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PHARMACOLOGY > GI System Drugs > Flashcards

GI System Drugs Flashcards

1
Q

Mechanism: Misoprostol

A

PGE1 analog:

  • Increases production and secretion of gastric mucous barrier
  • Decreases acid production
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2
Q

All antacids can cause ___

A

Hypokalemia

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3
Q

Class: Polyethylene glycol

A

Osmotic laxative

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4
Q

Class: Magnesium hydroxide

A

Antacid

Osmotic laxative

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5
Q

Mechanism:

Loperamide

Diphenoxylate (+ atropine)

A

Agonist at mu-opioid receptors → slows gut motility

Loperamide: Poor CNS penetration (low addictive potential)

Diphenoxylate: Slight diffusion across BBB (atropine added to reduce abuse)

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6
Q

Clinical use: Sulfasalazine

A
  1. Ulcerative colitis (UC)
  2. Crohn disease (colitis component)
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7
Q

Adverse effects: Ondansetron

A
  1. Headache
  2. Constipation
  3. QT interval prolongation
  4. Serotonin syndrome (when used with other serotonergic drugs)
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8
Q

Adverse effects: Stimulant laxative

Senna

A
  1. Diarrhea
  2. Melanosis coli (dark brown/black discoloration of colon due to pigment deposition in lamina propria)
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9
Q

Adverse effects: Osmotic laxatives

Magnesium hydroxide

Magnesium citrate

Polyethylene glycol

Lactulose

A
  1. Diarrhea
  2. Dehydration
  3. May be abused by bulimics
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10
Q

Adverse effects: Bulk-forming laxatives

Psyllium

Methylcellulose

A
  1. Bloating
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11
Q

Overuse: Calcium carbonate (antacid)

A
  1. Hypercalcemia (milk-alkali syndrome)
  2. Rebound acid increase
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12
Q

Clinical use: Octreotide

A
  1. Acute variceal bleeds
  2. Acromegaly
  3. VIPoma
  4. Carcinoid tumors
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13
Q

Adverse effects: PPIs

A
  1. C. difficile infection
  2. Pneumonia
  3. Decreaes serum Mg2+ with long-term use
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14
Q

Adverse effects: Misoprostol

A
  1. Diarrhea
  2. Contraindicated in women of childbearing potential (abortifacient)
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15
Q

Mechanism: Emollient laxative

Docusate

A

Osmotic draw into lumen → increases water absorption by stool

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16
Q

Adverse effects: Octreotide

A
  1. Steatorrhea
  2. Increase risk of cholelithiasis due to CCK inhibition
  3. Nausea
  4. Cramps
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17
Q

Clinical use: Ondansetron

A
  1. Controlling post-op vomiting
  2. Cancer chemotherapy
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18
Q

Adverse effects:

Loperamide

Diphenoxylate

A
  1. Constipation
  2. Nausea
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19
Q

Class: Senna

A

Stimulant laxative

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20
Q

Adverse effects: Orlistat

A
  1. Steatorrhea
  2. Decrease absorption of fat-soluble vitamins
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21
Q

Mechanism: Orlistat

A

Inhibits gastric and pancreatic lipase → decreases breakdown and absorption of dietary fats

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22
Q

Mechanism: H2 blockers

Cimetidine

Ranitidine

Famotidine

Nizatidine

A

Reversible block of histamine H2-receptors → decreasing H+ secretion by parietal cells

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23
Q

Mechanism: Stimulant laxative

Senna

A

Enteric nerve stimulation → colonic contraction

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24
Q

Clinical use: H2 blockers

A
  1. Peptic ulcer
  2. Gastritis
  3. Mild esophageal reflux
25
Q

Mechanism: Ondansetron

A

5-HT3 antagonist

Decrease vagal stimulation

Powerful central-acting antiemetic

26
Q

Adverse effects:

Metoclopramide

Prochlorperazine

A
  1. Parkinsonian effects
  2. Tardive dyskinesia
  3. Restlessness
  4. Drowsiness/fatigue
  5. Depression
  6. Diarrhea
27
Q

Mechanism: Octreotide

A

Long-acting somatostatin analog

Inhibits secretion of various splanchnic vasodilatory hormones

28
Q

Overuse: Aluminum hydroxide (antacid)

A
  1. Constiaption
  2. Hypophosphatemia
  3. Proximal muscle weakness
  4. Osteodystrophy
  5. Seizures
29
Q

