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Gastrointestinal Module > Pharmaco ulcer/ antiemetic > Flashcards

Pharmaco ulcer/ antiemetic Flashcards

1
Q

What is peptic ulcer disease

A

Inflamed lesions of the mucosa of the upper GIT

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2
Q

Peptic ulcer disease causes

A

Increased acid secretion
Decreased PG secretion
H pylori infection
Increased pepsin production

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3
Q

Would eradication of h pylori reduce recurrence of ulcers

A

Yes

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4
Q

What is dyspepsia

A

Heartburn or indigestion

Epigastric discomfort after meals

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5
Q

Is dyspepsia associated with GERD

A

Yes

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6
Q

What is GERD

A

Gastro esophageal reflux disease is backflow of acid chyme from stomach into the esophagus

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7
Q

Symptoms of GERD

A

Dyspepsia
Dysphasia ( severe case)
Chest pain ( severe case)
Sore throat if gets there

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8
Q

GERD complications

A

Esophageal ulcers
Esophageal erosions
Narrowing of esophagus

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9
Q

What is zollinger Ellison syndrome

A

Formation of tumors in the pancreas or the duodenum

Cause increase in gastrin and therefore increase in acid secretion

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10
Q

Acute gastroparesis

A

Delay in gastric emptying seen after surgery or trauma or infection

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11
Q

Irritable bowel syndrome

A

Non inflammatory disease with altered bowel movement causing either diarrhea or constipation

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12
Q

Comstipation

A

Difficult passage of hard and dry stool into the anus

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13
Q

Constipation treatment

A

Increased fibres in diet ( fruits , vegetables, whole grains )

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14
Q

Vomiting

A

Physiological Reflex due to presence of irritating substance in GIT or blood
Generally preceded by nausea

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15
Q

Diarrhea

A

Increased frequency of elimination of stool as well as altered consistency of stools

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16
Q

What is a cause of severe diarrhea

A

Bacterial infection

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17
Q

What hormones stimulate acid secretion

A

Gastrin
Acetylcholine
Histamine

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18
Q

What receptors do histamine bind to in GIT

A

H2 receptors

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19
Q

What are the drugs that inhibit acid secretion

A

H2 antagonists
Anticholinergic
Proton pump inhibitors
PG analogs

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20
Q

How can you treat acid hypersécrétion

A

Inhibit acid secretion from parietal cells
Neutralize acidity
Cytoprotective agents
Eradicate h pylori

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21
Q

Antacids action

A

Neutralize acidity of stomach

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22
Q

Types of antacids

A

Aluminum hydroxide
Magnesium hydroxide
Carbonates

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23
Q

Aluminum hydroxide reacting with acid in stomach produce …

A

Water

Insoluble aluminum chloride salt which will be excreted ( increased risk of constipation)

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24
Q

Aluminium hydroxide reduces absorption of …

A

Tetracyclines

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25
Q

What is the effect of mgcl2 formed by magnesium hydroxide in stomach on the intestine ?

A

Laxative effect

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26
Q

Products you can combine antacids with

A

Maalox
Mucogel
Gaviscon
Gastrocote

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27
Q

Types of carbonate antacids

A 
Calcium carbonate ( effective) 
Sodium bicarbonate ( fast)
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28
Q

Are antacids used as primary treatment for peptic ulcer ?

A

NO

Just dyspepsia

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29
Q

Action of histamine antagonists

A

They inhibit cAMP and protein kinases activation
Inhibit proton pump
Reduce pepsin

30
Q

Examples of H2 receptor antagonists

A

Cimetidine
Ranitidine
Nizatidine
Famotidine

31
Q

Where are H2 antagonists absorbed

A

Gut

32
Q

Diseases that you can treat with H2 antagonists

A

Dyspepsia
Peptic ulcers
GERD

33
Q

Cimetidine adverse effect

A

Gynecomastia

34
Q

Cimetidine inhibits …

A

CYP450
CYP2C9
CYP2D6
CYP3A4

35
Q

Proton pump inhibitors inhibit reversible or irreversibly the proton pump?

