GI system Flashcards
Name the classifications of GI tract drugs
- Drugs influencing appetite
- Drugs influencing gastric secretion
- Drugs affecting gastric motility
- Drugs influencing pancreatic secretion
- Drugs affecting intestinal motility
- Drugs for hepatobiliary disorders
Name the classifications of drugs affecting the appetite
A . Stimulants of appetite (Appetizers)
- Bitters 2. Hormonal preparations
- Insulin
B. Suppressors of appetite (Anorexigens)
Which drug should be applied in case cachexia
- Insulin
Which condition is treated with anorexigens
- Obesity
What group of drugs is contraindicated for peptic ulcers?
- NSAIDS
Name 2 possible causes of peptic ulcers(stomach and duodenum)
- NSAIDS
- Gastritis
Name a possible reason for a duodenal peptic ulcer
- Excessive secretion of gastric acid
Name a cause for gastritis
- H. Pylori
Name a cause for hyposectretion of acid
- Gastritis in the body of the stomach => atrophic gastritis => hyopsectretion of stomach acid => gastric ulcer
Name the classifications of stimulants of gastric secretion and their drugs
A . Stimulants of gastric secretion
- Histamine
- Bitters
B. Drugs for replacement therapy
- Pepsin
- Hydrochloric acid
Name the use of stimulants of gastric secretion
To produce enough acid to digest food so it wont damage the stomach wall and create an ulcer
Name the classifications of surpressors of gastric sectretion and their drugs
- M-cholinoblockers (antagonists)
- Pirezepine - H2-histamine receptor blockers
- Ranitidine
- Famotidine - Inhibitors of proton pump
- Omeprazole
MOA of omeprazol
- Inhibits Na+, K+-ATPase (proton pump)
necessary for transport of H+ from parietal cells of gastric mucous membrane lumen of stomach
Indications for omeprazol
- Peptic ulcer disease
- Gasatroesophagal reflux disease
- Chronic gastritis with the hypersecretion of acid
- Zolinger-Ellison syndrome
Side effects of omeprazol
- Naussea, diarrhea, constipation, meteorism, pain in the stomach
- Headache, weakness, depression, vision distrurbance
- Skin rash
- Arthralgia, myalgia, eosinophilia
contraindications of omeprazol
- pregnancy
- lactation
- childhood
- Severe hepatic disease
pharmacokinetics of rantidine
- administered orally, IM, IV
- well absorped via GI tract
- acts within 15 mins, works 8-12 hours
- excreted via urine in 24 hrs
pharmacokinetics of omeprazol
- administered orally, IV, IV infusion
- absorped via small intestines
- acts within 60 mins, works more then 24 hrs
- metabolized in liver
- excreted via urine & feces
MOA of ranitidine
- Inhibits H2-histamine receptors in parietal cells of the gastric mucous membrane
pharmacodynamics of ranitidine
- Inhibition of gastric secretion
- Decrease in total volume of gastric juice
- Decrease in pepsin activity
indications of ranitidine
- Peptic ulcer disease
- Reflux-esophagitis
- Zolinger-Ellison syndrome bleeding from the upper regions of the GI tract
- The prophylaxis of bleeding in patients suffering from peptic ulcer
- The prophylaxis of gastric juice aspiration in surgery under general anesthesia.
side effects of ranitidine
- Headache, virtigo
- Skin rash
- Increase of plasma concentration of hepatic enzymes
- Thrombocytopenia
- Hypersensitivity
Contraindications for rantidine
- pregnancy
- lactation
- childhood
- Severe renal and hepatic diseases
- Gastric malignancy
Which M-cholinoblockers are used as antisecretory agents
- Pirenzepine
- Atropine
What are antacids?
- preparations for acid neutralization.
- Antacids are absorbable (NaHC03) and non-absorbable (CaC03, Mg(OH)2, Al(OH)3
Name 3 antacids
- Sodium bicarbonate
- Magnesium Oxide
- Aluminum hydroxide
Name 2 combined antacids
- Almagel
- Maalox
What are gastroprotectors and what do they do?
- Drugs that cover the stomach with a protective layer to prevent damage
- Ulcer healing
Name 2 gastroprotectors
- Sucralfate
- Bismuth subcitrate
Name an enhanced mucosal resistance drug
- Misoprostol
MOA of Bismuth nitrate
- forms a protective cover on the surface of ulcers and erosions
- stimulates regeneration by the accumulation of an epidermal growth factor
- increases prostaglandin E, synthesis
- promotes the production of mucus and bicarbonates
- inhibits the activity of pepsin
- has an anti-helicobacter action
Indications for Bismuth nitrate
- peptic ulcer disease
- chronic gastritis
- peptic ulcers caused by NSAIDs
- functional dyspepsia. The drug has no significant side-effects
Side effects of Bismuth nitrate
- black discoloration of feces
- rarely nausea
- vomiting
- diarrhea
- rash
MOA of Misoprostol
- semisynthetic prostaglandin
- binds to Pg receptors
- promotes mucus production and inhibits acid secretion
- improves the trophy of the gastric mucous membrane
Side effects of Misoprostol
- diarrhea
- the risk of precipitating contractions of the gravid uterus
Which drugs are listed as replacement therapy in excretory malfunction of the pancreas?
