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2514 Patho/phys/assess > week 2 - GI pharm > Flashcards

week 2 - GI pharm Flashcards

1
Q

what are the 6 antiemetics?

A
  1. scopolamine
  2. Dimenhydrinate - Gravol
  3. Nabilone
  4. Ondansetron- zofran
  5. Dexamethazone
  6. Metoclopramide- maxeran
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2
Q

What drug class is scopolamine and what is the MOA?

A

muscarinic receptor antagonist
blocks ACH for PNS
- so helps with GI not signaling emetic center

blocks nerve impulses between vestibular apparatus in inner ear to the emetic center

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3
Q

which antiemetic is best for motion sickness?

A

scopolamine

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4
Q

What are the adverse effects of scopolamine?

A
  1. CNS - sleep/drowsy
  2. blurred vision & dry mouth
  3. GU retention/GI constipation b/c PNS blocked
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5
Q

What drug class is dimenhydrinate and what is the MOA?

A

antihistimine
it blocks muscarinic receptors in vestibuler system so stops emetic signal

blocks GI receptors (ACH) so histimine can’t be released and acid can’t be made

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6
Q

What are the adverse effects of scopolamine?

A
  1. CNS - drowsy
  2. dry mouth
  3. Gu dysuria/ GI- constipation
  4. hypotension
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7
Q

What 4 things is Dimenhydrinate contraindicated in?

A
  1. other CNS depressants
  2. Gluacoma
  3. CKD
  4. dysuria
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8
Q

what drug class is Nabilone and what is the MOA?

A

cannabinoid
stops activation of receptors around vomiting centre

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9
Q

What are the adverse effects of Nabilone?

A
  1. CNS - drowsy, confusion
  2. Cardiac - tachy, hypotension
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10
Q

Is Nabilone a first line or 2nd line drug and why?

A

2nd line b/c of psycho-affect
abuse potential

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11
Q

what is nabilone contraindicated in?

A
  1. psychiatric disorder patients
  2. cardiovascular disease
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12
Q

What drug class is ondansetron and what is the MOA?

A

seratonin receptor antagonist
blocks serotonin receptors in CTZ

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13
Q

What are the 2 special adverse effects of Ondansetron?

A
  1. QT prolongation - EKG
  2. Muscle pain
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14
Q

Which antiemetic has no side effects when used shorter term?

A

dexamethasone

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15
Q

what is the drug class of dexamethasone?

A

glucocorticoid (steroid)

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16
Q

What drug class is metoclopramide (maxeran) and what is the MOA?

A
  1. prokinetic - promotes gastric emptying
    blocks dopamine + serotonin receptors in the CTZ
    upper GI responds to ACH so peristalsis happens
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17
Q

What are the adverse effects of metoclopramide - maxeran?

A
  1. tardive dyskinesia (remember my restless legs in concordia) w/long term use
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18
Q

What is metroclopramide (maxeran) contraindicated in?

A
  1. GI obstruction
  2. perforation
  3. hemorrhage
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19
Q

What is the one “other” antidiarrheal?

A

bismuth subsalicylate (pepto)

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20
Q

What is the MOA of bismuth subsalicylate (pepto)?

A

1.coats walls of the GI tract
2. stimulates mucous production
3. binds to toxins and bacteria for excretion

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21
Q

what are the adverse effects of bismuth subsalicylate (pepto)?

A
  1. increased bleeding time (not for PUD)
  2. hearing loss/tinnitus
  3. metalic taste
  4. blue gums
  5. dark stool
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22
Q

What are the 2 non-specific antidarrheals?

A
  1. loperamide- imodium
  2. Diphenoxylate + Atropine) - Lomotil
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23
Q

What drug class is loperamide - imodium and diphenoxylate + atropine - Lomotil?

A

Opiod

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24
Q

what antidiarrheal is good for people with iliostomy?

A

Imodium (note the I’s)

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25
Q

Which Opioid non-specific antidiarrheal causes neuro effects and which has none?

A
  1. diphenoxylate + atropine = lomotil - neuro effects
  2. loperamide- imodium - no neuro effects
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26
Q

What are the 2 osmotic laxatives?

A
  1. Magnesium hydroxide
  2. poly ethylene glycol
27
Q

What is magnesium hydroxide contraindicated in?

