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Block 1 - GI > Pharm > Flashcards

Pharm Flashcards

1
Q

Primary neurotransmitter of the excitatory motor neurons simulating the gut?
Inhibitory?

A

ACh

NO

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2
Q

Modulation of motility, secretions, and emesis involves ___ released by enterochromaffin cells in response to mucosal sensor activity

A

Serotonin (5-HT)

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3
Q

Reversible ACh inhibitors

A
  1. Mono and bis-quaternary ammonium of alcohols (DOA minutes)
    - edrophonium
  2. Carbamates (DOA hours)
    - neostigmine
    - physostigmine
    - pyridostigmine
    - donepezil
    - tacrine
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4
Q

Irreversible ACh inhibitors

A
  • Organophosphorus inhibitors (DOA hundreds of hours)
    • echothioohate
    • parathion
    • malathion
    • Sarin
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5
Q

Absorption and distribution of Cholinergic drugs are based on

A

Structure

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6
Q

Most cholinergic drugs are metabolized to ___ with excretion usually ___

A

Inactive proteins

Renal

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7
Q

Adverse effects of cholinergic drugs

A
  1. Overstimulating cholinergic receptors:
    - Bradycardia
    - Increased salivation
    - Respiratory distress
  2. Blocking cholinergic receptors:
    - Dry mouth
    - Visual disturbances
    - Urinary retention
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8
Q

Atropine blockade

A

Competitive

Reversible

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9
Q

Effects of cholinergic stimulates

A

Increase smooth muscle contraction
Relax sphincters
Stimulates secretion

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10
Q

Mechanism by which ACh effect is terminated

A

Hydrolysis by cholinesterase in the synaptic cleft

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11
Q

Treatment of hyperactivity of the gut

A

Antimuscarinic drugs: Atropine

-decrease motility and secretions

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12
Q

Salivary glands are ____ to atropine (antimuscarinic drugs) while GI secretory cells are ___.
Perspiration is ___
Tearing and nasal secretions are ___

A

Very sensitive
Very insensitive
Very sensitive
Sensitive

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13
Q

Direct acting cholinomimetics

A 
ACh
Bethanechol
Carbachol
Pilocarpine
Cevimeline
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14
Q

Indirect acting cholinomimetics

A

Neostigmine
Pyridostigmine
Echothiophate

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15
Q

Adrenergic agonists

A

NE
Epinephrine
Dopamine
Terbutaline

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16
Q

Adrenergic antagonists

A 
Prazosin
Phentolamine
Tamulosin
Doxazosin
Terazosin
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17
Q

Muscarinic antagonists

A

Atropine
Oxybutynin
Darifenacin

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18
Q

The first line drugs to treat peptic ulcer and severe GERD

A

PPIs
-prazoles

Ex: omeprazole, etc.

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19
Q

Drugs indicated for H. pylori infection-induced peptic ulcers

A

Antibiotics

  • clarithromyocin
  • amoxicillin
  • metronidazole
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20
Q

