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Human disease and therapeutics 2020 > Test #3 Pharmacology of the GI Tract > Flashcards

Test #3 Pharmacology of the GI Tract Flashcards

1
Q

is gastroesophageal reflux disease (GERD) acute or chronic? what about acid reflux?

A
  • GERD is chronic
  • acid reflux is acute (isolated incidents)
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2
Q

what are GERD/acid reflux episodes referred to as, and what percent of the population do they occur daily in?

A
  • heartburn
  • 7%
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3
Q

what are aggravating factors of GERD and acid reflux?

A
  • empty stomach
  • inclined (?)
  • increased age
  • obesity
  • fatty foods
  • caffeine/alcohol/smoking
  • large meals
  • some drugs
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4
Q

how can GERD and acid reflux symptoms be relieved?

A
  • small meals
  • reduced fat
  • reduced weight
  • elevate head of bed
  • avoid aspirin/NSAIDs
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5
Q

what are some ways that teeth can be protected from gastric acids (GERD and acid reflux)?

A
  • mouth guard
  • neutralize acid with basic solution
  • don’t brush teeth after gastric juices are in mouth (acidic)
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6
Q

what 3 medications are used to treat GERD/acid reflux?

A
  • antacids
  • H2 receptor blockers
  • proton pump inhibitors (PPIs)
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7
Q

what do antacids to do relieve the symptoms of GERD/acid reflux?

A

neutralize gastric HCl

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8
Q

what are the 4 typs of antacids used to relieve the symptoms of GERD and acid reflux?

A
  • magnesium salts
  • bicarbonate
  • calcium carbonate
  • aluminum salts (not very effective)
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9
Q

what is the side effect of magnesium salts?

A

diarrhea

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10
Q

what is the side effect of bicarbonate?

A

causes gas

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11
Q

what is the side effect of calcium carbonate?

A

constipation

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12
Q

which GERD/acid reflux medication is chalky?

A

calcium carbonate

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13
Q

are H2 receptor blockers useful for allergies? why or why not?

A

no, because they are not affective at H1 receptors

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14
Q

how do H2 receptor blockers relieve the symptoms of GERD and acid reflux?

A

they block H2 receptors in the gut, which reduces gastric secretions

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15
Q

are H2 receptor blockers typically OTC or Rx?

A

both

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16
Q

what are the 3 types of H2 receptor blockers?

A
  • cimetidine (tagamet)
  • ranitidine (zantac)
  • famotidine (pepcid)
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17
Q

what are the side effects of H2 receptor blockers?

A

headaches, diarrhea, drowsiness

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18
Q

are proton pump inhibitors available OTC or Rx?

A

both

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19
Q

what is the mechanism of PPIs?

A

disrupts hydrogen exchange for K in gastric parietal cells, which blocks production and release of HCl into the gut

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20
Q

what are the side effects of PPIs?

A

diarrhea, interferes with digestion, increases food allergies, oral sores/ulcers

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21
Q

PPIs are often combine with what other medication to relieve symptoms of GERD and acid reflux?

A

H2 receptor blockers

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22
Q

what are 4 types of PPIs?

A
  • omeprazole (prilosec)
  • omeprazole + sodium bicarbonate for fast release
  • lansoprazole (prevocid)
  • esomeprazole (nexium)
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23
Q

peptic ulcer disease includes ulcers in what two locations?

A

gastric (stomach) and duodenum

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24
Q

what are the causes of peptic ulcer disease?

A

inflammation of the epithelium, erosion, infection by H. pylori

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25
Q

what percent of peptic ulcer disease is caused by H. pylori infection?

A

70-80%

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26
Q

what are the symptoms of peptic ulcer disease?

A

epigastric burning, pain, bleeding in stools or vomit (hematemesis)

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27
Q

epigastric burning caused by peptic ulcer disease can be alleviated by what?

A

eating or taking antacids

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28
Q

what two things make pain associated with peptic ulcer disease worse?

A

empty stomach and at night

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29
Q

pain associated with peptic ulcer disease is often mistaken for what?

A

a heart attack (and vice versa - heart attack pain is often mistaken for peptic ulcer disease)

30
Q

what are two general ways peptic ulcer disease is treated?

A
  • suppress acidity to heal sores (this doesn’t cure it)
  • it can be cured with medication if it is H. pylori-related
31
Q

what medications can suppress acidity and heal sores of peptic ulcer disease?

A

antacids, PPIs, and H2 blockers

32
Q

is H. pylori infection contageous?

A

yes, especially within family members

33
Q

how is H. pylori-related peptic ulcer disease cured?

