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D1 Spring > Pharmacology - Drugs Acting on GI Tract (Exam 4) > Flashcards

Pharmacology - Drugs Acting on GI Tract (Exam 4) Flashcards

1
Q

Functions of GI tract

A

Digest/absorb ingested nutrients
Excrete waste products of digestion

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2
Q

GI diseases often present with _______ ___________

A

oral manifestations

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3
Q

GI related drug for treating Xerostomia

A

Sialagogues (cholinergic agonists)

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4
Q

GI related drug for short term control of salivary flow in dental procedures

A

Antisialoagogues (anticholinergics)

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5
Q

GI related drug for treating nausea and vomiting

A

Antiemetics

(antihistamines, D2 antagonists, cannabinoids)

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6
Q

Name 2 causes of nausea and vomiting in dentistry

A
  1. Swallowing blood after oral surgery
  2. Opioid analgesics during and post surgery
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7
Q

Acid peptic diseases are caused by damage in GI mucosa from ____________ and ___________ (ON EXAM)

A

gastric acid and pepsin

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8
Q

2 most common acid peptic diseases

A
  1. GERD (gastroesophageal reflux disease)
  2. PUD (peptic ulcer disease)
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9
Q

What is the major component of digestive fluid produced in the stomach?

A

Hydrochloric acid (HCl)

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10
Q

pH of stomach acid

A

1-2

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11
Q

Hydrochloric acid is secreted through the? (ON EXAM)

A

Proton pump (H+/K+ ATPase)

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12
Q

Which cells is the proton pump (H+/K+ ATPase) found in?

A

Parietal cells

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13
Q

Which cells produce hydrochloric acid?

A

Parietal cells

(H+/K+ ATPase proton pump is in parietal cells!)

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14
Q

Name 3 local and systemic endocrine effects that control and stimulate the proton pump (ON EXAM)

A
  1. Gastrin
  2. Histamine
  3. ACh
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15
Q

Most common symptom of GERD

A

Heartburn

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16
Q

What is GERD caused by?

A

Abnormal reflux of gastric contents retrograde through cardiac sphincter into esophagus

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17
Q

What is peptic ulcer disease caused by? (ON EXAM)

A

Helicobacter pylori infection (main cause)

Extended use of NSAIDS (less common)

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18
Q

Primary complication of peptic ulcer disease

A

Hemorrhage

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19
Q

T/F: antacids are weak acids

A

False! They’re weak bases

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20
Q

What happens if you take too many antacids?

A

Affects absorption of other medications by directly binding to the drug or altering the drug’s solubility

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21
Q

What drugs can antacids affect?

A

Antifungals (ketoconazole, itraconazole)
Antibiotics (tetracycline, fluoroquinolone)

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22
Q

H2 receptor antagonists can inhibit up to _____ of total 24-hr acid secretion

A

70%

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23
Q

Example of mucosal protective agents

A

Pepto bismol (bismuth subsalicylate)
Sucralfate

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24
Q

What does pepto bismol protect against?

A

Ulcers and erosions

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25
Q

What does pepto bismol treat?

A

Acute nonspecific diarrhea

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26
Q

What does pepto bismol reduce in acute diarrhea?

A

Stool frequency
Liquidity

27
Q

What does pepto bismol bind to?

A

Enterotoxins

28
Q

T/F pepto bismol has some antimicrobial effects

29
Q

What is sucralfate a complex of?

A

Aluminum hydroxide + sulfated sucrose

30
Q

T/F sucralfate provides a mechanical barrier over the surface of a gastric ulcer

A

FALSE, it provides a physical barrier over the surface of a gastric ulcer

31
Q

Drug class of choice for peptic ulcer disease and GERD

A

Proton pump inhibitors

32
Q

PPIs are __________ (longer/shorter) lasting and ________ (more/less) potent than H2 blockers

A

longer; more

33
Q

Proton pump inhibitor suffix

A

“-prazole”

34
Q

H2 receptor antagonist suffix

A

“-tidine”

35
Q

Main difference between PPIs and H2 antagonists

A

PPIs: IRREVERSIBLY inhibit proton pump
H2 antagonists: REVERSIBLY inhibit H2 receptor

36
Q

Which drug slows the metabolism of lidocaine and benzodiazepines, and is a potent inhibitor of cytochrome P450 enzymes?

