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GI Week 1 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

what is the receptor on pre synaptic parasympathetic cells that decreases action of ACh?

A

dopamine receptors

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2
Q

what is the receptor on pre synaptic parasympathetic cells that increases action of ACh?

A

motilin receptors

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3
Q

what is the MOA of metoclopramide?

A

inhibits the dopamine receptor on parasympathetic nerves to increas ACh release

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4
Q

what is metoclopramide used for?

A

gastroperesis

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5
Q

since metoclopramide is a dopamine inhibitor…where are a lot of toxicities found with it?

A

CNS

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6
Q

name the two common CNS toxicities with metoclopramide ?

A

acute dystonia and tardive dyskinesia

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7
Q

what is the CNS pathway that metoclopramide inhibits that leads to acute dystonia and tardive dyskinesia?

A

nigrostriatal pathway

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8
Q

what hormone can metoclopramide cause to be at elevated levels? why?

A

prolactin…due to anti dopamine effects and dopamine usually inhibits prolactin release

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9
Q

name the antibiotic that can treat gastroparesis

A

erythromycin

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10
Q

what is the MoA od erythromycin for gastroporesis?

A

activates the motilin receptor on parasymp nerves

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11
Q

what is an issue with erythromycin that renders it less effective long term?

A

tachyphylaxis…or desensitization to the drug

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12
Q

what is the name of the direct acting parasymp agonist to treat gastroparesis?

A

Bethanechol

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13
Q

what is the MoA of bethanechol?

A

directly binds M3 receptors

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14
Q

what is the name of the indirect para agonist for gastroparesis?

A

Neostigmine

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15
Q

what is the MoA of neostigmine?

A

inhibits AChEsterase so increases ACh in synaptic junction

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16
Q

how is neostigmine administered? what must you have on hand to give? why/

A

IV
Antidote of atropine
Because it has all toxicities associated with ramping up the parasympathetic system

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17
Q

what is the drug that serves as a barrier for acid in ulcerative diseases?

A

sucralfate

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18
Q

what is the MoA of sucralfate?

A

polymerizes at low pH and has negative charge so can bind to positive charge of exposed cells in gut

19
Q

how do antacids work?

A

they serve as buffers for acid in the GI tract

20
Q

name the three common bases in antacids

A

bicarbonate
carbonate
hydroxate

21
Q

bicarbonate can be absorbes so if you take a lot of it as an antacid what can this lead to?

A

metabolic alkalosis

22
Q

why do you administer Al(OH) and Mg(OH) together

A

because Al causes constipation and Mg causes diarrhea so they cancel each other out

23
Q

what molecule can get low when taking antacids? why is this?

A

hypophosphatemia because the antacids can bind the phosphate and make it insoluble and therefore cannot absorb it

24
Q

what does histamine cause in the stomach? what molecule stimulate histamine release and what cell releases?

A

causes acid release

gastrin causes enterochromaffin cells to release histamine

25
Q

what histamine receptors do histamine blockers for stomach acid target? is this one different from allergy histamine receptor?

A

H2…yes this is different than the H1 in the nasal area

26
Q

name the four common anti histamine drugs for stomach acid

A

cimetidine
ranitidine
famotidine
nizatidine

27
Q

what is the problem with cimetidine?

A

inhibits a bunch of CYPs in the liver

28
Q

what drugs does cimetidine interact with through its CYP inhibition?

A

warfarin
clopidogrel
oral contraceptives
theophylline

29
Q

what cells do PPIs target? what molecule on the cell?

A

parietal cells K+/H+ pump

30
Q

do PPIs work by binding the pump in the cell or in the lumen?

A

luminal side of the pump

31
Q

name the three toxicities of PPIs

A

vitamin B12 malabsorption
hypomagnesia
c diff

32
Q

why do PPIs lead to vitamin B12 malabsorption?

A

because Vitamin B12 is bound to protein when ingested and the stomach acid promotes the unbinding and without the acid the B12 does not get freed and absorbed

33
Q

what type of kidney issue can PPIs cause?

A

AIN

34
Q

what is the ending of the PPIs?

A

prazoles

35
Q

how do PPIs end up in the luminal area surrounding the parietal cells?

A

pH trapping…get + charge once in lumen and cannot leave

36
Q

what is the role of prostaglandin 2 (PGE2) in stomach acid production?

A

it inhibits the production of stomach acid

37
Q

name the drug that is a mimic of PGE2 that can help with stomach acid problems?

A

misprostol

38
Q

what stomach acid drug should not be given during pregnancy?

A

misoprostol

39
Q

what are the two main neurotransmitters that regulate the vomitting center?

A

serotonin and dopamine

40
Q

name the serotonin antagonist that works as an anti emetic?

A

ondansetron

41
Q

what is the toxicity of ondansetron to worry about?

A

prolonged QT interval

42
Q

name the two dopamine antagonists that are anti emetics?

A

prochlorperazine

promethazine

43
Q

why do prochloroperazine and promethazine not work as well for gastroparesis like metoclopramide does?

A

because they work more in the CNS and metoclopramide works mainly in stomach

44
Q

name the three common toxicities of prochloroperazine and promethazine

A

prolonged QT interval
acute dystonia
tardive dyskinesia

GI Week 1 (5 decks)

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