Pharmacology Flashcards
Multiple inputs can send signals to the _ region in the medulla that triggers nausea and vomiting
Multiple inputs can send signals to the area postrema region in the medulla that triggers nausea and vomiting
1. Cerebral cortex
2. Vestibular system
3. GIT
4. Chemotrigger zones
The two anti-cholinergic drugs used to reduce GI spasming in IBS-D are _ and _
The two anti-cholinergic drugs used to reduce GI spasming in IBS-D are hyoscyamine and dicyclomine
Diclycomine and Hyoscyamine work by (antagonizing/ agonizing) _ receptors
Diclycomine and Hyoscyamine work by antagonizing M3 receptors
What are some off-target toxicities of dicyclomine and hyoscyamine?
M3 receptors are also found in the eyes, salivary glands, bladder; they might cause dryness in these places
* Blurred vision
* Xerostomia
* Urinary retention
Opiod receptor agonists can be used to treat (diarrhea/conspitation)
Opiod receptor agonists can be used to treat diarrhea (anti-diarrheals)
Name three opiod receptor agonists that are used as anti-diarrheals
Name three opiod receptor agonists that are used as anti-diarrheals:
1. Eluxadoline
2. Loperamide
3. Diphenoxylate
What is the mechanism of eluxadoline and other opiods in treating IBS-D?
Opiods slow the firing of enteric neurons to reduce GI motility
* In other words, they almost “induce constipation”
(True/False) Eluxadoline crosses the BBB
False; Eluxadoline and other opiod anti-diarrheals do not cross the BBB
_ is a serotonin antagonist that can be used to treat IBS-D in women
Alosetron is a serotonin antagonist that can be used to treat IBS-D in women
Alosetron blocks _ cells from releasing 5-HT which normally stimulates GI motility
Alosetron blocks enterochromaffin cells from releasing 5-HT which normally stimulates GI motility
Name (3) bile acid sequestrants that are used to treat IBS-D caused by bile acid malabsorption
Name (3) bile acid sequestrants that are used to treat IBS-D caused by bile acid malabsorption:
1. Cholestyramine
2. Colesevelam
3. Colestpol
_ is a surfactant stool softener that can be used to treat constipation
Docusate is a surfactant stool softener that can be used to treat constipation
Name (4) osmotic stool softeners that passively facilitate defecation
Name (4) osmotic stool softeners that passively facilitate defecation:
1. Lactulose
2. Magnesium citrate
3. Sorbitol
4. Polyethylene glycol
Mechanism of action of lactulose (in setting of constipation)
Lactulose acidifies the gut, converting NH3 –> NH4+ which is then non-absorbable
_ and _ are two drugs that “tickle the colon” to promote contraction and relaxation
Bisacodyl and Senna are two drugs that “tickle the colon” to promote contraction and relaxation
_ is a laxative that activates Cl- channels to promote the movement of water into the colon
Lubiprostone is a laxative that activates Cl- channels to promote the movement of water into the colon
_ and _ are two guanylate cyclase agonists which work by increasing cGMP and stimulating the CFTR receptor in the gut
Linaclotide and Plecanatide are two guanylate cyclase agonists which work by increasing cGMP and stimulating the CFTR receptor in the gut
Odansetron is an anti-emetic which blocks _
Odansetron is an anti-emetic which blocks serotonin receptors
Proclorperazine is an anti-emetic which works by blocking _
Proclorperazine is an anti-emetic which works by blocking dopamine receptors
Metoclopramide is an anti-emetic which is a _
Metoclopramide is an anti-emetic which blocks dopamine receptors
Aprepitant is an anti-emetic which works by blocking _
Aprepitant is an anti-emetic which works by blocking neurokinin receptors (NK1)
Scopalamine is an anti-emetic which blocks _
Scopalamine is an anti-emetic which blocks M1 receptors
One toxicity of metocloperamide is _ , which are repetitive, involuntary movements
One toxicity of metocloperamide is tardive dyskinesia which are repetitive, involuntary movements
* Also causes restlessness, parkinsonian effects, hyperprolactinemia
H2 antagonists work by blocking _
H2 antagonists work by blocking H2 receptors on basolateral membrane of the parietal cells
The H2 receptor on the parietal cell is a _ protein coupled receptor
The H2 receptor on the parietal cell is a Gs protein-coupled receptor
* H2 blockers block the activation of cAMP
H2 blockers cause (reversible/ irreversible) blockage
H2 blockers cause reversible blockage
H2 blockers are taken before eating and are used to treat _
H2 blockers are taken before eating and are used to treat gastritis, GERD, PUD
H2 blockers end with “_”
H2 blockers end with “-idine”
* Cimetidine, famotidine, nizatidine
_ is an H2 blocker that causes CYP450 inhibition and can cause gynecomastia
Cimetidine is an H2 blocker that causes CYP450 inhibition and can cause gynecomastia
* It can also cross the BBB and can increase Cr levels
_ drug side effect includes increased risk for C. diff, risk for pneumonia, acute interstitial nephritis
PPIs drug side effect includes increased risk for C. diff, risk for pneumonia, acute interstitial nephritis
* Also reduced iron, B12, Ca2+, Mg2+ levels with prolonged use
PPI drugs end with the suffix _
PPI drugs end with the suffix “-azole”
* Omeprazole, pantoprazole, lansoprazole
Side effects for all antacids include:
Side effects for all antacids include: affecting drug bioavailability and renal excretion due to pH alteration
* Can also cause hypokalemia
Bulk forming laxatives like _ and _ are soluble fibers that draw water into the GIT lumen and promote peristalsis
Bulk forming laxatives like Psyllium and Methylcellulose are soluble fibers that draw water into the GIT lumen and promote peristalsis
Lubiprostone works by _
Lubiprostone works by directly activating Cl- channels to increase intestinal fluid secretions
Ondancetron is a drug that works by _
Ondancetron is a drug that works by antagonizing 5-HT3 receptors
* Anti-emetic drug
* Can cause QT prolongation or serotonin syndrome
Metoclopramide is a D2 receptor antagonist that treats nausea/vomiting and also _ gastric emptying and _ LES tone
Metoclopramide is a D2 receptor antagonist that treats nausea/vomiting and also increases gastric emptying and increases LES tone
_ is an anti-nausea medication that is also used to treat gastroparesis
Metoclopramide is an anti-nausea medication that is also used to treat gastroparesis
* And chronic GERD