A

Cimetidine

37
Q

3 adverse effects with long term PPI use

A
  1. Alters normal gastric pH
  2. Alters medication absorption
  3. Impacts metabolism of medications by CYP450
38
Q

What is the mechanism of prostaglandins?

A

Bind to parietal cell receptor to decrease acid secretion

Stimulate mucus and bicarbonate secretion to inhibit acid secretion

39
Q

Contraindications of prostaglandins

40
Q

How do we treat an H. pylori infection?

A

Triple regimen of a PPI with two antibiotics (clarithromycin + amoxicillin/metronidazole)

41
Q

What is the effectiveness of the triple regimen being influenced by?

A

Growing incidence of bacterial resistance to clarithromycin

42
Q

What treatment is recommended in areas of high resistance and in cases where clarithromycin-based therapy has failed in treating H. pylori infections?

A

Quadruple therapy

(PPI/H2 blocker + pepto bismol + metronidazole + tetracycline)

43
Q

These drugs should be avoided in patients with an ulcer

A

Corticosteroids

44
Q

What should NOT be used for pain management of pts with PUD? Why?

A

Aspirin and Ibuprofen

They’re NSAIDS

45
Q

What drugs are used for chronic idiopathic constipation?

A

Linaclotide and Plecanatide
Lubiprostone
Prucalopride
Lactitol

46
Q

What drugs are used for chronic idiopathic constipation and IBS-C?

A

Linaclotide and Plecanatide
Lubiprostone

47
Q

What kind of drugs are Linaclotide and Plecanatide, and what do they do?

A

Guanylate cyclase-C agonists

Increase fluid secretion and muscle movement

48
Q

What kind of drug is Lubiprostone, and what does it do?

A

Cl- channel activator

Increases fluid secretion

49
Q

What kind of drug is Prucalopride, and what does it do?

A

Serotonin receptor agonist

Has prokinetic activity and increases peristalsis

50
Q

What kind of drug is Lactitol, and what does it do?

A

Non-absorbable disaccharide

Sweetener in food, laxative, and increases peristalsis

51
Q

Gastroparesis is most common in pts with?

A

Diabetes mellitus

52
Q

Name 2 GI stimulants that can treat gastroparesis

A

Metoclopramide (antiemetic activity)
Erythromycin

53
Q

Difference between IBS and IBD

A

IBS: intestinal disorder where we do NOT know the cause

IBD: intestinal disorders with severe inflammation and bleeding and damage to GI tract

54
Q

What do medications for IBS-C do?

A

Increase fluid secretion in intestine

55
Q

What are 2 types of IBD?

A

Crohn’s disease
Ulcerative colitis

56
Q

Pts with IBD are at increased risk of developing caries and oral infections. Why?

A

IBD treatment involves suppressing the immune response which leads to more infections and caries

57
Q

Avoid prescribing _________ for IBD pts because they may trigger a flare-up

58
Q

What does sucralfate reduce the absorption of?

A

Tetracycline

59
Q

What drugs are opioid derivatives?

A

Diphenoxylate
Loperamide

60
Q

What is the mechanism of Diphenoxylate and Loperamide?

A

Mu-opioid receptor agonists
Decrease motility

61
Q

What do Diphenoxylate and Loperamide treat?

A

Acute nonspecific diarrhea

62
Q

Which opioid derivative is available OTC since it does not cross BBB or cause addiction?

A

Loperamide

63
Q

Which drugs antagonize Metoclopramide’s prokinetic activity in the GI tract?

A

Opioids
Anticholinergics

D1 Spring (47 decks)

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