GI/Renal Pharm Flashcards
What is the difference between GER and GERD?
GER is the physiologic retrograde passage of fluid from the stomach to the esophagus, while GERD is a pathologic condition causing medical complications due to this retrograde flow.
What are the major mechanisms allowing GER in infants?
Transient lower esophageal sphincter relaxations unrelated to swallowing are the major mechanism allowing GER.
What is the role of human milk in the infant GI tract?
Human milk provides beneficial bacteria to the infant GI tract, potentially more so than probiotics.
What are probiotics?
Probiotics are live microorganism cultures investigated to prevent NEC.
What are the mechanisms of protection provided by probiotics?
- Enhanced gut barrier functioning
- Decreased colonization with pathogenic microorganisms
- Modified host immune response
- Increased enteric nervous system maturation
What are prebiotics?
Prebiotics are exogenous products containing substrates that promote colonization by commensal organisms.
What is the primary carbon source for bacterial species in the intestine?
Human milk oligosaccharides.
What is the significance of synbiotics?
Synbiotics are products containing both prebiotics and probiotics, but research has been limited.
What is the primary use of diuretics?
Diuretics promote the excretion of water and electrolytes, primarily used in inappropriate salt and water retention.
What factors modulate Glomerular Filtration Rate (GFR)?
- Systemic arterial pressure
- Intra-renal arteriolar resistance
- Plasma oncotic pressure
What role does angiotensin II play in renal function?
Angiotensin II stimulates sodium and water reabsorption by increasing aldosterone secretion.
What causes edema in congestive heart failure (CHF)?
Increased pressure in venous circulation moves fluid into the interstitium, resulting in edema.
What are the classifications of diuretics based on their action?
- Filtration diuretics
- Osmotic diuretics
- Inhibitors of carbonic anhydrase
- Loop diuretics
- Thiazide diuretics
- Potassium-sparing diuretics
What is the mechanism of action of loop diuretics?
Loop diuretics inhibit sodium reabsorption in the ascending limb of the loop of Henle.
What are osmotic diuretics and their effect?
Osmotic diuretics increase tubular fluid osmolality, impairing water reabsorption and increasing urine output.
What is the function of histamine-2 receptor antagonists?
They block H2 receptors in acid-producing gastric parietal cells, suppressing HCl production.
What are the potential risks of routine use of proton pump inhibitors (PPIs)?
- Increased risk of GI and respiratory tract infections
- Vitamin B12 deficiency
- Hypomagnesemia
- Bone fractures
- Rebound hyperacidity after discontinuation
What is the mechanism of action of metoclopramide?
Metoclopramide acts as a central and peripheral dopamine antagonist, increasing gastric tone and accelerating intestinal transit.
What are probiotics and their benefits for term and preterm infants?
Probiotics are live microorganisms that confer health benefits; for term infants, they decrease allergic disease, and for preterm infants, they decrease NEC and mortality.
What is the role of phenobarbital in treating hyperbilirubinemia?
Phenobarbital induces hepatic enzymes, enhancing conjugation and excretion of bilirubin.
Fill in the blank: The primary source of energy for intestinal epithelial cells derived from oligosaccharides is _______.
short chain fatty acids.
True or False: Diuretics are contraindicated in cases of nephrogenic diabetes insipidus.
False.
What is the primary risk associated with NEC?
Sepsis
NEC stands for Necrotizing Enterocolitis, a serious gastrointestinal problem mostly seen in premature infants.
Which drug has been shown to induce hepatic enzymes, enhancing conjugation and excretion for hyperbilirubinemia?
Phenobarbital
Phenobarbital is effective in reducing bilirubin levels in conditions like mild Crigler-Najjar syndrome type II and Gilbert syndrome.
