Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHARM EXAM 2 > IBS, IBD, antiemetics, Prokinetic Agents > Flashcards

IBS, IBD, antiemetics, Prokinetic Agents Flashcards

1
Q

IBS- Idiopathic chronic relapsing disorder

A

Do not know hwat is causing it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chronic relapsing IBS

A

comes & goes @ times better @ times worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Inflammatory Bowel

A

Crohn’s and Ulcerative Colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Goal of irritable bowel therapy

A

relieve abdominal discomfort & improve bowel function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

is irritable bowel a relapsing condition or a chronic progressibe condition

A

chronic relapsing condition not a chronic progressive condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IBS components

A

pain, diarrhea, constipation- you just treat the syndromes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

IBS with Diarrhea

A

diarrhea and fecal urgency

resolves spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

RXs for IBS with Diarrhea

A

Loperamide

Dipenoxylate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

IBS with constipation

A

bulk forming agents are best

not make the diarrhea worse- although if they cause cramping they can increase pain

bulk formers are not enough to relieve constipation can try osmotic agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

IBS with abdominal pain

A

trycyclics TCAD works best

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

RXs used in IBS with abdominal pain

A

Amitriptyline
desipramine
nortriptylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antispasmodics

A

acute attacks of abdominal pan or before meals in patients with post prandial symptoms

work through their anticholinergic effect inhibiting muscarinic input in the enteric plexus & on smooth muscle

higher doses too antichlolinergic & not tolerated well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antispasmodic RXs

A

Dicyclomine (Bentyl)
Hyoscyamine (Levsin)

Not very effective and many adverse rxns, on beers list, not covered by medicare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Are antispasmodics covered my medicare

A

No, dangerous for old ppl. on BEERS list

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Serotonin 5-HT3 Receptor Antagonists MOA

A

5-HT receptors in GI tract activate pain sensation and regulate intestinal motility and secretions

MOA: Inhibit pain sensation from gut to spinal cord, inhibit motility & increase transit time of bowel.

decrease nausea, bloating, pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alosetron (Lotronex)

A

-Serotonin 5-HT3 Receptor Antagonists

for IBS with severe diarrhea

allowed to be prescribed by those with special training

Decreases pain 10-20% more than placebo, decreases number of BMs, abdominal pain, cramps, & urgency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MAJOR ADR of Alosetron (Lotronex)

A

Ischemic Bowel Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

RX Chloride Chemical Activator

A

Lubiprostone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lubiprostone MOA

A

Prostaglandin derivative that activates chloride channels in GI tract, stimulating intestinal fluid secretion

used for idiopathic constipation IBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Contraindication of Lubiprostone MOA

A

patients with GI obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Probiotics RX

A

lactobacillus & bifidobacterium

50 billion units/dau

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Antibiotic RX

A

Rifaximin

imporvies IBS symptoms and bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

IBD

A

Ulcerative Colitis and Crohn’s Dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

