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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
Which Opioid non-specific antidiarrheal causes neuro effects and which has none?
1. diphenoxylate + atropine = lomotil - neuro effects 2. loperamide- imodium - no neuro effects
26
What are the 2 osmotic laxatives?
1. Magnesium hydroxide 2. poly ethylene glycol
27
What is magnesium hydroxide contraindicated in?
Renal disease b/c mag will already be high. Kidneys can't secrete it
28
What laxative helps purge poisons?
magnesium hydroxide
29
what laxative is commonly used pre-colonoscopy?
polyethylene glycol
30
What is the 1 stimulant laxative?
Bisacodyl (dulcolax)
31
What laxative is given with constipation from opiods?
bisacodyl (dulcolax) - think codine... type meds
32
when should bisacodyl (dulcolax) be taken?
at bed time
33
what is a commonly abused drug in bulimia nervosa and anorexia nervosa?
bisacodyl (dulcolax)
34
What is the MOA of bisacodyl (dulcolax) ?
stimulate motility - non systemic
35
What is an osmotic laxative?
lactulose
36
What is lactulose commonly used for when not a laxative?
hepatic encephalophathy
37
What is the MOA of lactulose?
it turns into lactic acid in the intestine and helps ammonia NH3 turn into ammonium NH4 and leave the body
38
what should we teach patients to do with psyllium?
drink LOTS of water. you don't want it stuck in esophagus
39
what laxative is good post MI?
docusate sodium (colace) - think sodium is a heart related thing
40
What medication do we give for chronic IBD? UC & crohn's
5-aminosalicylates - sulfasalazine
41
Is 5-aminosalicylates - sulfasalazine used for acute or chronic IBD?
chronic - to maintain remission
42
what are the 2 adverse effects of 5-aminosalicylates- sulfasalazine ?
1. risk for bleeding 2. arthralgia - joint pain
43
what do we remember about salicylates?
anti-inflammatory - like an NSAID
44
what medication do we give for acute UC?
budesonide - glucocordicoid
45
what is budesonide - glucocordicoid given for?
actue IBD - to induce remission NOT maintain remission
46
Do we give glucocordicoid- budesonide to UC or crohns?
UC only b/c it works in the ascending colon and illium (bottom)
47
What are the adverse effects of glucocordicoid - budesonide?
think steroids- adrenal suppression- cushings osteoporosis increased infection
48
When is Infliximab used with IBD?
moderate to severe UC and crohn's
49
Do not give infliximab with other immuomodulator or immunosuppresants because it can increase the risk of __________
lymphoma
50
what are the 3 adverse effects of Infliximab?
1. chest pain (angina) 2. HTN 3. Hypotention
51
what are the 4 drug classes for PUD?
1. H2 receptor antagonist - ranitadine 2. PPI - omeprazole 3. antiucler - sucralfate, misoprostol, antacids 4. antibacterial drugs
52
When do we administer Ranitadine?
1 hour from other meds
53
what are the 2 main adverse effects of ranitadine?
1. confusion 2. PN - b/c less H+= more bacteria
54
what are the 4 main adverse effects of omeprazole?
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
when do we administer omeprazole?
before meals
56
What is Sucralfate used to treat?
GERD duodenal ulcers
57
how long does sucralfate adhere to ulcers?
6 hours
58
when do we administer sucralfate with antacids and/or other meds?
30 min to 1 hour before or after antacids 2 hours from meds
59
What is the MOA of misoprostol?
suppresses gastric acid
60
what is misoprostol contraindicated in?
pregnancy
61
what is a common group of meds given for GERD, PUD and gastritis?
antacids- antiulcer
62
when do we administer antacids?
after meals
63
which two antacids go well together?
magnesium hydroxide (poop lots) + aluminum hydroxide- amajel (constipation)
64
Who should not receive aluminum hydroxide?
people with hypophophatemia because it loves to bind to phosphate

2514 Patho/phys/assess (27 decks)

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