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Pharm > Lecture 9: OTC Digestives > Flashcards

Lecture 9: OTC Digestives Flashcards

1
Q

How does Histamine affect airways and bloodvessels?

A

It causes vasodilation of blood vessels and constriction of the airways

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2
Q

What receptor G receptor is histamine linked to?

A

Gq

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3
Q

What does Histamine being Gq linked do in airways?

A

It increases intracellular calcium and causes constriction of muscles

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4
Q

How does histamine being Gq linked affect blood vessels?

A

The increase in intracellular calcium causes an increase of synthases that produce NO diffuses into smooth muscle around blood vessels and causes dilation

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5
Q

What is another name for heartburn?

A

GERD

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6
Q

What is Acid-Peptic Disease?

A

A group a of disorder involving either excessive acid secretion or erosion of mucosal lining of the GI tract

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7
Q

What are the Acid-Peptic diseases?

A
  • GERD
  • Peptic ulcers
  • Stress-related gastritis
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8
Q

How do drugs used to treat acid-peptic disease work?

A

They reduce intragastric acidity by manipulating acid secretion, promote mucosal defense, or eradicate bacterium

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9
Q

What are the two parts of the stomach?

A

The antrum and fundus

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10
Q

What do parietal cells in the fundus do?

A

Secrete acid into the stomach

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11
Q

Which cells does a pH less <3 in the stomach act on?

A

D and G cells

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12
Q

What cells in the stomach do amino acids act on?

A

G cells

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13
Q

What is responsible for the acidity in the stomach?

A

The H+/K+ ATPase proton pump

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14
Q

What does the The H+/K+ ATPase proton pump do?

A

Move acid from the parietal cell into the gastric lumen

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15
Q

What is the energy source for the The H+/K+ ATPase proton pump?

A

ATP

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16
Q

Where do the protons that the the H+/K+ ATPase proton pump pumps out come from?

A

Carbonic anhydrase which removes the proton from bicarbonate

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17
Q

What are the three important controls of acid release?

A
  • Acetylcholine on M3 receptors
  • Histamine on H2 receptors
  • Gastrin on CCKb receptors
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18
Q

What do G cells in the antrum respond to?

A

Intraluminal dietary peptides

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19
Q

What do G cells released when stimulated by peptides?

A

Gastrin

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20
Q

What does Gastrin bind to?

A
  • CCK receptors on parietal cells

* Enterochromaffin cells (H cells)

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21
Q

How does Gastrin affect enterochromaffin cells (H cells)?

A

Causes them to release histamine which bind to histamine receptors (H2) on parietal cells

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22
Q

What does the vagus nerve stimulation of postganglionic neurons do in the stomach?

A

Stimulates postganglionic neurons of the enteric system to release acetylcholine

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23
Q

What does acetylcholine released by postganglionic fibers of the enteric nervous system do?

A

Binds to muscarinic receptors on parietal cells

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24
Q

What kind of G receptors are CCK receptors?

A

Gq

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25
Q

How do the CCK receptors affect parietal cells?

A

They increase secretion

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26
Q

How does the increase of intraluminal acid affect D cells?

A

Increase in acid causes D cells to release somatostatin

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27
Q

What does Somatostatin released by D cells do?

A

Inhibits gastrin release from G cells

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28
Q

What are Antacids?

A

Weak bases that neutralize stomach acid by reacting with protons in the lumen of the gut

29
Q

What are the Popular antacids?

A
  • Magnesium hydroxide

* Aluminium hydroxide

30
Q

What is one of the effects of magnesium hydroxide?

A

Strong laxative effect because it traps water in the gut

31
Q

What is another effect of aluminium hydroxide?

A

It has constipating action because it precipitates phosphate to produce salt which dries things out

32
Q

What are Proton pump inhibitors?

A

Lipophilic weak bases that diffuse into the parietal cell and inactivate the H+/K+ ATPase transporter

33
Q

What can prolonged use of Proton Pump inhibitors lead to?