6 groups of Rxs used to treat IBD

A

1) Aminosalicylates
2) Corticosteroids
3) Immunosuppressants
4) TNF inhibiotrs
5) Antibiotics
6) Probiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Aminosalicylates
these drugs contain 5-aminosalicylic acid (5-ASA) used for the induction and maintenance of remission used for the induction and maintenance of remission
26
Two types of aminosalicylates
Mesalamine | Azo compounds
27
Mesalamine (5-ASA) RXs
5-ASA alone Pentasa: time release formulation- SMALL INTESTINE Asacol- pH in DISTAL ILEUM AND PROXIMAL COLON dissolve it Rowasa or Canasa: apply at anus RECTUM and SIGMOID COLON- enema
28
Azo Compounds
- 5-ASA bound to another molecule - binding allows it to get through stomach - broken down in ileum and colon
29
what enzyme breaks down Azo compounds in the ileum and colon?
azoreductase
30
Azo RXs
Sulfasalazine (Azulfidine) breaks down into 5 ASA and sulfapyridine Olsalazine (Dipentum) breaks down into 5-ASA & an inactive compound Balsalazide (Colazal)- 5-ASA & inactive compound
31
Aminosalicylates whould not be administered with what?
antacids, change in pH cause premature dissolution and coating
32
MOA of Aminosalicylates
of 5- ASA works topically on the surface of the intestine to inhibit prostaglandins and other mediators of inflammation.
33
5-ASA inhibits which inflamatory mediators?
1) IL-1 2) TNF alpha 3) prostoglandins
34
Clinical uses of Aminosalicylates
Ulcerative colitis- first line for mild to moderate ulcerative colitis, induces and maintains remission
35
Sulfasalazine
5-ASA | Sulfasalazine- highest incidence of side effects due to absorption of sulfapyridine
36
Sulfasalazine ADRs
arthralgias bone marrow suppression SJS
37
Antibiotics used in IBS particulary Crohn's
Metronidazole (Flagyl) Ciprofloxacin (Cipro) Rifaximin (Xifaxan)
38
Glucocorticoids For Inflammatory MOA
suppress inflammation inhibits production of inflammatory cytokines
39
Clinical uses of steroids in IBD
: moderate to severe active inflammatory bowel, once in remission, taper and try not to use for maintenance
40
Steroids RX
oral prednisone hydrocortisone enemas Budesonide
41
Budesonide
15 times more potent than prednisone Can be used on a daily basis, only works in the bowel high first-pass metabolism allow for a 2 week overlap when changing from prednisone to budesonide
42
Budesonide RXs
Entocort | Uceris
43
Entocort
for mild to moderate Crohns
44
Uceris
for mild to moderate UC
45
Immunomodulatory Agents
Azathioprine & Mercaptopurine Methotrexate Cyclosporine Tacrolimus
46
Azathioprine & Mercaptopurine USE and MOA
maintain remission in both ulcerative colitis and Crohn’s inhibit purine synthesis; anti-proliferative effects and induce t-cell apoptosis
47
Methotrexate-Use and MOA
-one day/week -Used for moderate to severe steroid-dependent and steroid resistant Crohn’s MOA: inhibits DNA synthesis and causes cell death
48
Cyclosporine
-patients w/ severe steroid resistant UC
49
Tacrolimus
Alternative to cyclosporine
50
Meds for IB biologic agents
Infliximab (Remicade) Adalimumab (Humira) Certolizumab (Cimzia) Golimumab (Simponi) -mab- all target TNF Used for moderate to severe ulcerative colitis and/or crohns’
51
Antiemetics
One drug usually enough if simple nausea and vomiting
52
Pathophysiology of vomiting
A vomiting center is located in the brainstem, when stimulated it tells the stomach to contract & expel contents. This center has muscarinic, histamine & serotonin receptors. Drugs that block these receptors can have an antiemetic effect.
53
areas that trigger vommiting
Chemoreceptor trigger zone: outside the blood brain barrier : dopamine, opioid, serotonin, & neurokinin receptors Vestibular system: muscarinic & histamine receptors Pharyngeal area: gag reflex GI tract
54
Major Antiemetic Rx Groups
``` Serotonin 5HT3 antagonists Corticosteroids Phenothiazines Benzamides Anti-histamines Scopolamine Dronabinol ```
55
Serotonin 5HT3 Antagonists MOA
Block receptors at chemoreceptor trigger zone
56
Serotonin 5HT3 Antagonists Clinical Use
- acute chemo | - radiation
57
ADR of Serotonin 5HT3 Antagonists
Prolonged QT
58
Serotonin 5HT3 Antagonists RXs
Ondansetron (Zofran) Granisetron (Kytril) Dolasetron (Anzemet) Palonosetron (Aloxi)- chemo therapy
59
Corticosteroid antiemetic RXs
Dexamethasone & prednisone
60
Dexamethasone & Cortecosteroid antiemetic use
Acute & delayed N,V due to chemotherapy make 5HT3 work better when used in combination
61
Phenothiazines
anti-psychotics and very sedating, also are potent anti-emetics Most effective in simple N,V SEDATION
62
Phenothiazines RXs
-antipsychotics Prochlorperazine (Compazine) Promethazine (Phenergan)
63
Phenothiazine Black Box
contraindicated if 2years old b/c of fatal respiratory suppression
64
Benzamides RXs
Metaclopramide (Reglan) | Trimethobenzamide (Tigan)
65
benzamides MOA and ADR
-dopamine receptor blockade ADR- Parkinson like syndrome
66
Anti-Histamines Clincial use and ADR
-motion sickness ADR- Anticholinergic effects, sedating
67
RXs Anti-histamines
Diphenhydramine (Benadryl) Dimenhydrinate (Dramamine) Meclizine (Antivert) Doxylamine (Unisom)
68
Hyoscine
- antihistamine/antichlolinergic - best for motion sickness - apply patch 4 hrs before travel - up to 72 hrs
69
Dronabinol (Marinol)
THC chemo increases appetite
70
Simple N,V
use phenothizine
71
post chemo
use multiple meds
72
Prokinetic Agents
- increases gut motility | - GERD b/c move acid out of stomach so less in esophagus, gastroparesis
73
2 RXs of Prokinetics
Cholinomimetics | Metoclopramide
74
Cholinomimetics MOA
Stimulate cholinergic receptors on muscles cells & myenteric plexus, increasing GI motility
75
Neostigmine
Cholinomimetics IV in hospital for acute pseudo-obstruction. Moves bowel but get a lot of GI side effects
76
Metoclopramide (Reglan) MOA
MOA: Dopamine receptor antagonist that causes increased esophageal peristalsis, increased lower esophageal sphincter pressure, increased gastric empting
77
Clincial use Metoclopramide and ADRs
- GERD- use w/ H2s and PPIs - Diabetic gastroparesis - mildly effective anti-emetic b/c of dopamine receptors on chemoreceptor trigger zone ADR- antipsycotic CNS, tardive dyskinesia, extrapyramidal effects

PHARM EXAM 2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions