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Pharmacology > Week 8 GI track > Flashcards

Week 8 GI track Flashcards

1
Q

What is ulcer?

A

Ulcers formed in the muscular mucosa in the wall of the GI tract
Ulcers occur when stomach acid damages the lining of the digestive tract.

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2
Q

2 type of ulcer

A

duodenum
stomach(gastric ulcer)

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3
Q

Ulcer
What are 3 main causes?

A

Helicobacter pylori infection
Used NSAIDS
Stress related mucosal damage

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4
Q

What are mucosa protection? 4

A

Mucosa secretion(physical barrier)
Bicarbonate(chemical barrier)
Microcirculation(protection method)
Prostaglandin

Maintain basic environment
Our body have too little these protection stuff

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5
Q

H. pylori
How to transmit?
Most affected populations?

A

Fecal-oral and oral-oral
Kids
Nurses

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6
Q

Ulcer caused by H. pylori
Medication

A

Helidac
Prevpac
Pylera

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7
Q

Which medication H. pylori starting resistance?

A

Prevpac

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8
Q

What NSAIDS dose to our body?

A

Dec production of prostaglandins
(ibuprofen etc)

Prostaglandins support our body’s protective factor(mucus, bicarbonate, microcirculation)

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9
Q

Ulcer caused by NSAIDs
Medication

A

Misoprostil
(Cytotec)

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10
Q

Misoprostil primary used these day is?

A

Promote abortion

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11
Q

Misoprostil
a) action
b) ADRs

A

a) Synthetic prostaglandin E1 analog
Inc mucosal protection
dec gastric acid secretion

b) Diarrhea moderate to severer
Contraindication pregnancy

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12
Q

Helidac®
contain?

A

Bismuth subsalicylate
Metronidazole
Tetracycline
H2RA

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13
Q

Prevpac®
contain?

A

Clarithromycin
Amoxicillin
Lansoprazole

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14
Q

Pylera®
contain?

A

Bismuth subcitrate
Metronidazole
Tetracycline
Omeprazole

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15
Q

What is the GERD?
Gastroesophageal Reflux Disease

A

Most common GI disorder
Tissue damage due to reflux of gastric contents into the esophagus

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16
Q

What is the condition of the GERD?

A

Chronic, relapsing condition related abnormal anatomy and motor function

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17
Q

GERD
Typical symptoms 6

A

Heartburn
Acid regurgitation
Belching (burping)
Abdominal bloating
Early satiety(unable to eat a full meal)
Nausea

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18
Q

GERD
Lifestyle modifications 7

A

Lose weight #1 cause
Smaller meals and low-fat foods
Avoid acid food
-citrus juice, tomato products, caffeine
Avoid lying down for 2-3 hr after meal
Avoid smoking!!
Elevate HOB
Avoid tight clothing

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19
Q

Antacids

A

Neutralize gastric acid
Rapid onset
Short duration of action
(take 7-10 times per day)
Mostly local acting

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20
Q

Aluminum hydroxide
Product name

A

Neutralize gastric acid
Alternagel
Amphojel

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21
Q

Aluminum hydroxide
ADRs

A

Aluminum= Constipation!!
Osteoporosis
Phosphate depletion

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22
Q

Magnesium
Product name

A

Neutralize gastric acid

Milk of Magnesia
Mag-OX

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23
Q

Magnesium
ADRs

A

Diarrhea
Hypokalemia
Hypermagnesemia (renal insufficiency)

