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year 2 pharmacology > GI pharmacology I > Flashcards

GI pharmacology I Flashcards

1
Q

HCl is secreted by what cell?

A

parietal cell

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2
Q

mucus and bicarb are secreted by what cells?

A

superficial epithelial cells

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3
Q

histamine is secreted by what cell type?

A

ECL

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4
Q

gastrin is secreted by what cell type?

A

G cell

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5
Q

what is the key NT that promotes acid secretion?

A

Ach (direct and indirect regulation)

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6
Q

what is the neurocrine regulatory NT of mucus secretion?

A

Ach

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7
Q

what is the paracrine regulatory NT of mucus secretion?

A

PGs

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8
Q

what are the roles of PGs?

A
  1. mucus and bicarb secretion
  2. suppression of HCl secretion
  3. increased gastric blood flow
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9
Q

what are the antacid agents?

A
  1. sodium bicarbonate
  2. calcium carbonate
  3. magnesium hydroxide
  4. aluminum hydroxide
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10
Q

what are the adverse effects of sodium bicarbonate?

A
  1. metabolic alkalosis

2. excessive salt absorption

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11
Q

what are the adverse effects of calcium carbonate?

A
  1. acid rebound

2. gas / bloating

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12
Q

what are the adverse effects of magnesium hydroxide?

A

osmotic diarrhea

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13
Q

what are the adverse effects of aluminum hydroxide?

A

constipation

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14
Q

how do histamine blockers work?

A
  1. competitive inhibition of H2 receptors (highly selective)
  2. partial decrease in gastrin induced secretion of HCl
  3. partial block of muscarinic induced HCl secretion
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15
Q

what are the H2 blocker drugs?

A
  1. cimetidine (Tagemet)
  2. ranitidine (Zantac)
  3. nizatidine (Axid)
  4. famotidine (Pepcid)
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16
Q

what are the adverse effects specific to cimetidine?

A
  1. CNS
  2. endocrine
  3. inhibition of hepatic CYP metabolism
17
Q

what is the preferred route for H2 blocker use?

A

need to be absorbed in GI tract

18
Q

where do the PPIs become activated?

A

low pH apical surface of parietal cell

19
Q

what is the mechanism of action for PPIs?

A
  1. drug is absorbed
  2. uptake on basolateral side of parietal cell
  3. concentrates in low pH environment
  4. activation
  5. irreversible binding to pump
20
Q

what are the PPIs drugs?

A
  1. omeprazole (Prilosec)
  2. lansoprazole (Prevacid)
  3. rabeprazole (Aciphex)
  4. esomeprazole (Nexium)
  5. pantoprazole (Protonix)
21
Q

how does sulcralfate work?

A
  1. adheres to ulcer to create physical barrier

2. stimulates mucus secretion (possibly via PGs)

22
Q

what is the main clinical use for misoprostol? what is a major adverse effect?

A
  1. NSAID ulcers

2. uterine contractions in pregnant women

23
Q

what drug should be considered for a hospitalized patient in whom you want to prevent stress related bleeding and acid secretion?

A

sucralfate

24
Q

what is the first line of defense for H. pylori and gastric ulcers?

A
  1. PPI
  2. clarithromycin
  3. amoxicillin or metronidazole

year 2 pharmacology (70 decks)

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