___ is a potent P-450 inhibitor

It also has antiandrogenic effects (prolactin, release, gynecomastia, importence, decreased libido in males)

Can cross BBB and placenta

A

Cimetidine

30
Q

___ can chelate and decrease effectiveness of other drugs (e.g., tetracyclines)

A

Calcium carbonate

31
Q

Laxatives are indicates for ___ or ___

A

Constipation

Patients on opiates requiring bowel regimen

32
Q

Mechanism: Osmotic laxatives

Magnesium hydroxide

Magnesium citrate

Polyethylene glycol

Lactulose

A

Provide osmotic load to draw water into GI lumen

33
Q

___ is an osmotic laxative that also treats hepatic encephalopathy because gut flora degrade it into metabolites (lactic acid, acetic acid) that promote nitrogen excretion as NH4+

34
Q

Metoclopramide and Prochlorperazine cause drug interactings with ___ and ___

A

Digoxin

Diabetic agents

35
Q

Clinical use:

Loperamide

Diphenoxylate

36
Q

Class: Docusate

A

Emollient laxative

37
Q

Clinical use: PPIs

A
  1. Peptic ulcer
  2. Gastritis
  3. Esophageal reflux
  4. Zollinger-Ellison syndrome
  5. Component of H. pylori triple therapy
  6. Stress ulcer prophylaxis
38
Q

Clinical use:

Aprepitant

Fosaprepitant

(-pitant)

A
  1. Antiemetic for chemotherapy-induced N/V
39
Q

Class: Magnesium citrate

A

Osmotic laxative

40
Q

Clinical use:

Bismuth

Sucralfate

A
  1. Increase ulcer healing
  2. Travelers’ diarrhea
41
Q

Metoclorpramide and Prochlorperazine are contraindicated in patients with ___ or ___ (due to D2-receptor blockade)

A

Small bowel obstruction

Parkinson disease

42
Q

Mechanism:

Metoclopramide

Prochlorperazine

A

D2 receptor antagonists - increases:

  • Resting tone
  • Contractility
  • LES tone
  • Motility
  • Promotes gastric emptying

Does not influence colon transport time

43
Q

Clinical use:

Metoclopramide

Prochlorperazine

A
  1. Diabetic and post-surgical gastroparesis
  2. Antiemetic
  3. Persistent GERD
44
Q

Mechanism: PPIs

(-prazole)

A

Irreversibly inhibit H+/K+ ATPase in stomach parietal cells

45
Q

Class: Lactulose

A

Osmotic laxative

46
Q

Overuse: Magnesium hydroxide

A
  1. Diarrhea
  2. Hyporeflexia
  3. Hypotension
  4. Cardiac arrest
47
Q

Antacid use can affect absorption, bioavailability, or urinary excretion of other drugs by altering ___ or by ___

A

Gastric and urinary pH

Delaying gastric emptying

48
Q

Adverse effects: Emollient laxative

Doxusate

49
Q

Mechansm:

Aprepitant

Dosaprepitant

(-pitant)

A

Substance P antagonist:

Blocks neurokinin-1 (NK1) receptors in brain

50
Q

Mechanism:

Bismuth

Sucralfate

A

Bind to ulcer base providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer

Require acidic environment

Usually not given with PPIs or H2 blockers

51
Q

___ and ___ are H2 blockers that decrease renal excretion of creatinine

Other H2 blockers are relatively free of these effects

A

Cimetidine

Ranitidine

52
Q

Class: Methylcellulose

A

Bulk-forming laxative

53
Q

Clinical use: Orlistat

A

Weight loss

54
Q

Clinical use: Misoprostol

A
  1. Prevention of NSAID-induced peptic ulcers (NSAIDs block PGE1 production)
  2. Off-label: Induction of labor (ripens cervix)
55
Q

Mechanism: Sulfasalazine

A

Combination:

  • Sulfapyridine (antibacterial)
  • 5-aminosalicylic acid (anti-inflammatory)

Activated by colonic bacteria

56
Q

Adverse effects: Sulfasalazine

A
  1. Malaise
  2. Nausea
  3. Sulfonamide toxicity
  4. Reversible oligospermia
57
Q

Class: Psyllium

A

Bulk-forming laxative

58
Q

Mechanism: Bulk-forming laxatives

Psyllium

Methylcellulose

A

Soluble fibers: Draws water into gut lumen, forming a viscous liquid that promotes peristalsis

PHARMACOLOGY (33 decks)

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