- Pancreatin
- Panzinorm forte
- Festal
- Mezim forte
- Creon
Indication of excretory malfunction replacement therapy drugs
- Chronic pancreatitis
Clinical uses of excretory malfunction replacement therapy drugs
To replace the enzymes necessary fro the digestion of proteins fats and carbohydrates(creatorrhea, steatorrhea)
Which drugs are listed as antienzymatic/anitprotease drugs?
- Aprotinin/contrycal
- Aminocaproic acid
Indications of antienzymatic/antiprotease drugs
- pancreatitis
- pancreanecrosis
MOA of antienzymatic/antiprotease drugs
- directly acting inhibitors of proteolysis and fybrinolisis
Name the drugs listed as bile drugs/choleretics
- Allochol
- Cholenzym
Indications for choleretics
- Cholecystitis
- Cholelythiasis
clinical uses of choleretics
- stimulate the production and secretion of dilute bile fluid
Name an enhancer drug for bile flow
- Magnesium sulfate
Name the listed cholespasmolytics
- Atropine
- Drotaverine/No-spa
Name the listed hepatoprotectors
- Legalon
- Darcyl
- Essentiale
- Gepabene
- Thiotriazolin
Name the listed cholelitholytic agents
- Chenodeoxycholic/chenofalk
- Ursodeoxycholic acid/ursofalk
What are hepatoprotectors?
- preparations protecting hepatocytes from different aggressive factors
What are cholelitholytics?
-
Which group of drugs stimulate motility of the stomach and intestine?
- M-cholinomimetics
- acetylcholinesterase inhibitors
Name the listed M-cholinomimetic
Neostigmine/ Proserine
Name the listed antagonists of dopamine and serotonin receptors
- Domperidone/ Motillium
- Metoclopramide/ Cerucal
Name a centrally acting emetic
- Apomorphine
MOA of Apomorphine
- stimulant of CTZ and vomiting center.
- Apomorphine is centrally acting drug, a D2-dopamine receptor agonist. It is used in acute poisonings
The pharmacological management of disturbances of intestinal motility includes
- use of laxatives (purgatives) to treat constipation
- use of antidiarrheal drugs (opioids, adsorbents, astringents) to treat non-infectious diarrhea
- use of antimicrobial drugs to treat diarrhea caused by infection
- application of cholinoblockers and myotropic spasmolytics to treat spasticity in the gut
MOA of metoclopramide
- is a specific blocker of D2 dopamine receptors.
- it is 5-HT3-antagonist
- it inhibits chemoreceptors of the trigger zone
- the drug inhibits the sensitivity of visceral nerves translating impulses from the pylorus and duodenum to the emetic center
Pharmacokinetics of metoclopramide
- a decrease in vomiting and nausea
- an increase in the tone of the stomach and intestine
- the promotion of gastric evacuation
- the prevention of a esophagal and pyloric reflux
- the stimulation of intestinal peristalsis
- the normalization of the tone of the bile bladder and bile secretion
- the stimulation of prolactin secretion
Indications of metoclopramide
- vomiting and nausea of different origin
- disturbances of the gut motility in dyspepsia, reflux-esophagitis, gastro- duodenitis, peptic ulcer, meteorism, and postoperative atonia ofthe stomach and intestine
- x-ray investigations of the gut.
Side effects of metoclopramide
- Constipation, diarrhea & drymouth
- weakness, headache,, depression, akatasia, extrapyramidal disturbances in children
- parkinsonism
- spasm of the face
Contraindication of metoclopramide
- hypersensitivity
- GI bleeding
- Bowel occlusion
- Ulcer formation
- abdominal surgeries
- pregnancy
- extra pyramidal disorder
- epilepsia
- childhood
- severe renal and hepatic failure
What is the pharmokinetics in laxatives
- promote and facilitate bowel evacuation by acting locally to stimulate intestinal peristalsis or to soften bowel contents
Name the listed laxatives classification
- saline laxatives
- laxatives containing antraglycosides
- vegetable oils
- synthetic laxatives
Name the saline laxative
- Magnesium Sulfate
Name the laxative containing anthraglycosides
- Senadexin
Name the synthetic laxatives
- Sodium picosulfate/ Guttalax
- Bisacodyl
- Lactulose/ Duphalac
- Combined => Cafiol + Regulax
MOA of laxatives
- promote evacuation of the bowel through stimulation of fluid and electrolyte transport or increases in propulsive motility
Drugs that surpress stomach motility
- cholinergic blockers => atropine
MOA surpressing durgs for stomach motility
- eliminate smooth muscle spasms by blocking cholinergic receptors
Name the Spasmolytic drugs
- drotaverine/ no-spa
- combinations => Baralgin & Spazgan
What are the indications for antiemetics
- vomiting
- naussea
- motion sickness
Name the listed antiemtic
- benzocaine
What is the purpose of taking anti-diarrheal drugs?
- relieving symptoms of diarrhea
Name the listed anti-diarrheal drug
- Loperamide/ Imodium
What are anti-flatulant agents?
- drug used for the alleviation or prevention of excessive intestinal gas
Name the listed anti-flatulant drugs
- Peppermint
- Simethicone/ Espumisan
- Chamomile
Effects of anti-flatulant drugs
- preventing gas
> enzyme-based dietary supplements break down indigestible substances and prevent substances from reaching large intestine intact - relieving gas
> agent will coalesce smaller gas bubbles into larger bubbles, making release of gas within the gastrointestinal tract easy via burping or flatulence
