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Gastrointestinal > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

why is histamine released

A

in response to Ach

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2
Q

what does histamine do

A

activates adenylyl cyclase > inc cAMP > inc proton pumps > inc gastric secretion

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3
Q

why is Ach released?

A

parasympathetic cholinergic neurones

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4
Q

other than histamine release, what does Ach do?

A

binds to parietal cells activating PLC and causing inc Ca2+ which causes an inc in proton pump action

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5
Q

what is gastrin’s action?

A

binds to CCK2 Rs activating PLC causing inc Ca2+ > inc proton pump action > inc gastric secretions

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6
Q

what is the pathophysiology of vomiting

A

reverse peristalsis =
toxic material in gut > enterochromaffin cells in mucosa release mediators > sensory afferent nerves activated > AP discharged to brainstem > co-ordination by vomiting centre

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7
Q

causes of vomiting?

A

toxic material, mechanical stimuli, vestibular system, stimuli within CNS

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8
Q

what is the main zone for emetic stimuli?

A

chemoreceptor trigger zone

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9
Q

which receptors activate chemoreceptor trigger zone?

A

dopamine and Ach

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10
Q

what is big risk of NSAID abuse?

A

liver failure & GI ulcer

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11
Q

for patients with cirrhosis/ liver disease, what is the Moto for drug prescription?

A

start low, go slow

give renal excretion medicine

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12
Q

what are the 4 drugs that control gastric secretion?

A

PPIs, NSAIDs, Histamine H2 receptor antagonists, alginates and antacids

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13
Q

name 2 PPIs?

A

omeprazole and iansoprazole

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14
Q

which drug inhibits proton pump so reduces HCl secretion?

A

PPIs

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15
Q

how are PPIs given

A

oral or IV

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16
Q

what are PPIs given for?

A

peptic ulcers, GORD, helicobacter pylori

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17
Q

True/False…

PPIs inc chance of GI tract infection

A

True

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18
Q

named example of NSAID?

A

misoprostol

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19
Q

action of NSAIDs?

A

inhibits COX-1 so less prostaglandins to inc histamine promoting HCl secretion

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20
Q

what are NSAIDs used for?

A

inflammation e.g. IBD

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21
Q

common side effect of NSAIDs?

A

abdominal pain and ulcers

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22
Q

named example of histamine H2 receptor antagonist…?

A

ranitidine

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23
Q

action of histamine H2 receptor antagonist?

A

blocks H2 receptor dec HCl secretion

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24
Q

what is histamine H2 receptor antagonist given for?

A

gastric ulcers, NSAID associated ulcers

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25
Q

what are named exampled of antacids and alginates?

A

gavsicon, peptac, mucogel

26
Q

what is the action of antacids?

A

buffers HCl

27
Q

what are antacids typically given for?

A

GORD

28
Q

what are the 9 anti-motility drugs including antidiarrhoeals

A 
antimuscarinic drugs
anti motility drugs 
amino salicylic acid 
steroids
anti-TNF therapy 
immunosuppressants 
laxatives - bulk forming 
laxatives- osmotic 
laxatives- stimulant
29
Q

what is an example of antimuscarinic drugs?

A

buscopan and atropine

30
Q

what do antimuscarinic drugs do?

A

blocks muscarinic Ach receptors

31
Q

what are antimuscarinics given for?

A

relieve SM spasm, IBS

32
Q

what is of note of antimuscarinic drugs?

A

should be given cautiously in patients with arrhythmias

33
Q

what are antimotility drug examples?

A

loperamide, codeine phosphate

34
Q

what do drugs like loperamide do?

A

electrolyte replacement

35
Q

when are anti motility drugs given?

A

acute diarrhoea, IBS

36
Q

what must be excluded before prescribing anti motility drugs?

A

c.diff infection

37
Q

give named examples of amino salicylic acids?

A

mesalazine, balsalazide, sulphasalazine

38
Q

what is amino salicylic acid given for?

A

UC, occasionally RA

39
Q

give named examples of steroids?

A

Prednisolone, hydrocortisone

40
Q

what are steroid’s action?

A

anti-inflammatory

41
Q

what are 5 side effects of steroids

A

osteoporosis, wt gain, thinning of skin, HT, cataracts, diabetes

42
Q

how does anti-TNF alpha therapy act?

A

blocks pro-inflammatory cytokines and induces apoptosis of T cells

43
Q

what are 2 examples of immunosuppressants?

A

methotrexate, azathioprine

44
Q

what are 3 side effects of immunosuppressants?

A

pancreatitis, leucopaenia, hepatitis

45
Q

what is an example of bulk forming laxatives?

A

ispagula husk

46
Q

what are laxatives given for?

A

constipation, faecal impaction

47
Q

what are examples of osmotic laxatives?

A

lactulose, phosphate enemas, senna

48
Q

what are examples of stimulant laxatives?

A

Senna, glycerol suppository, sodium pico sulphate

49
Q

which of the 3 types of laxatives is given for chronic diarrhoea due to diverticular disease/ IBS?

A

bulk forming laxatives

50
Q

what are the 6 anti emetic drugs?

A 
dopamine D2 receptor antagonists 
anti-muscarinics 
histamine H1 receptor antagonists 
phenothiazines 
5-HT3 receptor antagonist 
neurokinin-1 R antagonist
51
Q

give 3 named examples of dopamine D2 receptor antagonists?

A

domperidone, metoclopramide, chlorpromazine

52
Q

what are dopamine D2 receptor antagonists tx for?

A

nausea and vomiting, GORD for pts who don’t respond to PPIs

53
Q

anti muscarinic named example as anti-emetic?

A

scopolamine

54
Q

what are anti-muscarinics used for in anti-emetic terms?

A

motion sickness

55
Q

what are 2 named examples of histamine H1 receptor antagonists

A

cyclizine, cinnarizine

56
Q

what are histamine H1 receptor antagonists typically used for to treat?

A

vertigo

57
Q

chlorpromazine is an example of which anti-emetic drug?

A

phenothiazines

58
Q

what are phenothiazines used for?

A

nausea due to chemo

59
Q

what are ondanesteron and palonesterone examples of?

A

5-HT3 receptor antagonist

- these must be given cautiously !

60
Q

fossaprepitant and apreptant are examples of…?

A

NK-1 receptor antagonists

Gastrointestinal (24 decks)

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