A

Irreversibly

36
Q

Which drug is the most longer acting one ? H2 antagonists or proton pump inhibitors

A

Proton pump inhibitors

37
Q

Types of proton pump inhibitors

A 
Omeprazole
Lansoprazole
Pantoprazole 
Rabeprazole
Esomeprazole
38
Q

Disease treated by proton pump inhibitors

A

Peptic ulcer ( 4 weeks)
Zollinger-Ellison syndrome
GERD (omeprazole, lansoprazole)

39
Q

Side effects of using atropine for peptic ulcer

A

Blurred vision

Urinary retention

40
Q

M1 selective antagonist drug name

A

Pirenzepine

41
Q

Role of cytoprotective agents in peptic ulcer management

A

Physical barrier over surface of ulcer

42
Q

Cytoprotective agents in peptic ulcers drugs name

A

Sucralfate
Bismuth chelate
Misoprostol

43
Q

Sucralfate action

A

Protect ulcer
Inhibit pepsin
Stimulates PG synthesis
Stimulates mucus and bicarbonate

44
Q

When do you use sucralfate

A

If patient can’t handle h2 antagonists or proton pump inhibitors drugs

45
Q

Bismuth chelate Action

A 
Protect ulcer
Adsorbs Pepsin
Stimulates PG synthesis 
Stimulates bicarbonate secretion 
Used for eradication of h pylori in combination
46
Q

Can bismuth chelate cause encephalopathy ?

A

Yes in case of renal excretion impairment

47
Q

Misoprostol nature

A

PG E1 analogue

48
Q

How do you use misoprostol

A

As prophylaxis against peptic ulcer for patients taking NSAIDs

49
Q

Can you take misoprostol in pregnancy ?

A

No can induce labor

50
Q

What drugs are used in h pylori eradication ?

A

Proton pump inhibitors OR H2 receptor antagonists
+
(2 or more)
Amoxicillin , clarithromycin, bismuth chelate, metronidazole, tetracycline

51
Q

Most common h pylori treatment

A

Omeprazole
Amoxicillin
Metronidazole

52
Q

What initiates vomiting

A

Nucleus of cells in medulla forming vomiting center

53
Q

How do you activate the vomiting center

A

By activating afférent fibers from chemoreceptors trigger zone, the inner ear, or the cortex

54
Q

How do you activate the chemoreceptors trigger zone ?

A

Stimulation of serotonin, dopamine, histamine, muscarinic receptors

55
Q

What are the types of antiemetics

A 
Serotonin receptors antagonist 
Dopamine receptor antagonists 
Cannabinoids
Histamine ( H1)receptor antagonist 
Antimuscarinic receptors
Steroids
56
Q

Serotonin receptors antagonists name

A

Ondansetron

Granisetron

57
Q

Serotonin receptor antagonist action

A

Block 5-HT3 receptors in CTZ and GIT

reduce stimulation of vomiting center peripherally and centrally

58
Q

When do you use ganisetron and ondansetron?

A

In chemotherapy induced Emesis
Postoperative emesis

Not for non severe emesis

59
Q

What can you add to ondansetron therapy failure to make it work

A

Dexamethasone

60
Q

Types of dopamine receptor antagonists

A

Prochlorperazine
Domperidone
Metoclopramide

61
Q

Which one is more effective in chemotherapy induced emesis , ondansetron or prochlorperazine?

A

Ondansetron

62
Q

Metrocloprqmide action

A

Act on D2 receptor and 5-HT3 ( so used in GERD)

63
Q

Types of synthetics cannabinoids

A

Nabilone

Dronabinol

64
Q

Adverse effects of cannabinoids

A 
Drowsiness 
Dry mouth 
Mood change 
Postural hypotension 
Hallucinations
65
Q

Antiemetics Antihistamines

A

Dimenhydrinate
Meclizine
Promethazine

66
Q

What antihistamines do you use for motion sickness

A

Dimenhydrinate

Meclizine

67
Q

Antimuscarinic used for motion sickness

A

Scopolamine

68
Q

Antispasmodic agents goal

A

Relieve cramps or spams of stomach and intestines

69
Q

2 groups of antispasmodics

A

Anticholinergics ( autonomie innervation)

Relaxants ( affect smooth muscle directly)

70
Q

Antispasmodic anticholinergic

A

Hyoscine
Propantheline
Dicycloxerine

71
Q

Muscles relaxants antispasmodic

A

Mebeverine
Drotaverine
Alverine

Gastrointestinal Module (15 decks)

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