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pharmacology Flashcards

1
Q

What do mucus cells secret in the gastric crypt?

A
  • bicarbonate

- mucus

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2
Q

What do parietal cells secret in the gastric crypt?

A
  • hydrochloric acid
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3
Q

What do enterochromaffin-like cells secrete in the gastric crypt?

A
  • histamine
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4
Q

What do G cells secrete in the gastric crypt?

A
  • gastrin
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5
Q

What do D cells secrete in the gastric crypt?

A
  • somatostatin
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6
Q

What do chief cells secrete in the gastric crypt?

A
  • pepsinogen
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7
Q

What does histamine bind to?

A
  • Histamine H2 receptors in the gastric lumen

- subsequent activation of adenylyl cyclase

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8
Q

What causes the release of histamine by enterochromaffin-like cells?

A
  • stimulation by acetylcholine
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9
Q

What happens to the number of protons pumps when histamine binds to H2 receptors?

A
  • activation of adenylyl cylase
  • increase in cAMP
  • increases number of proton pumps increasing gastric acid secretion
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10
Q

What is ACh released by?

A
  • parasympathetic cholinergic neurons
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11
Q

what does ACh bind to on parietal cells?

A
  • binds to muscarinic (M3) ACh cells receptors
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12
Q

What happens with an increase in intracellular Ca2+?

A
  • evokes cell signalling pathways
  • increases number of proton pumps
  • increases gastric acid secretion from parietal cells
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13
Q

What does gastrin bind to on parietal cells?

A
  • CCK2 receptors

- causes an increase in intracellular Ca2+ levels

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14
Q

What does somatostatin bind to and what does it cause?

A
  • binds to SST2R receptors

- inhibits adenylyl cyclase

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15
Q

What affect does somatostatin have on the levels of cAMP?

A
  • decreases cAMP

- Decreases gastric acid secretion from parietal cells

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16
Q

What affects do antacids has and how do they achieve this?

A
  • reduce the symptoms of excessive gastric secretion by buffering HCl
  • buffering system
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17
Q

Name 2 examples of antacids?

A
  • gaviscon

- peptac

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18
Q

What do NSAIDs disrupt in terms of gastric secretions?

A
  • inhibit COX-1
  • Reduced availability of prostaglandins results in histamine secretion from enterochromaffin-like cells
  • promoting HCl secretion
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19
Q

What does misoprostol do?

A
  • analogue of prostaglandin E1
  • analogue agonist of prostaglandin E1
  • Reduces gastric acid secretions
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20
Q

What are proton pump inhibitors

A
  • irreversibly inhibit H+/K+ ATPase pump
  • reduces HCl secretion
  • examples: lansoprazole, omeprazole etc.
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21
Q

What is an effect of having a low pH in the stomach?

A
  • reduces defences against infection via the GI tract
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22
Q

Examples of histamine H2 receptor antagonists, and what do they do?

A
  • ranitidine, cimetidine

- block H2 receptor, eventually reduces HCl secretion

23
Q

Explain the effect of a H.pylori infection on the gastric lining

A
  • The H. pylori bacteria weakens the protective mucous coating of the stomach and duodenum, - - allowing acid to get through to the sensitive lining beneath. -Both the acid and the bacteria irritate the lining and cause a ulcer.
24
Q

How would you treat a H.pylori infection that forms a peptic ulcer?

A
  • Proton pump inhibitors

- antibiotics (clarithromycin and amoxicillin)

25
Q

What is vomiting triggered by?

A
  • triggered by the vomiting/emetic centre located in the brain stem
26
Q

What is unusual about the blood brain barrier in the chemoreceptor trigger zone?

A
  • fairly porus
  • toxins can get in and activate the neurons within that area
  • eventually resulting in the vomiting reflex
27
Q

What are the main neurotransmitters involved in nausea/vomiting?

A
  • 5-HT
  • dopamine
  • ACh
28
Q

Antihistamines act on what receptor?

A
  • H1 receptor antagonists
29
Q

What are some examples of antihistamines?

A
  • cyclizine

- promethazine

30
Q

5 examples of anti-emetic drugs?

A
  • anti-histamines
  • anti-muscarinics
  • 5HT3 receptor antagonists
  • dopamine receptor antagonists
  • neurokinin-1 receptor antagonists
31
Q

Side effects of antihistamines?

A
  • sedation

- because they act at H1 receptors in the brain

32
Q

Antimuscarinics act at what receptor?

A
  • muscarinic acetylcholine receptor antagonist
33
Q

Side effects of antimuscarinics

A
  • dry mouth
  • tachycardia
  • constipation
34
Q

How do 5-HT3 receptor antagonists work as an anti-emetic?

A
  • antagonist in the chemoreceptor trigger zone of the medulla in the hindbrain and in the GI tract
35
Q

Side effects of 5-HT3 receptors?

A
  • constipation
  • diarrhoea
  • headache
36
Q

What receptors do dopamine receptor antagonists act on for an anti-emetic effect?

A
  • D2 receptors in the chemoreceptor trigger zone of the medulla in the hindbrain and in GI tract
37
Q

Side effects of dopamine receptor antagonists?

A
  • diarrhoea
38
Q

How do antidiarrhoeal drugs work?

A
  • electrolyte replacements

- some opiates bind to µ-opiate receptors

39
Q

What drugs can be used in the prevention and treatment of peptic ulcers?

A
  • Proton Pump Inhibitors

- H2 receptor antagonists

40
Q

What drugs would be used to treat GORD?

A
  • H2 receptor antagonists
  • Proton Pump inhibiotrs
  • Alignates and Antacids
  • Antiemetics
41
Q

What are the metabolic functions of the liver?

A
  • regulation of carbohydrate, lipid and amino acid metabolism
42
Q

What hormones are deactivated in the liver?

A
  • insulin
  • glucagon
  • ADH
  • steroid hormones
43
Q

What hormones are activated in the liver?

A
  • T3

- 25- Hydroxyvitamin D2

44
Q

What storage function does the liver have?

A
  • fat soluble vitamins
  • water soluble vitamins (B12)
  • iron, copper
  • glycogen
45
Q

What proteins are synthesised in the liver?

A
  • albumin
  • apolipoprotiens
  • carrier proteins
46
Q

What protection effect does the liver have?

A
  • kupffer cells

- production of immune factors

47
Q

What dexotification function does the liver have?

A
  • endogenous (bilirubin)

- drugs etc.

48
Q

What happens to bile between meals?

A
  • produced continously
  • stored and concentrated in the gallbladder
  • sphincter of Oddi closed
49
Q

What happens to bile during meals?

A
  • chyme in the duodenum, stimulates the smooth muscle of the gallbladder to contract (CCK, vagal impulses)
  • sphincter of Oddi opens
50
Q

What do secretions from hepatocytes contain?

A
  • primary bile acids
  • water and electroylets
  • IgA
51
Q

What drug may be suitable for cholelithiasis?

A
  • ursodeoxycholic acod
52
Q

What are resins used to treat?

A
  • hyperlipidaemia
  • cholestatic jaundice
  • bile acid diarrhoea
53
Q

Explain how hepatic encephalopathy occurs?

A
  • severe hepatic failure
  • detoxification of ammonia via urea cycle fails
  • blood NH3 levels rise exerting a toxic effect
54
Q

What may be used as indirect treatments of hepatic encehpaholpathy?

A
  • lactulose

- antibiotics

GI (36 decks)

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