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Intro To Drugs > test 3 > Flashcards

test 3 Flashcards

1
Q

Celio/ and lapar/o

A

Related to the abdomen

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2
Q

Cholecyst/o

A

Related to the gall bladder

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3
Q

Choledoch/o

A

Related to the bile duct

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4
Q

Enter/o

A

Related to the intestines

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5
Q

Gastr/o

A

Related to the stomach

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6
Q

Hepat/o

A

Related to the liver

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7
Q

Peritone/o

A

Related to the peritoneal cavity

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8
Q

-emesis

A

Related to vomiting

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9
Q

-lith

A

Referring to a stone

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10
Q

-pepsia

A

Referring to digestion

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11
Q

-phagia

A

Related to eating/swallowing

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12
Q

-rrhage

A

Related to bleeding

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13
Q

-stenosis

A

A narrowing or stricture

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14
Q

Anorexia

A

Lack of appetite

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15
Q

Ascites

A

Collection of fluid in the peritoneal cavity

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16
Q

Deglutition

A

Swallowing

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17
Q

Dysphagia

A

Difficulty swallowing

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18
Q

Hematochezia

A

Presence of bright red blood in the stool

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19
Q

Melena

A

Black, tarry stools containing digested blood

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20
Q

Steatorrhea

A

Presence of fat in the stool

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21
Q

Fistula

A

Abnormal tubular conection between organs, vessels,

intestines, etc

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22
Q

Cirrhosis

A

Liver disease characterized by the replacement of

normal parenchyma with connective tissue

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23
Q

ALT

A

Alanine transaminase/aminotransferase

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24
Q

AST

A

Aspartate transaminase/aminotransferase

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25
Q

BM

A

Bowel movement

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26
Q

GERD

A

Gastroesophageal reflux disease

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27
Q

GIT

A

Gastrointestinal tract

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28
Q

IBD

A

Inflammatory bowel disease

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29
Q

IBS

A

Irritable bowel syndrome

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30
Q

LFTs

A

Liver function tests

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31
Q

PUD

A

Peptic ulcer disease

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32
Q

Gastrointestinal diseases

A 
Gastroesophageal Reflux Disease (GERD)
 Peptic ulcer disease (PUD)
• Gastric Ulcer
• Duodenal Ulcer
 Liver disease
• Portal hypertension
• Cirrhosis
• Drug-Induced diseases
• Viral hepatitis
 Pancreatitis
Inflammatory Bowel Disease (IBD)
• Ulcerative Colitis
• Crohn’s Disease
 Irritable Bowel Syndrome (IBS)
 Symptomatic problems
 Diarrhea
 Constipation
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33
Q

Gastroesophageal Reflux DZ Pathophysiology

A

Abnormal reflux of gastric contents from the
stomach to the esophagus
 Mucosal irritation, pain, bleeding, perforation,
strictures and hyperplasia can result

34
Q

Proton Pump Inhibitors

A

Drugs of choice for treatment of GERD
 MOA
• Inhibits H+/K+ ATPase pump on parietal cells
responsible for secretion of HCl into stomach
• Causes potent reduction of acid secretion

35
Q 
Omeprazole 
• Esomeprazole 
• Lansoprazole
• Rabeprazole 
• Pantoprozole
A

Proton Pump Inhibitors

36
Q

Proton Pump Inhibitors Dosage forms

A

Oral
 Parenteral (esomeprazole, lansoprazole, pantoprazole)
 Omeprazole suspension (Zegerid®)

37
Q

Proton Pump Inhibitors Important points to consider

A

Oral products should not be crushed or chewed

 Generally given prior to meals

38
Q

Cimetidine
• Ranitidine
• Nizatidine
• Famotidine

A

H2 receptor antagonists

39
Q

H2 receptor antagonists MOA

A

Binds to histamine-2 receptors on parietal cells to

reduce acid secretaion in the stomach

40
Q

H2 receptor antagonists dosage forms

A

Oral

• Parenteral (cimetidine, ranitidine, famotidine)

41
Q

H2 receptor antagonists Important points

A

Cimetidine has been associated with a number of
significant drug interactions (inhibits microsomal
enzyme systems)