A

Renal disease b/c mag will already be high. Kidneys can’t secrete it

28
Q

What laxative helps purge poisons?

A

magnesium hydroxide

29
Q

what laxative is commonly used pre-colonoscopy?

A

polyethylene glycol

30
Q

What is the 1 stimulant laxative?

A

Bisacodyl (dulcolax)

31
Q

What laxative is given with constipation from opiods?

A

bisacodyl (dulcolax) - think codine… type meds

32
Q

when should bisacodyl (dulcolax) be taken?

A

at bed time

33
Q

what is a commonly abused drug in bulimia nervosa and anorexia nervosa?

A

bisacodyl (dulcolax)

34
Q

What is the MOA of bisacodyl (dulcolax) ?

A

stimulate motility - non systemic

35
Q

What is an osmotic laxative?

A

lactulose

36
Q

What is lactulose commonly used for when not a laxative?

A

hepatic encephalophathy

37
Q

What is the MOA of lactulose?

A

it turns into lactic acid in the intestine and helps ammonia NH3 turn into ammonium NH4 and leave the body

38
Q

what should we teach patients to do with psyllium?

A

drink LOTS of water. you don’t want it stuck in esophagus

39
Q

what laxative is good post MI?

A

docusate sodium (colace) - think sodium is a heart related thing

40
Q

What medication do we give for chronic IBD?
UC & crohn’s

A

5-aminosalicylates - sulfasalazine

41
Q

Is 5-aminosalicylates - sulfasalazine used for acute or chronic IBD?

A

chronic - to maintain remission

42
Q

what are the 2 adverse effects of 5-aminosalicylates- sulfasalazine ?

A
  1. risk for bleeding
  2. arthralgia - joint pain
43
Q

what do we remember about salicylates?

A

anti-inflammatory - like an NSAID

44
Q

what medication do we give for acute UC?

A

budesonide - glucocordicoid

45
Q

what is budesonide - glucocordicoid given for?

A

actue IBD - to induce remission NOT maintain remission

46
Q

Do we give glucocordicoid- budesonide to UC or crohns?

A

UC only b/c it works in the ascending colon and illium (bottom)

47
Q

What are the adverse effects of glucocordicoid - budesonide?

A

think steroids- adrenal suppression- cushings
osteoporosis
increased infection

48
Q

When is Infliximab used with IBD?

A

moderate to severe UC and crohn’s

49
Q

Do not give infliximab with other immuomodulator or immunosuppresants because it can increase the risk of __________

A

lymphoma

50
Q

what are the 3 adverse effects of Infliximab?

A
  1. chest pain (angina)
  2. HTN
  3. Hypotention
51
Q

what are the 4 drug classes for PUD?

A
  1. H2 receptor antagonist - ranitadine
  2. PPI - omeprazole
  3. antiucler - sucralfate, misoprostol, antacids
  4. antibacterial drugs
52
Q

When do we administer Ranitadine?

A

1 hour from other meds

53
Q

what are the 2 main adverse effects of ranitadine?

A
  1. confusion
  2. PN - b/c less H+= more bacteria
54
Q

what are the 4 main adverse effects of omeprazole?

A
  1. dyspepsia- rebound H+
  2. PN- b/c less H+ = more bacteria
  3. fractures b/c less H+ = less cal. absorption
  4. hypomagnemia b/c less H+ = less mag absorption
55
Q

when do we administer omeprazole?

A

before meals

56
Q

What is Sucralfate used to treat?

A

GERD
duodenal ulcers

57
Q

how long does sucralfate adhere to ulcers?

A

6 hours

58
Q

when do we administer sucralfate with antacids and/or other meds?

A

30 min to 1 hour before or after antacids
2 hours from meds

59
Q

What is the MOA of misoprostol?

A

suppresses gastric acid

60
Q

what is misoprostol contraindicated in?

A

pregnancy

61
Q

what is a common group of meds given for GERD, PUD and gastritis?

A

antacids- antiulcer

62
Q

when do we administer antacids?

A

after meals

63
Q

which two antacids go well together?

A

magnesium hydroxide (poop lots) + aluminum hydroxide- amajel (constipation)

64
Q

Who should not receive aluminum hydroxide?

A

people with hypophophatemia because it loves to bind to phosphate

2514 Patho/phys/assess (27 decks)

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