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USU Pharmacology > Unit 4: Gastrointestinal system > Flashcards

Unit 4: Gastrointestinal system Flashcards

1
Q

What are the 3 categories of drugs that support the treatment of nausea?

A

Serotonin antagonists, antihistamines, and prokinetic

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2
Q

What is the mode of action of nausea medications?

A

Blocks serotonin receptors in the chemoreceptor trigger zone (CTZ)

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3
Q

What are the 3 categories of drugs that support the treatment of constipation?

A

Fiber supplements, stool softeners, and stimulant laxatives

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4
Q

What is the main category that supports the treatment of diarrhea?

A

Opiods

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5
Q

What are the 6 kinds of peptic ulcer medications?

A
  1. Histamine2-receptor antagonists
  2. Proton pump inhibitors
  3. Mucosal protectants
  4. Antacids
  5. Prostaglandin E analog
  6. Antibiotics
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6
Q

What is the prototype for Histamine2-receptor antagonists?

A

ranitidine hydrochloride (zantac)

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7
Q

What is the mode of action for Histamine2-receptor antagonists like ranitidine hydrochloride?

A

Reduce acid secretion by blocking H2 receptors which decreases gastric acid and pH.

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8
Q

What does ranitidine hydrochloride treat?

A

Peptic ulcers, GERD, Heartburn, dyspepsia, and pathologic gastric hypersecretory disorders

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9
Q

What endings do H2 receptor antagonists have?

A

-dine

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10
Q

What is the prototype for proton pump inhibitors?

A

omeprazole (prilosec)

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11
Q

What is the mode of action for proton pump inhibitors like omeprazole?

A

Proton pump inhibitors block ALL gastric acid secretion

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12
Q

What endings do Proton pump inhibitors have?

A

-prazoles

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13
Q

What does omeprazole treat?

A

Peptic ulcers, GERD, erosive esophagitis, hypersecretion of gastric acid PLUS prolonged dyspepsia

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14
Q

What are the adverse effects of omeprazole?

A

Long-term medication ingestions = bone loss
Few other effects, except N/V, diarrhea

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15
Q

What is the prototype for mucosal protectants?

A

sucralfate (Carafate)

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16
Q

What does sucralfate treat?

A

Acute duodenal ulcers

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17
Q

What is the pharmacological action:

A

Chemical reaction in stomach creates a gel or thick paste in the stomach. Coats ulcers, and creates a barrier between the stomach and gastric secretions.

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18
Q

How often is sucralfate administered?

A

4x/day on empty stomach: one hour before breakfast, lunch, dinner, and bedtime.

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19
Q

What is the prototype for antacids?

A

aluminum hydroxide (Amphojel)

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20
Q

What is the main adverse effects of antacids?

A

Constipation and diarrhea

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21
Q

What is the mode of action for antacids?

A

Alkaline compound - neutralizes gastric acid

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22
Q

What is the reasoning behind calling antacids high maintenance?

A
  • PO 4x/day
  • 2 hours before/after drugs
    -4 ox. milk/water: chew well
  • Interacts with other drugs
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23
Q

What is the prototype for Prostaglandin E analogs?

A

misoprostol (Cytotec)

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24
Q

What do prostaglandin E analogs do?

A

Prevent gastric ulcers in patients taking long-term NSAIDs long term and also used in L&D to soften cervix of pregnant women ready to deliver.

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25
Q

What is the mode of action for prostaglandin E analogs?

A

Decreased stomach acid, increased production of protective mucous and bicarbonate, and increased vasodilation of blood flow in the gastric wall.

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26
Q

What are the side effects for prostaglandin E analogs?

A

Dysmenorrhea and miscarriage: do not administer to pregnant women until time to deliver. GI upset, severe diarrhea, and abdominal pain.

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27
Q

What do antibiotics prevent and treat in terms of the GI tract?

A

Peptic ulcers

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28
Q

What is the leading cause of peptic ulcer disease?

A

Helicobacter pyloris

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29
Q

What is necessary to heal gastric ulcers?

A

Antibiotics

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30
Q

What is the mode of action for nausea medications?

A

block serotonin, dopamine, or histamine1 receptors in CTZ

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31
Q

What is the prototype for serotonin antagonists?

A

ondansetron (Zofran)

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32
Q

What is ondansetron used for?

A

nausea/vomiting from chemotherapy, radiation therapy, and postop recovery.

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33
Q

What are key points for serotonin antagonists?

A

Administer before, not after n/v is occurring; scheduled dosing is most effective. Can be given orally or through IV.

34
Q

What are the precautions for ondansetron?

A

young children (under 4), liver dysfunction; rifampin lowers action of ondansetron, and known prolonged QT syndrome

35
Q

What is the prototype for antihistamines in terms of GI?

A

dimenhydrinate (Dramamine)

36
Q

What does dimenhydrinate treat?

A

Motion sickness and vertigo

37
Q

What are the adverse effects of dimenhyrinate?

A

sedation, dizziness, anticholinergic effects

38
Q

What is the action of antihistamines?

A

block histamine1 receptors in the inner ear and CTZ

39
Q

What is a safety alert for antihistamines?

