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Dyspepsia > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

GORD

A

Reflux of acidic contents into oesophagus.
Symptoms: Burning sensation.
Worse when bending.
Causes: Weak sphincter, Increased abdominal pressure; Pregnant, Obese.

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2
Q

Gastritis

A

Inflammation of stomach lining.
NSAIDs
Alcohol

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3
Q

Peptic Ulceration

A 
H. pylori infection --> Gastritis --> Ulceration
Symptoms: 
Sharp stabbing pain-precise.
Vomiting blood
Nausea
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4
Q

Dyspepsia warning signs

A 
Over 55
Tarry stools
Weight loss
Trouble swallowing
Vomiting blood
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5
Q

Cephalic phase

A 
Anticipation of food
Parasympathetic --> 
Ach --> 
Acid Release -->
Gastrin Release
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6
Q

Gastric Phase

A 
Distension by food (eaten)
Ach, Histamine, Gastrin released.
Ach --> Acid release
       --> Pepsinogen release --> Peptide fragments                        -->Stimulate G cells--> More acid release.
       --> Mucus release
Histamine --> Acid release.
Gastrin --> Acid release.
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7
Q

Intrinsic factor

A

Produced by parietal cells.
Promotes vitamin B12 absorption.
Vitamin B12 cofactor in blood cell production.

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8
Q

Saliva production

A

Parasympathetic–>Ach–>Muscarinic –> Enzyme secretion
–>Vasodilation
Vasodilation caused by
BRADYKININ

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9
Q

Acetylcholine

A

Vagus nerve –> Ach –> M3 –> PHOSPHOLIPASE –> Ca2+ = Proton Pump Activated

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10
Q

Histamine

A

Histamine –> H2 –> α unit unbinds –> GDP –> GTP
–> Adenylyl Cyclase
Adenylyl Cyclase –> AMP –> cAMP
cAMP phosphorylates proton pump.

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11
Q

Gastrin

A

Released by antral cells.
CCK2 receptors
Ca2+–> Proton pump activated

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12
Q

Arachidonic acid

A

Cell membrane (released by Phospholipase A2) –> Arachidonic acid –> (Cox pathway) Prostaglandins

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13
Q

Prostaglandins

A

PGE2 and PGI2 inhibit cAMP increase
Supress proton pump
ALSO: Pain, inflammation etc

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14
Q

NSAIDs

A

Stop COX –> Stop prostaglandins –> increase acid
–> stop pain etc
Aspirin: Not for pain, inflammation etc. Use for antiplatelet

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15
Q

Antacids

A 
Sodium bicarbonate
Magnesium hydroxide (Diarrhea) + Aluminium hydroxide (constipation)
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16
Q

Alginates

A

Raft forming

Alginic acid + saliva = viscous foam

17
Q

H2 receptor antagonists

A

Cimetidine (Inhibits CYP450)
Ranitidine (Zantac)
Famotidine

-Best given at night

18
Q

EC50

A

Concentration of agonist that gives 50% response.

19
Q

PPI’s

A

Omeprazole (OTC)
Pantoprazole (OTC)
Lansoprazole

  • Avoid prolonged use; rebound acid hypersecretion
  • Bind to cysteine residues in proton pump
20
Q

Prostaglandin analogues

A

Misoprostol
Inhibit cAMP rise
Suppress acid release.

21
Q

H. pylori treatment

A 
Triple Therapy:
2 Antibiotics: 
Clarithromycin (Drug interactions)
Amoxicillin (Penicillin allergy?)
Metronidazole (NO ALCOHOL)

1PPI

22
Q

Erythropoiesis

A
  • Production of RBC
  • Controlled by Erythroprotein (EPO)
  • Released by peritubular cells in kidney
23
Q

Reticulocyte

A
  • Immature RBC

- Retic count elevated when more erythropoiesis; Bleeding?

24
Q

Fe2+

A
  1. From diet
  2. Fe3+ produced by mucousal cells of duodenum.
  3. Bind to apoferritin
  4. Releaseed into blood, binds to transferrin.
  5. Iron to bone marrow.
  6. Iron to Hb.
25
Q

WBC

A

Neutrophils-Phagocytosis
Eosinophils-Parasite
Basophils-Histamine
Lymphocytes-Antibodies

Production: Colony stimulating factors (proteins)

26
Q

Haematocrit

A

Packed cell volume

% volume that is RBC

27
Q

Mean corpuscular volume

A

Volume of individual RBC

Measured in fl=10-15 of a litre

28
Q

Blood Groups

A

A: A antigens, B antibodies
B: B antigens, A antibodies
AB: AB antigens
O: No antigens but a + b antibodies

29
Q

Rhesus D

A
  • Mother Rhesus -ve
  • Child Rhesus +ve
  • Mother produces antibodies against Rhesus D
  • Antibodies attack 2nd child.
30
Q

Anaemia symptoms

A

Shortness of breath
Weakness
Lethargy
Tachycardia-Higher heart rate as thin blood

31
Q

Iron deficient anaemia

A

Microcytic (smaller RBC)

Causes: Diet (rare), Menstruation, Pregnancy

32
Q

Megaloblastic anaemia

A

Macrocytic (larger RBC)
Defective DNA synthesis, bone marrow contains megaloblasts.
VitB12/Folate deficiency.

33
Q

Pernicious anaemia

A

Lack of intrinsic factor for B12 absorption

Autoimmune disease

34
Q

Haemolytic anaemia

A

Higher rate of RBC destruction

Spherocytosis: Genetic, Abnormal reduction in RBC membrane protein, cells fragile.

35
Q

Sickle Cell anaemia

A

Genetic
Abnormal Hb, RBC=Sickle shape
Block microcirculation, causes haemolytic anaemia

36
Q

Aplastic anaemia

A

Insufficient production of RBC, WBC + Platelets
Tired, Bleeding, Infections
Causes: Viral, drugs

37
Q

Polycythaemia

A 
Higher RBC
Higher blood viscosity
Causes: 
Primary-Bone marrow
Secondary-More EPO; Altitude, smoking

Dyspepsia (4 decks)

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