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HSS3106 - Pharmacology > Lecture 13- Medications for Digestive Disorders > Flashcards

Lecture 13- Medications for Digestive Disorders Flashcards

1
Q

What are some common GI issues?

A
  1. Ulcers
  2. heartburn
  3. GERD
  4. Diarrhea
  5. Constipation
  6. Vomiting
  7. Gastroparesis –> food moves out of stomach too slowly
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2
Q

What is a peptic ulcer?

A
  • from bacteria (Helicobacter pylori) in stomach
  • use of anti-inflammatory painkillers (NSAIDs or aspirin)
  • alcohol and caffeine can cause them too!
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3
Q

What are the signs and symptoms of peptic ulcers?

A

All about the FOOD you eat
all about the TIME you eat

  • abdominal pain around 3 hours of taking a meal
  • loss appetite and weight loss
  • bloating
  • nausea and vomiting
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4
Q

How do we treat peptic ulcers when NSAIDs or aspirin caused them?

A
  1. stop taking the meds (unless otherwise by doctor)
  2. use PPIs (Proton pump inhibitors) –> help reduce acid in stomach
  3. or use H2 antagonists –> help reduce acid in stomach
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5
Q

How do we treat peptic ulcers when Helicobacter pylori caused it?

A

use of TWO antibiotics
1. metronidazole and clarithromycin
2. amoxicillin and clarithromycin

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6
Q

How do we prevent heartburn?

A
  • watch what you eat!!
  • Exercise!!
  • Timing of food
  • how fast you eat
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7
Q

How do we treat heartburn and excessive acid from least strength to most strength (3) ?

A
  1. Antacids
  2. H2-receptor antagonists
  3. proton pump inhibitors
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8
Q

What are the 4 antacids generic names and trade names?

A
  1. aluminum hydroxide
  2. calcium carbonate with magnesium hydroxide –> Rolaids
  3. Magnesium hydroxide/aluminum hydroxide with simethicone
  4. sodium bicarbonate
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9
Q

What do antiacids do?

A

neutralize digestive acids

FIRST drug recommended for heartburn and mild symptoms

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10
Q

What does antiacids consist of?

A
  • magnesium
  • calcium
  • aluminium
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11
Q

What can antacids cause in the intestines?

A
  • interact with drugs –> REDUCE absorption
  • can be avoided if take drugs ONE hour BEFORE or THREE hours AFTER taking the antacid
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12
Q

What are the two ADVERSE EFFECTS of Antacids?

A

diarrhea

constipation

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13
Q

Why should “Tums” be used in caution with older adults?

A

likelyhood of having following conditions:
- renal disease
- ventricular fibrillation
- CVD
- hypercalcemia —> kidney failure

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14
Q

What is GERD?

A

“Gastroesophageal Reflux Disease”

  • lower esophageal sphincter is weakened/relaxed, allowing gastric juices to flow into esophagus

-chronic

  • mucosal damage produced by abnormal reflux in esophagus
  • symptoms: heartburn, regurgitation, sore throat, etc…
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15
Q

What are the two H2 receptor antagonists generic and trade names?

A
  1. famotidine —> PEPCID
  2. ranitidine –> ZANTAC
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16
Q

What does H2 receptor antagonists do?

A
  • BLOCK H2 receptors to REDUCE gastric secretions for 6-24 hours
  • prevent heartburn episodes
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17
Q

What is the ADVERSE EFFECTS of H2-receptor antagonists?

A
  • GI probs
  • cardiac arrhythmias
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18
Q

Why was ZANTAC taken off the market?

A

because of presence of a carcinogen –> NDMA (N-nitrosodimethylamine)

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19
Q

What are the 4 Proton Pump Inhibitors generic and trade names?

A
  1. esmoprazole
  2. lansoprazole
  3. omeprazole
  4. misoprostol
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20
Q

What do Proton Pump Inhibitors do?

A
  • BLOCK HCL production!!!
  • heals ulcers, relieves GERD
    -most effective!
  • if it is MODERATE or SEVERE symptoms
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21
Q

What are the ADVERSE effects of PPIs?

A
  • GI related
  • long term –> risk of fractures, pneumonia, clostridum difficile dirrehea, hypomagnesia, vitaminB12 deficiency , chronic kidney disease, dementia
22
Q

What is Misoprostol?

A
  • a prostoglandin
  • affect GI motility and gastric acid secretion
  • ONLY for people who are both taking NSAIDs and are at high-risk NSAID-induced ulcers
23
Q

What is the 4 types of diarrhea?

