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GI > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Mucus cells secrete what?

A

Mucus and bicarbonate

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2
Q

Parietal cells secrete what?

A

Hydrochloric acid

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3
Q

Enterochoromaffin like cells secrete what?

A

Histamine

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4
Q

G cells secrete what?

A

Gastrin

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5
Q

D cells secrete what?

A

Somatostatin

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6
Q

Chief cells secrete what?

A

Pepsinogen

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7
Q

HCl secretion from gastric parietal cells includes which 4 channels?

A
  • chloride bicarbonate exchanger
  • chloride potassium symporter
  • H+/K+ ATPase (proton pump)
  • carbonic anhydrase
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8
Q

Describe the action of histamine

A
  • secreted by the enterochromaffin-like cells in the gastric glands in response to stimulation by ACh
  • histamine binds to H2 receptors with subsequent activation of adenylyl cyclase
  • the increase in cAMP increases the number of proton pumps, increasing gastric acid secretion from parietal cells
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9
Q

Describe the action of ACh

A
  • released by parasympathetic cholinergic neurons
  • ACh binds to muscarinic ACh receptors on parietal cells with subsequent activation of PLC
  • the increase in intracellular Ca2+ evokes cell signalling pathways that increase the number of proton pumps, increasing gastric acid secretion from parietal cells
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10
Q

Describe the action of gastrin

A
  • released by G cells
  • gastrin binds to CCK2 receptors on parietal cells with subsequent activation of PLC
  • the increase in intra cellular Ca2+ increases the number of proton pumps, increasing gastric acid secretion from parietal cells
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11
Q

Describe the action of somatostatin

A
  • secreted by D cells in the gastric glands
  • binds to SST2R receptors, inhibiting adenylyl cyclase
  • the decrease in cAMP results in decreased gastric acid secretion from parietal cells
  • somatostatin binding to SST2R receptors on enterochromaffin cells results in reduced histamine release and decreased gastric acid secretion from parietal cells
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12
Q

Mechanism of action of antacids

A

Reduce the symptoms of excessive gastric acid secretion by buffering HCl

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13
Q

Mechanism of action of NSAIDs

A
  • disrupt the production of prostaglandins by inhibiting COX-1
  • the reduced availability of prostaglandins results in histamine secretion from enterochromaffin like cells, promoting HCl secretion from parietal cells
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14
Q

What drug is an analogue of prostaglandin E1?

A

Misoprostol

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15
Q

Describe the features of misoprostol

A
  • indicated for prophylaxis of NSAID induced peptic ulcers
  • side effects; abdominal pain and diarrhoea
  • also induces labour
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16
Q

Name some proton pump inhibitors

A
  • lansoprazole
  • omeprazole
  • pantoprazole
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17
Q

Describe the mechanism of action of proton pump inhibitors

A
  • irreversibly inhibit H+/K+ ATPase pump which reduced HCl secretion
  • indicated for benign gastric acid ulceration and NSAID-associated gastric ulceration, gastro-oesophageal reflux disease and Zollinger-Ellison syndrome
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18
Q

Side effects of proton pump inhibitors

A
  • increased stomach pH reduces defences against infection via the GI tract
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19
Q

Name some histamine H2 receptor antagonists

A
  • ranitidine
  • cimetidine
  • famotidine
  • nizatidine
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20
Q

Mechanism of action of histamine H2 receptor antagonists

A
  • blocking the H2 receptor eventually reduces HCl secretion
  • complete block of H2 receptors results in a rapid effect
  • indicated for benign gastric acid ulceration and NSAID-associated gastric ulceration
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21
Q

How do you eradicate h. pylori infection?

A

PPIs + antibiotics (clarithromycin and amoxicillin or metronidazole)

22
Q

Nausea and vomiting may be attributed to what?

A
  • anxiety
  • motion sickness
  • migraine
  • pregnancy
  • side effects of drugs
23
Q

Vomiting is a defence mechanism triggered by what?

