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GI Midterm 1 > Pharmacology of Prokinetics, Acid-Peptic Disorders, and Antiemetics (Quiz) > Flashcards

Pharmacology of Prokinetics, Acid-Peptic Disorders, and Antiemetics (Quiz) Flashcards

1
Q

what is gastroparesis

A
  • failure of the stomach to empty properly
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2
Q

what does motilin do

A
  • stimulate motility
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3
Q

what does dopamine do for motility

how

A
  • inhibits motility

- inhibitory presynaptic dopamine receptor (D2)

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4
Q

what does acetylcholine do for motility

A
  • stimulates motility
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5
Q

MOA of Metoclopramide

A
  • inhibition of dopamine D2 receptor

- increase contraction and motility

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6
Q

Toxicities of Metoclopramide

short or long term use

A
  • acute dystonia - short term
  • tardive dyskinesia - long term
  • hyperprolactinemia
  • anxiety, restlessness, depression
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7
Q

what are acute dystonia and tardive dyskinesia known as

A
  • extrapyramidal symptoms (EPS)
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8
Q

how EPS’s caused

important brain parts involved

A
  • inhibition of central dopamine pathway that regulates skeletal muscle movement
  • substantia nigra
  • dorsal striatum
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9
Q

how does Metoclopramide cause hyperprolactinemia

A
  • inhibits central dopamine pathway that inhibits release of prolactin
  • therefore excessive prolactin secreted
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10
Q

Erythromycin MOA

A
  • motilin receptor agonists
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11
Q

side effect of Erythromycin

A
  • GI distress
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12
Q

pharmacokinetics issues with Erythromycin

A
  • tachyphylaxis (desensitization) after 10-14 days
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13
Q

what drug do you use if metoclopramide fails

A
  • erythromycin
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14
Q

MOA of Neostigmine

A
  • indirect acting cholinergic agonist

- inhibits acetylcholinesterase and increases amount of acetylcholine at synapse

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15
Q

toxicities of Neostigmine

A
  • pro parasympathetic effects
  • excessive saliva production
  • decreased CO
  • bradycardia
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16
Q

what is the antidote to Neostigmine

A
  • atropine
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17
Q

role of prostaglandin E2

A
  • inhibits gastric acid secretion
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18
Q

MOA of Sucralfate

A
  • polymerizes at low pH of stomach
  • negatively charged so binds positively charged proteins in stomach ulcer
  • forms a barrier
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19
Q

types of antacids

A
  • NaHCO3
  • CaCO3
  • Al(OH)3
  • Mg(OH)2
20
Q

MOA of antacids

A
  • directly neutralize stomach acid
21
Q

toxicity of NaHCO3

A
  • metabolic alkalosis
22
Q

toxicity of Mg(OH)2 and Al(OH)3

how do we solve this

A
  • diarrhea
  • constipation
  • combine the two to off-set each other’s toxicities
23
Q

toxicity of antacids

how

A
  • hypophosphatemia

- molecules are insoluble and prevents PO4 absorption

24
Q

which are the antihistamines

A
  • Ranitidine
  • Famotidine
  • Cimetidine
25
Q

MOA of Antihistamines

A
  • competitive, reversible inhibitors of H2 receptor in parietal cells
26
Q

can acid-peptic antihistamines significantly cross the blood brain barrier

A
  • no
27
Q

pharmacodynamics issue with Antihistamines

A
  • other pathways may compensate for blockage and build up tolerance
28
Q

important toxicity of Cimetidine

which drugs

what’s the exception to the rule

A
  • drug interactions due to inhibition of CYP enzymes
  • will reduce their clearance
  • warfarin
  • anti-epileptics
  • theophylline
  • clopidogrel - doesn’t get activated
  • oral contraceptives
29
Q

importance of theophylline

A
  • low therapeutic index
30
Q

proton pump inhibitor drugs

A
  • omeprazole
  • esomeprazole
  • lansoprazole
  • pantoprazole
  • rabeprazole
31
Q

MOA of PPIs

A
  • irreversible non competitive antagonist of H+/K+ pump
32
Q

toxicities of PPIs

A
  • C. diff infection
  • hypomagnesia
  • vitamin B12 malabsorption
  • AIN
33
Q

pharmacokinetics issues with PPIs

A
  • pH trapping drives them into secretory canaliculus
34
Q

MOA of Misoprostol

A
  • prostaglandins E2 analog

- inhibits gastric H+ secretion

35
Q

toxicities of Misoprostsal

A
  • promotes abortion of fetus
36
Q

what are some neurotransmitters associated with signals that affect vomiting

A
  • dopamine
  • serotonin
  • acetylcholine
  • neurokinin
37
Q

MOA of Ondansetron

what’s it used for

A
  • serotonin antagonist

- anti-emetic

38
Q

Toxicities of Odansetron

A
  • prolonged QT interval
39
Q

MOA of Prochlorperazine and promethazine

what are they used for

A
  • D2 receptor antagonists

- anti-emetic

40
Q

toxicities of Prochlorperazine and promethazine

A
  • acute dystonia
  • tardive dyskinesia
  • prolonged QT
41
Q

for what conditions do you use sucralfate

A
  • GERD (pregnancy)
42
Q

for what conditions to you use antacids

A
  • GERD
43
Q

for what conditions do you use antihistamines

A
  • GERD

- peptic ulcer disease

44
Q

for what conditions do we use PPIs

A
  • GERD
  • peptic ulcer disease
  • Zollinger-Ellison syndrome
  • NSAID associated ulcers
  • H. pylori eradication
45
Q

for what conditions do we use misoprostol

A
  • NSAID associated ulcers

GI Midterm 1 (25 decks)

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