A
  1. Osmotic
  2. secretory
  3. Inflammatory and infectious
  4. associated with Deranged motility
24
Q

What is Osmotic Diarrhea?

A

excessive amounts of solutes are retained –> water will not be absorbed therefore wet poos

25
Q

What is Secretory diarrhea?

A

When secretion of water into the intestinal lumen exceeds absorption

26
Q

What is Inflammatory and infectious diarrhea?

A

disruption of epithelium due to microbial or viral pathogens

27
Q

What is diarrhea associated with deranged motility?

A

intestinal contents must be adequately exposed to the epithelium and retained long enough to allow absorption

28
Q

What determines diarrhea?

A

The CONSISTENCY of the poo

29
Q

What are two antidiarrheals generic and trade names?

A
  1. bismuth subsalicylate –> Pepto-bismol
  2. loperamide –> Imodium
30
Q

What does Pepto-bismol do?

A
  • anti-inflammatory and antiacid
  • for “heartburn, indigestion, upset stomach, DIARRHEA”!
31
Q

What does loperamide/ Imodium do?

A
  • anti-diarrheal
  • opioid-receptor agonist
  • does NOT cross blood brain barrier, therefore does NOT effect CNS
32
Q

How can we get constipation (5 things)?

A
  1. Diet
  2. medications (opioids)
  3. metabolic and muscular
  4. structural and functional abnormalities
  5. pyschological –> stress
33
Q

What are 4 types of meds to treat constipation?

A
  1. Osmotic laxatives
  2. Stool Softeners and lubricants
  3. laxative stimulants
  4. fibre products/bulk-forming laxatives
34
Q

What is one osmotic laxative medication generic name and trade name?

A

milk of magnesia

35
Q

What do osmotic laxative meds do?

A
  • pull water into the large intestine, creating bulk and causing a more liquid stool –> pressure leads to stimulate contractions
  • for violent overnight relief / short term relief
36
Q

can you develop a dependence for osmotic laxatives?

A

YES!!
- decreases strength of physiological muscles in rectum and colon
- after you go off of them, you have to go back because you cannot physically push poop out

37
Q

What is the name of a stool softener used as a medication to treat it constipation?

A

Glycercin

38
Q

What do Stool Softeners do?

A

allow fluids to mix into the stool
- make it easier to pass
coats stool and bowel wall with a water-resistant film (lubricants)

39
Q

Should you drink lots of fluids when taking stool softeners?

A

YES

40
Q

What are two names of Stimulant laxatives used to treat constipation?

A
  1. bisacodyl –> DULCOLAX
  2. Senna –> Black- draught
41
Q

What do Stimulant laxatives do?

A

contain an irritant that stimulates the lining of bowel –> CONTRACTIONS!!

42
Q

Should you use laxatives for long term use?

A

no

43
Q

What is the name of a bulk-forming laxative?

A

Metamucil

44
Q

What does bulk-forming laxatives do?

A

make stool larger, helps intestines contract–> bowel movement!
slow-acting (12 hours-3 days)

45
Q

What are EMETICS?

A

induce vomiting (for emergency purposes)

46
Q

What an ANTIEMETICS?

A

to prevent vomiting

47
Q

What are the 8 antiemetics you can use?

A
  1. 5-HT3 receptor antagonists
  2. dopamine antagonists
  3. antihistamines
  4. cannabinoids
  5. benzodiazepines
  6. anticholinergics
  7. steroids
  8. Herbs –> ginger or pepperint
48
Q

What are the 4 antiemetics from the table we should know?

A
  1. Haldol (dopamine antagonist)
  2. reglan (misc agent)
  3. Dramamine (antihist)
  4. Benadryl/Gravol (antihist)
49
Q

What is Gastroparesis?

A

-aka = delayed gastric emptying
- slows or stops the movement of food from stomach to small intestine
-symptoms:
a. nausea
b. feel full after eating very little
c. vomitting undigested food several hours after meal

50
Q

What can aggravate Gastroparesis?

A

greasy or rich foods

large quantities of foods with fiber

drinking beverage high in fat or carbonation

51
Q

How do you treat gastroparesis?

A
  1. reglan –> medication to stimulate stomach muscle contractions
  2. erythromycin –> increase contractions that move food through stomach
  3. Botox –> into the pylorus to keep it open longer
  4. modify eating habits
  5. electrical stimulation
52
Q

What has the FDA come out about the medication “reglan”?

A

rare reports causing ….
“irreversible neurological side effect of tardive dyskinesia” (affects movement)

HSS3106 - Pharmacology (18 decks)

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