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PAC3421 - Respiratory & GI Therapeutics > GI Therapeutics > Flashcards

GI Therapeutics Flashcards

0
Q

Name 5 different types of anti-emetics and give an example for each one.
Ouch!

A 
mACH antagonist - Hyoscine
H1 antagonist - Promethazine
D2 antagonist - Metaclopramide
NK1 antagonist - Aprepipant
5HT2 antagonist - Ondanzetron
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1
Q

Types of laxatives

A 
Bulk-forming laxatives
Osmotic laxatives
Stimulant laxatives
Stool softeners
Methylnaltrexone
Prokinetic agents
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2
Q

What types of drugs may be used to control gastric acid secretion and treat peptic ulcers? Give an example for each treatment

A

Antacids - aluminium hydroxide, magnesium hydroxide
H2 antagonists - cimetidine, ranitidine, famitidine
PPIs - omeprazole, esomeprazole, pantoprazole
Antibiotics - amoxicillin, clorithromycin
Prostaglandin analogue - misoprostol
Physical agents - sucralfate, bismuth

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3
Q

How do you treat vomiting that is due to pain?

A

You treat the pain. When the pain subsides nausea goes with its.

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4
Q

Antiemetics that can be used in pregnancy

A

Promethazine (H1 receptor antagonist)

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5
Q

What anti-emitics are used for chemotherapy?

A

Ondansetron - 5HT3 antagonist

cannabinoids

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6
Q

What drugs can be used to treat motion sickness?

A

Hyoscine - H1 antagonist

Promethazine - mAch antagonist

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7
Q

What anti-emetics are used for post-operative nausea?

A

Ondansetron - 5HT3 antagonist

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8
Q

Antidiarrhoeals

A

Opioids (eg codeine, loperamide)
Oral rehydration salts
Antispasmotics (cisapride, hyoscine butylbromide, meverine)
Peppermint oil

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9
Q

Bismuth subcitrate mechanism of action

A

Forms acid-resistant protective coating on ulcer site.
Also had antibacterial properties against H. Pylori.

Use: H. Pylori eradication after fairer of first line treatments

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10
Q

Name 3 kinds of antacids

A
  • Mg2+/Al3+ compounds
  • Carbonate/bicarbonates
  • Alignates or simeticone
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11
Q

Name 3 H2 antagonist drugs

A
  • Famotidine
  • Rantitide
  • Cimetidine
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12
Q

Name 5 proton pump inhibitors

A
  • Omeprazole
  • Esomeprazole
  • Lansoprazole
  • Pantoprazole
  • Rabeprazole
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13
Q

Name three classes of drugs used to control gastric acid

A
  • Antacids
  • Proton pump inhibitors
  • H2 antagonists
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14
Q

What are the two major causes associated with peptic ulcer disease?

A
  • Helicobacter pylori

- NSAIDS

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15
Q

How do H. pylori infections lead to peptic ulcers?

A

Loss of D cells -> decreased somatostatin secretion -> excess gastrin release from G cells -> excess H+ release from parietal cells
Excess acid leads to inflammation and damage -> ulcers

16
Q

How do NSAIDS lead to ulcer disease?

A

Systemic effect:
NSAID -> inhibit COX1/2 -> prostaglandin suppression -> loss of prostaglandin-mediated inhibition of acid secretion -> increased acid secretion

Topical effect:
Interaction between NSAID and gastric epithelium -> damage protective mucous barrier

17
Q

How do prostaglandins protect gastric mucosa?

A

Stimulate:

  • bicarbonate secretion
  • mucus secretion
  • blood flow
18
Q

What is the mechanism of action of Antacids?

A

Neutralise HCl secreted by parietal cells

19
Q

What is the mechanism of action of H2 antagonists?

A

Competitively block H2 receptors on parietal cells -> reduced H+ secretion

20
Q

What is the mechanism of action of PPIs?

A

IRREVERSIBLY inactivate the hydrogen/potassium ATPase enzyme system (proton pump) -> suppressing both stimulated and basal acid secretion.
(when PPIs are stopped -> synthesis of new hydrogen/potassium ATPase

21
Q

Prostaglandin analogue used in the treatment of hyper acid secretion

A

Misoprostol

22
Q

Treatment for Helicobacter Pylori

A

PPI + clarithromycin + amoxyiclin

23
Q

How does H. Pylori cause ulcers?

A

Causes a loss of somatostatin producing D cells which means gastrin production is no longer inhibited by somatostatin. Increased gastrin results in increased H+ production.

24
Q

bulk forming laxatives mechanism & example

A

draw water out of tissues and increases faecal bulk (stimulates peristaltic activity).
eg. fibre

25
Q

osmotic laxatives mechanism & example

A 
draws water into lumen via osmotic gradient.
eg. sorbitol
       lactulose
       macrogol
       saline laxatives
26
Q

Stimulant laxatives mechanism & example

A

direct stimulation of nerve endings in colonic mucosa (increased motility)
eg. bisacodyl
senna
sodium picosulfate

27
Q

Stool softeners mechanism & example

A

softens stool by helping mix water into faeces
eg. docusate
liquid paraffin
poloxamer

28
Q

prokinetic agents mechanism & example

A

stimulates motility by increase strength of contractions (5HT4 receptor agonist)
eg. prucalopride

29
Q

methylnaltrexone

A

peripherally acting competitive mu opioid receptor antagonist.
blocks constipating effects of opoid.
Doesn’t cross BBB
–> doesn’t inhibit analgesic effects
use when regular laxatives are inadequate

PAC3421 - Respiratory & GI Therapeutics (5 decks)

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