A

Older men taking antihistamines can cause urinary retention

40
Q

What are the precautions for antihistamines?

A

children under 2, elderly: glaucoma, prostate hypertrophy liver dysfunction, GI/urinary obstruction.

41
Q

What is the prototype for prokinetics?

A

metoclopramide (Reglan)

42
Q

What is the mode of action for prokinetics?

A

dopamine and serotonin receptor blocker, increases peristalsis, lower esophageal sphincter tone, and CTZ threshold

43
Q

What are the adverse effects of prokinetics?

A

drowsiness, GI upset, EPS (tardive dyskinesia) with long-term use

44
Q

What is the prototype for fiber supplements?

A

psyllium (Metamucil)

45
Q

What do fiber supplements prevent/treat?

A

constipation, diverticulosis, irritable bowel syndrome, regulates stools with diarrhea and fecal ostomies

46
Q

What is the pharmacologic action of fiber supplements?

A

glutinous mass that forms bulk laxative; absorbs water from the intestine; non-digestible

47
Q

When should you not give psyllium?

A

If the patient has a blockage

48
Q

What is the prototype for stool softeners?

A

docusate sodium (colace)

49
Q

Why is psyllium more effective than docusate sodium?

A

Because it takes two to three days for docusate sodium to begin to work but psyllium works faster.

50
Q

What do stool softeners treat?

A

constipation fecal impactions, and hard/painful stools

51
Q

What is the pharmacologic action of docusate sodium?

A

lower surface tension to absorb water into stool

52
Q

When should you not give docusate sodium?

A

patient has an impaction, n/v, stomach pain, or using mineral oil. diabetes mellitus, heart failure, or edema.

53
Q

What is the prototype for stimulant laxatives?

A

bisacodyl (Dulcolax)

54
Q

What do stimulant laxatives treat?

A

constipation, slow transit, stool evacuation prior to surgery

55
Q

What is the pharmacologic action of stimulant laxatives?

A

increases intestinal motility and transit; increases water/electrolytes secretion from intestine

56
Q

When should you not give stimulant laxatives?

A

Children under 1; eating disorders, impaction, hemorrhoids, N/V, stomach pain, and antacids

57
Q

What is the prototype for opioids in terms of antidiarrheal medications?

A

diphenoxylate atropine (lomotil) and loperamide (Imodium)

58
Q

What is the pharmacologic action for opioids in terms of GI?

A

decreases intestinal peristalsis

59
Q

What are the side effects of opioids in terms of GI?

A

CNS effects; anticholinergic effects

60
Q

What is the prototype for irritable bowel syndrome with diarrhea?

A

alosetron (Lotronex)

61
Q

What does alosetron treat?

A

IBS-D in women only

62
Q

What is the pharmacologic action of alosetron?

A

serotonin 5-HT3 receptor antagonist. Decreases visceral pain; slows peristalsis

63
Q

What must happen for a patient to be administered alosetron?

A

sign tx agreement

64
Q

What are the side effects of alosetron?

A

constipation which can lead to impaction, perforation, and even obstruction

65
Q

What is the prototype for irritable bowel syndrome with constipation?

A

lubiprostone (Amitiza)

66
Q

What does lubiprostone prevent/treat?

A

IBS in women > 18; chronic idiopathic constipation in men and women

67
Q

What is the pharmacologic action of lubiprostone?

A

Serotonin 5-HT3 receptor agonist. Decreases visceral pain and slows peristalsis.

68
Q

What are the 4 categories of drugs that support the treatment of inflammatory bowel disease?

A
  1. 5-Aminosalicylates
  2. Immunosuppressants
  3. Immunomodulators
  4. Glucocorticoids
69
Q

What is it believed Crohn’s disease and ulcerative colitis are due to?

A

Autoimmune response

70
Q

What is the prototype for 5-aminosalicylates?

A

sulfasalazine (Azulfidine)

71
Q

What do 5-aminosalicylates treat?

A

Mild to moderate inflammatory bowel disease

72
Q

What is the pharmacologic action of sulfasalazine?

A

sulfonamide antibiotic that converts to aminosalicylic acid

73
Q

What are the side effects of sulfasalazine?

A

nausea, fever, rash, arthralgia, blood disorders

74
Q

What is the administration of sulfasalazine?

A

PO after meals to decrease transit time

75
Q

What are the precautions for sulfasalazine?

A

Sulfa allergy, salicylates (aspirin)

76
Q

What is the prototype for immunosuppressants in terms of IBD?

A

azathrioprine (Imuran)

77
Q

What is the pharmacologic action of azathioprine?

A

Inhibits production of B and T lymphocytes with decreases immune response.

78
Q

What are the side effects of azathioprine?

A

N/V, anorexia, Hepatitis, bone marrow suppression

79
Q

What are the precautions for azathioprine?

A

patients with myasthenia gravis, renal/hepatic dysfunction should take only if the benefits outweigh the risks

80
Q

How do you administer azathioprine?

A

IV, PO (onset of therapeutic effect may take six months

81
Q

What is the difference between Crohn’s disease and ulcerative colitis?

A

Crohn’s: affects entire intestinal tract
Ulcerative colitis: affects only the colon

USU Pharmacology (14 decks)

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