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module 11 > pharma > Flashcards

pharma Flashcards

1
Q

What factors regulate gastric acid secretion?

A

Acetylcholine, histamine, gastrin

Acetylcholine acts through muscarinic receptors, histamine through H2 receptors, and gastrin through CCK receptor2.

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2
Q

What stimulates the release of acetylcholine for gastric acid secretion?

A

Sight, smell, taste, anticipation of food, presence of food, gastric distension

These stimuli are part of the cephalic and gastric phases of digestion.

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3
Q

What is the role of somatostatin (SST) in gastric acid secretion?

A

Inhibits gastric acid secretion

SST is released in response to low gastric pH and suppresses gastrin release.

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4
Q

What are the gastric defenses against acid?

A
  • Lower esophageal sphincter
  • Mucosal blood flow
  • Mucus secretion
  • Bicarbonate secretion
  • Prostaglandins E2 and I2

These mechanisms protect the stomach lining from acid damage.

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5
Q

What are the goals of therapy for acid peptic disease and GERD?

A
  • Reduce gastric acid production
  • Neutralize gastric H+
  • Protect stomach walls

These goals aim to alleviate symptoms and promote healing.

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6
Q

What are the classes of anti-acid drugs?

A
  • Antacids
  • Inhibitors of gastric acid production
  • Cytoprotective agents

Inhibitors include proton pump inhibitors (PPIs), H2 receptor antagonists, and muscarinic antagonists.

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7
Q

What are the main actions of antacids?

A
  • Partially neutralize gastric acid
  • Reduce pepsin activity
  • Stimulate prostaglandin production
  • Reduce ulcer pain

Antacids can promote healing of ulcers.

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8
Q

What are common examples of antacids?

A
  • Magnesium hydroxide
  • Aluminum hydroxide
  • Calcium carbonate
  • Sodium bicarbonate

These agents contain various salts that neutralize gastric acid.

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9
Q

What is a potential adverse effect of sodium bicarbonate?

A

Metabolic alkalosis

Sodium bicarbonate can cause systemic absorption leading to alkalosis, especially in patients with certain conditions.

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10
Q

What is the mechanism of action of proton pump inhibitors (PPIs)?

A

Covalently bind to H+/K+ ATPase pump

This inhibits gastric acid secretion for up to 36 hours.

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11
Q

What is the prototype proton pump inhibitor?

A

Omeprazole

Other examples include esomeprazole, lansoprazole, rabeprazole, and pantoprazole.

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12
Q

What are common adverse effects of omeprazole?

A
  • Headache
  • Dizziness
  • Abdominal pain
  • Diarrhea

These effects occur in at least 1% of patients.

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13
Q

What are H2 receptor antagonists used for?

A
  • Duodenal ulcers
  • Gastric ulcers
  • Reflux esophagitis

They suppress gastric acid secretion effectively.

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14
Q

What is the prototype H2 receptor antagonist?

A

Cimetidine

Other examples include ranitidine, famotidine, and nizatidine.

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15
Q

What is the main action of sucralfate?

A

Forms a protective gel at ulcer sites

This gel adheres to epithelial cells and prevents damage from acid.

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16
Q

What are the therapeutic uses of sucralfate?

A
  • Peptic ulceration
  • Treatment of epithelial wounds
  • Chemotherapy-induced mucositis

Sucralfate promotes healing and protects the mucosa.

17
Q

What is a common side effect of sucralfate?

A

Constipation

Other effects are very low, but it can adsorb and reduce the bioavailability of many drugs.

18
Q

True or False: Long-term use of PPIs is associated with an increased risk of certain infections.

A

True

This is likely due to decreased stomach acid production.

19
Q

What is dyspepsia?

A

Dyspepsia refers to indigestion or discomfort in the upper abdomen.

20
Q

What role does sucralfate play in epithelial wound healing?

A

Sucralfate increases the bio-availability of growth factors, especially fibroblast growth factor (FGF), promoting epithelial wound healing.

21
Q

How does sucralfate help in the treatment of chemotherapy-induced mucositis?

A

Sucralfate accelerates the activation of growth factors.

22
Q

What is the use of sucralfate in radiation proctitis?

A

Sucralfate is used as a paste enema.

23
Q

What benefit does sucralfate provide in the prevention of ulceration of diversion colitis?

A

Sucralfate preserves the mucus layer covering the epithelium, reducing inflammation.

24
Q

What is the advantage of sucralfate over H-2 blockers or antacids for stress ulcer prophylaxis?

A

Sucralfate is better for stress ulcer prophylaxis because H-2 blockers or antacids increase the pH of gastric contents, raising the risk of nosocomial pneumonia.

25
Q

What is Behcet Disease and how does sucralfate help?

A

In combination with topical corticosteroids, sucralfate reduces pain and promotes healing of oral ulcers.

26
Q

What is the prototype of prostaglandin analogs?

A

Misoprostol is the prototype of prostaglandin analogs.

27
Q

What is the mechanism of action of misoprostol?

A

Misoprostol stimulates prostaglandin E1 receptors on parietal cells to reduce gastric acid secretion and increases mucus and bicarbonate secretion.

28
Q

What does the term ‘cytoprotection’ refer to?

A

Cytoprotection means protection against gastric mucosal injury by mechanisms other than inhibition or neutralization of gastric acid.

29
Q

What are the pharmacokinetics of misoprostol?

A

Misoprostol is extensively absorbed, with vaginal and sublingual routes showing greater efficacy due to bypassing the liver first-pass effect.

30
Q

What are the adverse effects associated with misoprostol?

A

Adverse effects include diarrhea, abdominal pain, dyspepsia, flatulence, nausea, vomiting, and headache.

31
Q

What are the therapeutic uses of misoprostol?

A

Therapeutic uses include prevention of NSAID-induced gastric ulcers, labor induction, medical abortions, completing miscarriages, and preventing post-partum bleeding.

32
Q

What are bismuth compounds and their action?

A

Bismuth compounds, like bismuth subsalicylate, have weak antacid properties and bactericidal action against Helicobacter pylori.

33
Q

What are the adverse effects of prolonged use of bismuth compounds?

A

Prolonged use can cause encephalopathy, osteodystrophy, darkening of the oral cavity, and dark stools.

34
Q

What is the role of rebamipide?

A

Rebamipide exerts a cytoprotective effect by increasing prostaglandin generation in gastric mucosa and scavenging reactive oxygen species.

35
Q

What does ecabet sodium do?

A

Ecabet sodium increases the formation of PGE2 and PGI2 and inhibits H. pylori enzymes, preventing bacterial adhesion.

36
Q

What is Helicobacter pylori and its associated risks?

A

Helicobacter pylori is a gram-negative rod associated with gastritis and increased risks of gastric and duodenal ulcers, gastric adenocarcinoma, and gastric B-cell lymphoma.

37
Q

What is the rapid urease test for Helicobacter pylori?

A

The rapid urease test (CLO test) diagnoses H. pylori by detecting urease enzyme activity, indicated by a color change in the medium.

module 11 (1 decks)

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