A

Hypergastrinemia

34
Q

Why do PPIs lead to Hypergastrinemia?

A

Because acid secretion inhibits gastric release

35
Q

How do PPIs affect other drugs?

A

They decrease the bioavailability of vitamin B12 and other drugs that require acidity for absorption

36
Q

How does the stomach ensure vitamin B12 remains uncharged?

A

By creating a very low pH allowing B12 to accept a proton

37
Q

What is the active ingredient in Peptobismol?

A

Bismuth Subsalicylate

38
Q

What happens to Bismuth Subsalicylate in the gut?

A

It hydrolyzes to form Bismuth oxychloride and salicylic acid

39
Q

What does Salicylic Acid form from Bismuth Subsalicylate do in the gut?

A

Is a COX2 inhibitor and has anti-inflammatory properties

40
Q

What are the effects of Bismuth salts?

A

They have bactericidal effects and can bind to toxins

41
Q

What drug treats motion sickness?

A

Dimenhydrinate

42
Q

What it the action of Dimenhydrinate at the receptors?

A

It is a competitive antagonist at the H1 receptor

43
Q

How does Dimenhydrinate work?

A

It blocks histamine activity in the vestibular system from sending signals to the medulla

44
Q

What is Gastric motility controlled by?

A

Intrinsic neural plexuses (enteric nervous system)

45
Q

What can modulate activity of the Gut?

A

Central nervous system input via parasympathetic and sympathetic system

46
Q

What happens if autonomic control is removed from the gut?

A

It results in disorganized gastric activity however over time gastric activity will return to normal

47
Q

What does the Myenteric Plexus do?

A

Provides motor innervation to the muscular layer of the gut

48
Q

What does the Submucosal Plexus provide?

A

Secretomotor innervation to the mucosa

49
Q

What do the neurons of the plexus usually release?

A

Acetylcholine, serotonin and dopamine

50
Q

What do all-preganglionic neurons release?

A

Acetylcholine

51
Q

What do Postganglionic parasympathetic neurons release?

A

Acetylcholine

52
Q

What do Postganglionic sympathetic neurons release?

A

Noradrenaline

53
Q

How does acetylcholine affect the muscle of the GI tract?

A

Causes contraction of the muscle

54
Q

What G receptors are the adrenergic receptors linked to in the gut?

A

Gi

55
Q

What is constipation usually caused by?

A

Diet low in fiber and water

56
Q

What are laxatives?

A

Substances loosen stool or stimulate bowel movement

57
Q

What are the four kinds of laxatives?

A
  • Bulk forming
  • Osmotic
  • Lubricant
  • Stimulant
58
Q

How do Bulk forming laxatives work?

A

They contain plant fiber like psyllium and methylcellulose that draw water into the stool to make them larger and easier to pass

59
Q

How do Osmotic laxative work?

A

They contain ingredients like polyethylene glycol or magnesium that draw fluid into the bowel from nearby tissue

60
Q

How do Lubricant laxatives work?

A

They coat the surface of stools or anus to make it easier for stools to pass

61
Q

How do stimulant laxative work?

A

Contain ingredients like senna and bisacodyl that cause bowels to squeeze stools out (enhance smooth muscle)

62
Q

What are the most common diarrhea medications?

A
  • Loperamide

* Bismuth subsalicylate

63
Q

How does Loperamide work at a receptor?

A

It is a mu opioid agonist

64
Q

Where are Mu opioid receptors located?

A

On the myenteric plexus

65
Q

How does Bismuth Subsalicylate work to help diarrhea?

A

Its COX2 inhibition reduces inflammation and irritation

66
Q

What other effects does Loperamide have?

A

It has weak analgesic effects

67
Q

Why isn’t Loperamide rewarding or addictive like morphine or codeine?

A

Because it is a substrate of P-glycoprotein of the BBB and P-glycoprotein pumps drugs out of the brain

68
Q

What is P-hp inhibited by?

A

Tricyclic antidepressants

Pharm (31 decks)

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