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GI > Pharm: Motility Disorders > Flashcards

Pharm: Motility Disorders Flashcards

0
Q

What changes can cause achalasia?

A

Degeneration of:

(1) inhibitory myenteric plexus neurons
(2) vagal branches
(3) dorsal vagal nucleus

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1
Q

What are the possible aims of esophageal motility drugs?

A

(1) reduce LES pressure

(2) reduce vigor of distal esophageal smooth muscle contractions

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2
Q

What is the only effective medication used to treat achalasia?

A

Botulinum toxin, which inhibits release of acetylcholine at the NMJ.

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3
Q

What are the most effective treatments for achalasia?

A

(1) Heller myotomy
(2) pneumatic dilation
(3) peroral endoscopy myotomy

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4
Q

What medication is used to reduce muscular vigor in the distal esophagus?

A

5’ phosphodiesterase inhibitors.

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5
Q

What is the MoA of 5’ phosphodiesterase inhibitors?

A

They block NO degradation, prolonging smooth muscle relaxation and reducing contractile amplitude and propagation velocity.

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6
Q

In what part of the body can a majority of one’s serotonin be found?

A

In the GI tract, 95%.

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7
Q

What are the possible aims of gastric motility drugs?

A

(1) delay gastric emptying
(2) accelerate gastric emptying
(3) improve fundic accommodation

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8
Q

What is another name for a drug the accelerates gastric motility?

A

A prokinetic.

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9
Q

What is a notable prokinetic?

A

Metoclopramide. It is also used as an antiemetic.

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10
Q

What is the MoA of metoclopramide?

A

(1) 5HT4-receptor agonist

(2) D2-receptor antagonist

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11
Q

What 2 types of drugs delay gastric emptying?

A

(1) anticholinergics

(2) somatostatin analogues

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12
Q

J: This class of drugs includes dicyclomine and hyoscyamine.

A

What are anticholinergics?

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13
Q

What is the MoA of octreotide as a delayer of emptying?

A

It’s a somatostatin analogue that inhibits the release of serotonin and motilin.

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14
Q

J: This drug is commonly used to improve fundic accommodation.

A

What is buspirone?

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15
Q

What is the MoA of buspirone?

A

It is a 5HT1A-receptor agonist. As such, it:

(1) inhibits ACh release in the myenteric plexus
(2) promotes NO release

16
Q

When is fiber an appropriate treatment for constipation?

A

When the constipation is only mild or moderate.

17
Q

What is the MoA of fiber as a treatment of constipation?

A

It increases stool weight.

18
Q

What are 3 classes of laxatives and what are the MoAs?

A

(1) magnesium, sulfate, phosphate: create hyperosmolar luminal environment
(2) polyethylene glycol: binds water molecules
(3) anthraquinones & diphenylmethanes: mucosal afferent nerve fiber irritants

19
Q

What is lubiprostone?

A

A treatment for constipation that increases intestinal fluid secretion and transit by activating chloride channels.

20
Q

What is tegaserod?

A

A 5HT4-receptor partial agonist used to treat constipation.

21
Q

Why should tap water enemas be avoided?

A

Water intoxication.

22
Q

Why should soap suds enemas be avoided?

A

Colitis and necrosis.

23
Q

What are the important receptors on excitatory enteric motor neurons?

A

(1) 5HT3 receptor

(2) 5HT4 receptor

24
Q

What are the important receptors on inhibitory enteric motor neurons?

A

(1) 5HT1A receptor
(2) 5HT1D receptor
(3) 5HT7 receptor

25
Q

What cells in the GI tract are responsible for the release of serotonin?

A

Enterochromaffin cells.

26
Q

In what layers of the colon can interstitial cells of Cajal be found?

A

(1) submucosa
(2) within the circular smooth muscle layer
(3) between the circular and longitudinal muscle layers

27
Q

What is the simplest way to attempt to relieve constipation?

A

Drink water.

28
Q

What is the most notable antiemetic discussed? What is its MoA?

A

Odansetron, which is a 5HT4-receptor antagonist.

29
Q

What is a side effect of odansetron?

A

Constipation.

GI (39 decks)

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