A
  • prevpac - combination of lansoprazole (PPI), amoxicillin, and clarithromycin
  • milk of magnesia (magnesium based) may also help kill bacteria
34
Q

what nutrients are absorbed in the stomach?

A

water and alcohol

35
Q

what nutrients are absorbed in the duodenum?

A

Fe, Ca, Mg, Na, fats, water, proteins, vitamins

36
Q

what nutrients are absorbed in the jejunum?

A

carbohydrates and proteins

37
Q

what nutrients are absorbed in the ileum?

A

bile salts, vit B12, Cl

38
Q

what nutrients are absorbed in the colon?

A

water and electrolytes

39
Q

what are 4 types of GI motility disorders?

A

constipation, diarrhea, irritable bowel syndrome, inflammatory bowel disease

40
Q

what physically causes constipation?

A

mobility is too slow and too much water is being absorbed

41
Q

what is the pharmacological treatment of constipation?

A
  • laxatives
    • bisacodyl
    • docusate
42
Q

describe bisacodyl

A
  • OTC laxative for constipation
  • stimulant of smooth muscles
  • fast acting
  • suppository/oral
43
Q

what are the side effects of bisacodyl?

44
Q

describe docusate

A
  • aka dulcelax
  • OTC treatment for constipation
  • water retention in stools, causing softened stools
45
Q

what is diarrhea?

A
  • loose, watery stools
  • mobility is too fast, so not enough is absorbed
46
Q

what are the consequences of diarrhea?

A

dehydration, malnutrition

47
Q

what populations is diarrhea worse in?

A

young and elderly

48
Q

what are medications used to treat diarrhea?

A
  • loperamine (imodium)
  • bismuth subsalicylate (pepto-bismol)
  • anti-cholinergics (atropine)
49
Q

what is loperamine?

A
  • imodium
  • mild opioid agonist used to treat diarrhea
    • if diarrhea is severe, you can use strong opioid agonists
50
Q

is there a structural defect associated with irritable bowel syndrome?

A

no

exact cause is unknown

51
Q

what are the symptoms of IBS?

A

typically episodic pain and bloating

52
Q

IBS could be a ___ disorder

A

5HT-dependent neuromuscular disorder

53
Q

what percent of the population may suffer from IBS?

A

20% - it is the most common GI disorder

54
Q

what age population is IBS most common in? what is it associated with?

A
  • young adults and 50 year olds
  • possible association with stress and poor diet
55
Q

what are the treatment options for IBS?

A
  1. typically symptomatic treatment (ex. treat diarrhea or constipation with diet and anti-stress changes)
  2. drugs
56
Q

what are drugs used to treat IBS?

A
  • linaclotide (linzess)
    • only FDA-approved for IBS with constipation
57
Q

how does linaclotide (linzess) work?

A
  • it is a guanylate cyclase-C agonist
  • increases bowel movement, fluid secretion, and reduces pain
58
Q

what are the side effects of linaclotide (linzess)?

A

diarrhea and gas

59
Q

inflammatory bowel disease affects __% of the population

60
Q

what two disorders make up inflammatory bowel disease?

A

crohn’s disease and ulcerative colitis

61
Q

what location in the body does crohn’s disease affect?

A
  • can affect entire GI, but more intense in ileum and colon and intermittent areas with strictures between
  • presents as ulcerations, swellings, and scarring
62
Q

crohn’s disease is characterized by chronic ___ problems

63
Q

what type of pain is associated with crohn’s disease?

A

hypogastric

64
Q

what is a common location for fissures and fistulas associated with crohn’s disease?

A

perianal area

65
Q

patients with crohn’s disease have a higher incidence of ___ and ___

A

arthritis and colon cancer

66
Q

what can happen to the liver in patients with crohn’s disease?

A

fatty liver

67
Q

what can cause crohn’s disease?

A
  • possible genetic link
  • perhaps abnormal inflammatory response to normal flora
68
Q

can crohn’s disease go into remission?

69
Q

what medications can be used to treat crohn’s disease?

A
  • anti-inflammatories
    • mesalamine (topical)
    • corticosteroids (systemic)
  • antibiotics
    • metronidazole
70
Q

___ is similar to crohn’s disease but is limited to the colon and is more generalized, without strictures

A

ulcerative colitis

71
Q

what medications can be used to treat ulcerative colitis?

A

similar to crohn’s disease:

  • anti-inflammatories
    • mesalamine (topical)
    • corticosteroids (systemic)
  • antibiotics
    • metronidazole

Human disease and therapeutics 2020 (60 decks)

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