MISOPROSTOL
35
H Pylori causes peptic ulcer because...
Lives in mucus gel and secretes agents tht cause persistent inflammation weakens mucosal barrier Breakdown mucosal barrier exposed to pepsin and HCL
36
Drugs that reduce gastric acid secretion are used in the treatment of
- peptic ulcer - GORD (inapprop relaxation of LOS, reflux gastric acid secretion) - Acid hypersecretion (Zollinger-Ellison syndrome, Cushing's)
37
How do PPIs respond to changes in pH?
- They are BASIC PRODRUGS - Inactive at NEUTRAL pH - Conformational chnage and ACTIVATION in LOW ph(strongly acidic)
38
T/F | Omeprazole's full effect is only achieved after repeated dosing
T
39
T/F | Ranitidine has many common side effects
F | side effects rare
40
What is sucralfate?
MUCOSAL strengthener
41
How does sucralfate work?
- binds to the ulcer base (positively charged proteins) - forms complex gels with mucus – provides a mucosal barrier against acid and pepsin Increases mucosal blood flow, mucus, bicarbonate, prostaglandin
42
What are examples of Mucosal strengtheners?
Sucralfate | Bismuth chealate

Gastrointestinal Block (13 decks)

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