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hlsc final > GI tract > Flashcards

GI tract Flashcards

1
Q

Emesis

A

Complex reflex due to activation of the vomiting center in the medulla oblongata.

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2
Q

Direct Acting Stimuli

A

Cerebral cortex (fear)
Senosory Organs (odors, pain)
vestibular apparatus inner ear

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3
Q

indirect acting stimuli

A

Activation of chemoreceptor trigger zome CTZ
- signals from stomach/small intestine
- emetogenic compounds carried to CTZ via blood

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4
Q

Antiemetics

A

Serotonin Receptor Antagonists- Ondansetron

Substance P/NK1 Antagonist- Aprepitant

Dopamine Antagonists- Phenothiazines

Chemotherapy Induced

Pregnancy- Doxylamine and vit B6

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5
Q

Ondansetron mech

A

blocks 5-HT3 receptors in CTZ

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6
Q

Ondansetron TU

A

**Anticancer drugs
- radiation
- anesthesia
- pregnace

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7
Q

Ondansetron AE

A

diarrhea, dizziness
PROLONGED QT

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8
Q

Ondansetron DI

A

pt with long QT syndrome or taking QT drugs

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9
Q

Substance P/ NK1 Antagonist mech

A

blocks NK1 receptors in CTZ

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10
Q

Substance P/ NK1 Antagonist drug

A

Aprepitant

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11
Q

Substance P/ NK1 Antagonist TU

A

postoperative vomiting and CINV

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12
Q

Substance P/ NK1 Antagonist Pharm

A

well-absorbed
peak 4 hours
1/2 life 11 hours

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13
Q

Substance P/ NK1 Antagonist DI

A

complex- multiple DI
- can inhibit or induce P450

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14
Q

Dopamine Antagonists drug

A

Phenothiazines

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15
Q

Dopamine Antagonists mech

A

blocks dopamine (DA2) receptors in CTZ

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16
Q

Dopamine Antagonists TU

A

chemo
surgery
toxins

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17
Q

Dopamine Antagonists AE

A

respiratory depression

NOT FOR UNDER 2 YEARS

18
Q

Chemotherapy Induced Types

A

1) Anticipatory
2) Acute
3) Delayed

19
Q

Antiemetics are more effective at

A

preventing CINV than suppressing CINV

20
Q

Drug for treating pregnancy emesis

A

Doxylamine and vitamin 6
- first line
- Diclegis- delayed 10 mg tab

21
Q

Antidiarrheal drug groups

A

Nonspecific- provide symptomatic relief- dont influence underlying cause

Specific- treat underlying cause

22
Q

What is most effective at treating diarrhea?

A

Opiods
“Diphenoylate”

  • CNS effects dont occur
23
Q

Infectious diarrhea

A

bacteria / protozoa

self limited

limit antibiotics

24
Q

travelers diarrhea

A

E.Coli

Self-limited

Severe: ciprofloxacin
- children and pregnant: azithromyacin

25
Q

IBS treatments

A

Two Acid Suppressants

1) Proton pump Inhibitor (soprazole or omeprazole)

2) Histamine2 receptor blockers (famotidine or ranitidine)

26
Q

IBD forms

A

1) Crohns disease
- transmural inflammation

2) Ulcerative colitis
- inflammation of mucosa and submucosa of colon and rectum

27
Q

Drugs for IBD

A

1) 5-aminosalixylates
- sulfasalazine

2) Glucocorticoids
- hydrocorticoids

3) Immunosuppressant
- azathioprine/ mercaptopurine
- cyclosporine

4) Immunomomdulators
- infliximab

NONE ARE CURATIVE

28
Q

Sulfasalzine mech

A

metabolized into to compounds

1) 5-ASA
Reduce inflammation
- supresses prostaglandins synthesis and migration of inflamm cells into affected region

2) Sulfapyridine: responsible for adverse effects

29
Q

Sulfasalazine TU

A

mild - moderate colitis of crohns

30
Q

Sulfasalazine AE

A

fever, rash, arthralgia, anemia

  • blood counts should be done
31
Q

Glucocorticoids PH

A

IV or PO

PO- Budesonide- release in ilium and ascending colon

32
Q

TU Glucocorticoids

A

mild- moderate crohns in ilium or ascending colon
- mild - moderate colitis

33
Q

Immunosuppressants drug

A

Azathioprine/ Mercaptopurine

Cyclosporin

34
Q

Azathiospring/Mercaaptopurine

A

A is prodrug
M is active

  • pt not responding to traditional therapy
35
Q

Azathiospring/Mercaaptopurine AE

A

pancreatitis, neutropenia

36
Q

Cyclosporin

A

Stronger immunosuppressant / faster acting

acute, severe colitis / Crohns that has not responded to glucocorticoids

IV- rapidly induce remission

GENERAL SUPPRESSION OF IMMUNE SYSTEM

37
Q

Immunomodulators

A

Infliximab

IV infusion

38
Q

Infliximab mech

A

Monoclonal antibody designed to neutralize TNF-alpha (a key immunoinflammatory modulator

39
Q

Infliximab TU

A

moderate to sever Crohns and Colitis

  • reduces symptoms 65% in Crohn and 33% in Colitis
40
Q

Infliximab AE

A

infections (tuberculosis) and infusion reactions

hlsc final (12 decks)

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