42
Q

TNTC

A

Antacids

43
Q

Antacids MOA

A

Basic compounds that directly neutralize stomach acid

to form inert salts

44
Q

Antacids dosage forms

A

Oral

45
Q

Antacids Important points

A

Provides symptomatic relief from pain

• May have to be dosed frequently

46
Q

Antacids Common adverse reactions

A

Can cause electrolyte disturbances
• May induce diarrhea (magnesium containing antacids)
or constipation (aluminum containing antacids)

47
Q

Metoclopramide (Reglan®)
• Cisapride (Propulsid®) – removed from U.S. market in
2000, still available under compassionate use protocols

A

Promotility agents

48
Q

Promotility agents MOA

A

Increases gastrointestinal motility, accelerates gastric

emptying

49
Q

Promotility agents Important points

A

Metoclopramide can be used to treat a variety of
disorders (nausea/vomiting, gastroparesis
• Cisapride is associated with serious ventricular
arrhythmias and was withdrawn from the market
(although still available via compassionate use because
of its significant prokinetic activity)

50
Q

Promotility agents Common adverse reactions

A

CNS stimulation
• Diarrhea
• Extrapyramidal reactions (dyskinesias)

51
Q

Peptic ulcer disease (PUD) Pathophysiology

A

Gastric ulcer – exact mechanism unknown but is
related to decreased mucosal resistance, use of
NSAIDs and presence of H. pylori bacteria
 Duodenal ulcer – exact mechanism unknown but
is related to increased acidity, decreased mucosal
protection and presence of H. pylori bacteria

52
Q

PUD Antibiotics MOA

A

Inhibit protein translation for susceptible bacteria

53
Q

PUD Antibiotics Important points

A

Antibiotics are typically given for several weeks, and
patients should be educated on the importance of
compliance

54
Q

PUD Antibiotics Common adverse reactions

A

GI complaints
• Allergic reactions
• Tetracycline has photosensitivity reaction and can stain
teeth/bones
• Metronidazole can cause disulfiram-like reaction if
ingested with EtOH

55
Q

Inflammatory Bowel Disease (IBD) Pathophysiology

A 
Etiology remains unknown
 Related to the following risk factors:
• Infectious pathogens
• Genetics
• Immunologic changes
• Environmental factors (food, drugs, smoking)
 2 main categories of IBD:
• Ulcerative colitis
• Crohn’s Disease
56
Q

Sulfasalazine
• Mesalamine
• Olsalazine
• Basalazide

A

Drug Therapy for IBD

5-aminosalicylic acid derivatives

57
Q

5-aminosalicylic acid derivatives MOA

A

Local anti-inflammatory actions in the intestinal tract

drugs typically given PO or PR

58
Q

5-aminosalicylic acid derivatives Important points

A

Oral dosage forms should not be crushed or chewed

59
Q

5-aminosalicylic acid derivatives Common adverse reactions

A

Sensitivity reactions

• GI complaints

60
Q

Prednisone or prednisolone
• Dexamethasone
• Methylprednisolone
• Budesonide

A

Drug Therapy for IBD

Corticosteroids

61
Q

Corticosteroids important points

A

If used for prolonged periods, dose must be tapered

slowly if discontinued to avoid adrenal insufficiency

62
Q

Corticosteroids Common adverse reactions

A 
A significant number of systemic effects can occur
(partial list)
– Adrenal insufficiency
– Water/electrolyte disturbances
– Musculoskeletal effects
– Unusual fat deposition
– Increased risk of infection
63
Q

Irritable Bowel Syndrome (IBS) pathophysiology

A 
Exact mechanism unknown but probably related
to:
• Altered somatovisceral / motor dysfunction in the gut
• Visceral hypersensitivity
 Resulting problems are
• Diarrhea OR
• Constipation
• Intestinal pain
64
Q

Antidiarrheal agents MOA

A

Typically involves one of the following:
– Antimotility - Reduction in GI motility allowing for
greater water reabsorption in colon
– Adsorbents - Adsorption of toxins or digestive
fluids to the adsorbent agent
– Antisecretory – Reduce gastrointestinal secretions