A

The vomiting / emetic centre located in the brain stem

24
Q

Name the chemoreceptor trigger zone

A
  • 5HT3Rs

- D2Rs

25
Q

Name the main neurotransmitter systems involved in nausea / vomiting

A

5-HT, dopamine and Ach

26
Q

What are the three categories of anti-emetic drugs?

A
  • antihistamines (H1 receptor antagonists)
  • antimuscarinics (muscarinic acetylcholine receptor antagonists)
  • 5-HT3 receptor antagonists
27
Q

Name some antihistamines (H1 receptor antagonists)

A
  • cyclizine
  • promethazine
  • diphenhydramine
28
Q

Name some antimuscarinics (muscarinic acetylcholine receptor antagonists)

A
  • scopolamine (hyoscine)
29
Q

Name some 5-HT3 receptor antagonists

A
  • ondansetron
  • granisetron
  • palonosetron
30
Q

Name the two categories of anti-emetic drugs

A
  • dopamine receptor antagonists

- neurokinin-1 receptor antagonists

31
Q

Name some dopamine receptor antagonists

A
  • chlorpromazine
  • droperidol
  • haloperidol
  • prochlorperazine
  • metoclopramide
32
Q

Name some neurokinin-1 receptor antagonists

A
  • fosaprepitant

- apreptant

33
Q

Mechanism of action of antihistamine (H1 receptor antagonists)

A
  • act primarily as antagonists at histamine H1 receptors in the brain
  • indicated for nausea and vomiting > motion sickness
34
Q

Name side effects of antihistamine (H1 receptor antagonists)

A
  • sedation as they action at H1 receptors in the brain
35
Q

Mechanism of action of antimuscarinics (muscarinic ACh receptor antagonists)

A

Act primarily as antagonist at muscarinic ACh M1 receptors in the brain. Indicated for motion sickness

36
Q

Name side effect of antimuscarinics

A
  • dry mouth
  • tachycardia
  • constipation
37
Q

Mechanism of action of 5-HT3 receptor antagonists

A

Act primarily as antagonists at 5-HT3 receptors in the chemoreceptor trigger zone of the medulla in the hindbrain and also the 5-HT3 receptors in the GI tract

38
Q

Name side effects of 5-HT3 receptor antagonists

A
  • constipation
  • diarrhoea
  • headache
39
Q

Mechanism of action of dopamine receptor antagonists

A

Act primarily as antagonists at D2 receptors in the chemoreceptor trigger zone of the medulla in the hindbrain (except domperidone) and also the D2 receptors in the GI tract

40
Q

Name side effects of dopamine receptor antagonists

A
  • diarrhoea

- extrapyramidal side effects (except domperidone)

41
Q

Mechanism of action of neurokinin-1 receptor antagonists

A

Act primarily as antagonists at NK1 receptors in the GI tract and the chemoreceptor trigger zone of the medulla in the hindbrain blocking the effects of substance P (which evokes vomiting)

42
Q

Name side effects of neurokinin-1 receptor antagonists

A
  • constipation

- headache

43
Q

Name the two categories of drugs that affect GI motility

A
  • anti-diarrhoeal drugs

- laxatives

44
Q

Name some anti-diarrhoeal drugs

A
  • loperamide

- diphenoxylate

45
Q

Name some laxatives

A
  • ispaghula husk
  • senna
  • lactulose
46
Q

Describe anti-diarrhoeal drugs

A
  • electrolyte replacements
  • loperamide and diphenoxylate are opiates (binds to u-opiate receptors) that has reduced effect on the brain
  • sometimes combined with atropine (muscarinic Ach receptor antagonist)
  • high doses of loperamide have been associated with drug abuse
47
Q

Name side effects of anti-diarrhoeal drugs

A
  • constipation
  • sedation
  • respiratory depression
48
Q

Mechanism of action of ispaghula husk

A

Bulk forming laxative

49
Q

Mechanism of action of lactulose

A

Osmotic laxative&raquo_space; hepatic

50
Q

Mechanism of action of senna

A

Stimulant purgative, increases electrolyte / water secretion

GI (11 decks)

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