MOA of PPI

A

Inhibit H+/K+ ATPase on parietal cells thus reducing acid secretion

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21
Q

MOA of H2 antagonists

A

Block H2 receptors on parietal cells to reduce acid secretion

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22
Q

H2 antagonists

A
  • tidines

* same uses as PPIs but less potent with rapid onset of action

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23
Q

Antacids

A

Sodium bicarbonate
Calcium carbonate
Aluminum hydroxide
Magnesium hydroxide

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24
Q

Drugs that promote mucosal defense

A

Sucralfate
Misoprostol
Bismuth subsalicylate

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25
___ are weak bases that provide short term relief of peptic ulcer symptoms by neutralizing gastric acid
Antacids
26
MOA: coat GI wall Stimulate secretion of PGs, mucus, and bicarbonate Antimicrobial action
Bismuth subsalicylate
27
MOA: Coat GI wall Inhibit pepsin Stimulate secretion of PGs and bicarbonate
Sucralfate
28
This drug is used in combo with antibiotics and H2 blocker or PPI to treat H. pylori peptic ulcer or to prevent travelers diarrhea
Bismuth subsalicylate
29
This drug is a send to prevent stress gastritis and treat bile reflux gastropathy and oral mucositis
Sucralfate
30
MOA: | Block both central and peripheral 5-HT3 receptors
5-HT3 receptor antagonists | -setrons
31
MOA: | block central D2 or D2 and M receptors
D2 receptor blockers - metoclopramide - prochlorperazine - droperidol
32
MOA: | Enhance GABAs effect on Cl ion conductance
Benzodiazepines | -Lorazepam
33
MOA: | Block central and vestibular H1 receptors
H1 antagonists - diphenhydrazine - meclizine - doxylamine
34
MOA: | Block vestibular M1 receptors
M1 receptor antagonist | -scopolamine
35
MOA: Not clear Maybe blocking CB1 and 5-HT3 receptors?
Synthetic Cannabinoids
36
This drug is used in combo with corticosteroids. - It is the most effective treatment for prevention of acute severe vomiting caused by chemotherapy - Also used for radiation and post-op nausea and vomiting
5-HT3 receptor antagonists | -setrons
37
This drug is used in combo with corticosteroids for delayed chemotherapy-induced vomiting -Also used in combo with 5-HT3 blockers and corticosteroids to prevent acute delayed chemotherapy-induced vomiting
NK1 receptor blocker | -pitant
38
MOA: | Block central NK1 receptors
NK1 receptor blocker | -pitant
39
This drug is used for: 1. radiation, chemo, and infection-induced nausea and vomiting 2. general emesis 3. post-op nausea and vomiting, sedation
D2 receptor blockers 1. metoclopramide 2. Prochlorperazine 3. droperidol
40
This drug is used for anticipatory emesis
Benzodiazepines | -lorazepam
41
This drug is used for: 1. chemo induced vomiting 2. Motion sickness 3. With pyridoxine for pregnancy related emesis
H1 antagonists: 1. diphenhydrazine 2. meclizine 3. doxylamine
42
This drug is used as a transdermal patch to prevent motion sickness
M1 receptor antagonist | -Scopolamine
43
This drug is used for chemo induced emesis
Synthetic cannabinoids
44
MOA: 1. Stimulate "mu" receptors in enteric neurons 2. Inhibit presynaptic cholinergic action Used for ___
Opioids All forms of chronic diarrhea
45
MOA: 1. Bind to bacteria, toxin, and fluid 2. Binds to bile acid Side effects?
Adsorbents 1. Kaolin and Pectin - also bismuth subsalicylate 2. Bile-salt binding resins *may affect absorption of other drugs
46
This drug is used to treat: 1. Acute diarrhea in children 2. Travelers diarrhea 3. Bile malabsorption-caused diarrhea
Adsorbents 1. Kaolin and Pectin 2. bismuth subsalicylate 3. Bile-salt binding resins
47
MOA: Inhibits the secretion of numerous hormones and transmitters leading to reduced intestinal fluid secretion and decreased GI motility *used for
Synthetic somatostatin * diarrhea caused by endocrine tumor, vagotomy or dumping syndrome * short bowel syndrome * AIDS
48
MOA: Inhibit Cl secretion to intestinal lumen *used to treat ___
Chloride channel inhibitor *diarrhea caused by antiretroviral therapy
49
Treatment of mild IBS 1. Pain/bloating 2. Constipation predominant 3. Diarrhea predominant
1. Diet 2. Diet, fiber 3. Diet, loperamide
50
Treatment of moderate to severe IBS 1. Pain/bloating 2. Constipation predominant 3. Diarrhea predominant
1. Anticholinergics, rifaximin, antidepressants 2. Laxatives, lubiprostone, antidepressants 3. Loperamide, antidepressants, rifaximin, alosetron
51
Drugs used for IBD
1. Inflammatory suppressors 2. Immunomodulators 3. Biologicals
52
Drugs used for IBD: Inflammatory suppressors *specific uses
1. 5-ASA: mesalamine, sulfasalazine * mild to moderate UC, induce and maintain remission, RA 2. Oral corticosteroids: budesonide, prednisone * only used short term to induce remission * more potent than 5-ASAs
53
This drug, used for IBD, is also used in Crohn disease
Budesonide
54
Drugs used for IBD: Immunomodulators *specific uses
1. 6-mercaptopurine * used to maintain remission of UC and CD 2. Methotrexate 3. Cyclosporine 4. Tacrolimus
55
Drugs used for IBD: | Biologicals
1. Infliximab (anti TNF-alpha) * moderate to severe UC or CD 2. Natalizumab (anti alpha4 integrin) 3. Ustekinumab (interleukin 12/23 inhibitor)
56
MOA: Peripheral-increase gastro-esophageal peristalsis and LES pressure Central-block D2 receptors in CTZ *Uses?
Prokinetic agents (D2 receptor antagonists) *gastroparesis, nausea, and vomiting
57
MOA: Absorb water into fiber leading to increased fecal volume, thus promoting peristalsis and bowel evacuation *uses?
Bulk-forming laxatives | *prevent constipation
58
MOA: Permit water and lipids to penetrate feces or lubricate stool *uses?
Stool surfactant agents | *prevent constipation in patients who should avoid strain
59
MOA: Draw water into intestine and colon, increase fecal fluid, and stimulate colonic peristalsis *uses?
Osmotic laxatives * treat acute constipation or prevent chronic constipation * bowel prep
60
MOA: Stimulate smooth muscle contraction, increase colonic electrolyte and fluid secretion *uses?
Stimulant laxatives * same as osmotic lax. but more potent: * treat acute constipation or prevent chronic constipation * bowel prep
61
MOA: Stimulate type 2 chloride channel in small intestine thus increasing chloride-rich fluid secretion *uses?
Chloride channel activator *chronic constipation
62
MOA: Block intestinal "mu" receptors leading to increased intestinal motility *uses?
Opioid receptor antagonists *opioid-induced constipation

Block 1 - GI (15 decks)

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