65
Q 
Antimotility drugs
– Diphenoxylate / atropine (Lomotil®)
– Loperamide (Imodium®)
• Adsorbents
– Attapulgite
– Polycarbophil
• Antisecretory
– Bismuth subsalicylate (Pepto-Bismol®, Kaopectate®)
A

Antidiarrheals

66
Q

Antidiarrheals Important points

A

Should not be used for prolonged periods of time

67
Q 
Bulk forming agents
– Methylcellulose
– Polycarbophil
• Stool softeners
– Docusate sodium / calcium
• Stimulants
– Bisacodyl or senna
• Hyperosmotic agents
– Magnesium citrate / hydroxide/ sulfate
– PEG
A

Anti-constipation agents

68
Q

Alosetron (Lotronex®)

• Tegaserod (Zelnorm®)

A

Serotonergic agents

69
Q

Serotonergic agents MOA

A 
Alosetron = 5-HT3 antagonist
– Modulates enteric nervous system, regulating pain
receptors and GI secretions
– For diarrhea predominant IBS
• Tegaserod = 5-HT4 agonist
– Modulates enteric nervous system,
regulatingvisceral pain receptors and affects GI
secretions
– Used for constipation-predominant IBS
70
Q

Important points related to alosetron

A

Alosetron was withdrawn from market because of
potential for ischemic colitis and serious constipation
and may cause hospitalization or death.
• It is available under restricted guidelines now, and only
prescribers enrolled in the Lotronex® program may
prescribe the drug
• Alosetron is indicated only for women with severe
diarrhea-predominant IBS who have not responded to
conventional therapy
• Alosetron should be immediately discontinued if
constipation or symptoms of ischemic colitis develop

71
Q

Important points related to tegaserod

A

potential for inducing cardiac ischemia resulting in MI
or stroke
• The FDA has made tegaserod available to physicians
via a restricted distribution program for emergency
situations that are life-threatening or require
hospitalization

72
Q

Nausea

A

imminent need to vomit

73
Q

Retching

A

Labored movement of abdominal and

thoracic muscles prior to vomiting

74
Q

Vomiting

A

Forceful expulsion of gastric contents

75
Q

Nausea & vomiting are not diseases but are

A

symptoms of other problems

76
Q

Nausea & Vomiting Etiology

A 
GI diseases
 Cardiovascular disease
 Neurologic processes
 Metabolic / endocrine disorders
 Psychogenic causes
 Drugs
 Gastric outlet obstruction
 Motility disorders
 Infections
 Labyrinthine diseases
77
Q

Antiemetic agents moa

A 
Typically involves neurotransmitter modulation of the
following receptors:
– Histamine
– Acetylcholine
– Dopamine
– Serotonin
– Muscarine
– Cannabinoids
78
Q 
5-HT3 antagonists
– Ondansetron (Zofran®)
– Granisetron (Kytril®)
– Dolasetron (Anzemet®)
– Palonosetron (Aloxi®)
• Dopamine receptor antagonists
– Phenothiazine class
 Prochlorperazine (Compazine®)
 Chlorpromazine (Thorazine®)
– Metoclopramide
H1 receptor antagonists
– Cyclizine (Marezine®)
– Meclizine (Antivert®)
– Hydroxyzine (Vistaril®)
– Dimenhydrinate (Dramamine®)
– Diphenhydramine (Benadryl®)
• Muscarinic receptor antagonists
– Scopolamine (Transderm Scop®)
Cannabinoid receptor antagonists
– Dronabinol (Marinol®)
– Marijuana
• Corticosteroids
– Prednisone
– Dexamethasone
A

Antiemetic agents

79
Q

Antiemetic drugs are typically effective only for

certain types of nausea/vomiting

A 
Motion sickness
– Antihistamines
– Anticholinergics
• Gastroparesis
– Metoclopramide
• Surgery
– Trimethobenzamide
– Phenothiazines
– 5HT-3 Antagonists
Stimulation of the CTZ (drugs)
– 5HT3 antagonists
– Phenothiazines
– Butyrophenones
– Metoclopramide
– Corticosteroids
– Cannabinoids
80
Q

Antiemetic agents Important points

A

The etiology of the nausea/vomiting is important to

consider when selecting an antiemetic

Intro To Drugs (13 decks)

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