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24
Q

Calcium Carbonate
Product name

A

Neutralize gastric acid
Tums
Chooz

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25
Calcium Carbonate ADRs
Calcium stone formation Acid rebound (Calcium itself cause make more acid) Milk-alkali syndrome
26
Sodium Bicarbonate Product name
Neutralize gastric acid Alka-Seltzer Baking soda
27
Sodium Bicarbonate ADRs
Systemic alkalosis Sodium overload
28
Rolaids Product
Calcium carbonate Magnesium hydroxide Don't work well as Mylanta -Synthetic pharmacodynamic drug drug interaction
29
Mylanta Maalox What contain?
Magnesium hydroxide Aluminum hydroxide Works better diarrhea(Mg)+constipation(Al) cancel out -Pharmacodynamic antagonistic therapeutic drug drug
30
Antacids Drug interaction
Tetracycline (Antibiotics) -direct complex Bisphosphonates -reduce absorption Ketoconazole -Inc gastric pH to alkaline, dec absorption
31
Antacid + alginic acid=??
Gaviscon Aluminum and magnesium antacids
32
Gaviscon action
Forms a foam on the liquid present in the stomach Work only while is int he upright position
33
What medication decrease acid production?
H2RA Proton Pump Inhibitor (PPI) Misoprostil
34
H2RA Product name
Cimetidine Famotidine Nizatidine tidine
35
H2RA Action ADRs
Dec histamine-mediated release of acid Hormonal ADRs with cimetidine
36
Proton Pump Inhibiter Product name
Omeprazole Lansoprazole Dexlansoprazole Esomeprazole -prazole
37
PPI action ADRS
dec long lasting acid through inhibition of the enzyme responsible for secret gastric acid 95%!! Dizziness, drowsiness and constipation
38
PPI Risk
risk associated with long term use Pneumonia with COPD pt (almost none acid cannot kill bacteria) Osteoporosis Inc risk of fracture
39
PPI how to take?
Take 20-30 min BEFORE first major meal of the day Suppress food activated acid release
40
Simethicone Product name
Mylicon Gas-X Mylanta Gas
41
Simethicone action
relive intestinal gas Prevent form of large gas bubbles Safe for kids and baby
42
What nausea? What vomiting?
Inclination to vomit - I'm going to vomit Ejection of stomach contents
43
Major concern N/V? 4
Dehydration Metabolic alkalosis (because all acid throwing up) Loss of electrolytes Esophageal damage
44
Anticholinergics Product name?
scopolamine meclizine dimenhydrinate
45
Anticholinergics used for? ADRs?
simple nausea Motion sickness -doesn't help pt who already vomiting Drowsiness Dry mouth Dry everything Constipation
46
Serotonin Receptor Antagonists Product name
dolasetron granisetron ondansetron palonosetron SETRON!!!
47
Serotonin Receptor Antagonists used for? ADRs?
Acute N/V Chemotherapy-including N/V -if pt not vomit, inc cancer curing raters headache Constipation or diarrhea
48
Dopamine Antagonists Product name
promethazine metoclopramide
49
Dopamine Antagonists used for? ADRs?
Acute N/V ADRs this drug not so common d/t a lot of side effects -dimness -confusion -abnormal involuntary movement
50
Cannabinoids products name
dronabinol nabilone Marijuana drug
51
Cannabinoids used for? ADRs?
Mild moderate nausea (not for vomiting) Less effective than others Sedation dizziness ataxia
52
Corticosteroids Product name
dexamethasone methylprednisolone
53
Corticosteroids used for? ADRs?
Post-surgical N/V **Only for SHORTERM used*** Short term used for avoid ADRs
54
Neurokinin Antagonist Product name Used for? ADRs?
aprepitant chemotherapy N/V Post-surgical N/V ** Very expensive, only hospitalization Well tolerated
55
Hemorrhoid? heh·mr·oyd
痔
56
Constipation Background
Very common (20% of population) Range vary based on pt so be sure to assess baseline
57
Constipation Causes
Diet (lack of fluid and fiber) Lifestyle GI disease Metabolic disorder Pregnancy Drugs (aluminum)
58
Constipation symptoms-major 5
Dec frequency Hard/dry stool Painful defecation Abdominal distention Palpable mass
59
Constipation symptoms-minor Kids 4
Rectal pressure Headache Dec appetite Abdominal pain
60
Constipation symptoms RED FLAG 5
Blood in stools (hemorrhoid? GI cancer?) Weight loss Fever Anorexia Nausea and vomiting
61
Constipation Complications
Anal fissure Hemorrhoids Rectal prolapse Fecal impaction
62
Bulk forming Laxatives Product name
Psyllium Methylcellulose Calcium polycarbophil Wheat dextrin
63
Bulk forming Laxatives a) action b) onset
Absorbs water to inc fecal mass Distending bowel to initiate reflex activity　膨らむ 12-72hr
64
Bulk forming Laxatives a) ADRs b) Comments
Flatulence(accumulation of gas) Abdominal cramping/blotting Must drink sufficient water Avoid in dehydrated patients
65
Stool softeners a) Product name -calcium -sodium b) onset
Docusate surfak Docusate colace 1 to 2days
66
Stool softeners action
Soften stool mass (keep water in stool)
67
Stool softeners a) ADRs b) Comments
Diarrhea Works best for prevention Prevents straining(pulled muscle)
68
Stimulants action
Inc peristalsis by irritating nerves in colon
69
Constipation Stimulants a) products name b) onset
a) Senna, Biscodyl, Castor oil b) 6-12 hr (PO) 15-30min (suppository/into bottom)
70
Constipation Stimulants a) ADRs b) Comments
a) Abdominal cramps (sever) diarrhea b) Laxative dependency if use too much
71
Osmotic laxatives a) Products b) onset
Hypertonic electrolytes, Magnesium citrate Magnesium hydroxide (MOM) Sodium phosphate, Golytely Dose dependent (1-8 hr oral, minutes rectally)
72
Osmotic laxatives action
Inc water content in bowel stimulates peristalsis Hold water in bowel through osmotic pressure
73
Osmotic laxatives a) ADRs b) Comments
a) Diarrhea/cramping Dehydration Electrolyte imbalance Caution in renal failure (hypertonic electrolytes)
74
Lubricants a) Product name b) onset c) action
a) Mineral oil (not orally) b) 24-48hr c) Coats feces easing passage of stool Maintains water in stool
75
Lubricants a) ADRs b) Comments
a) Can ne absorbed, causes an inflammatory reaction Lipid pneumonia b) Absorb fat soluble vitamins tends to leak from rectum Best used a component of an enema
76
Diarrhea background
Not a disease, it a symptom of disease Marked by inc stoll frequency (lack of control) abdominal cramps Rectal urgency Loose, watery formed stools Usually self-limiting 3-4 days
77
Diarrhea causes
Infection(viral and bacteria) Drugs (antibiotics, laxatives, orlistat) Food Malabsorption
78
Adsorbents product name Onset
Attapulgite 12hr to 2days
79
Adsorbents action
Absorbs excess fluid in the intestine, stabilizes stool mass
80
Adsorbents a) ADRs b) Comments
Constipation Not absorbed (No systemic ADRs) Drug interactions due to complexation
81
Anti-peristaltic Product name Onset
Loperamide(Imodium) 45-60 mins
82
Anti-peristaltic action
Prolong intestinal transit time by stimulating GI opioid receptors Allow for longer water reabsorption
83
Anti-peristaltic a) ADRs b) Comments
Constipation abdominal pain 4mg followed by 2mg after each loose stool(Max 16mg/day) for up to 48hr Contraindication in patients<2 years old
84
Which diarrhea medication has black box waring?
Anti-peristaltic/Loperamide(Imodium) Black box warning!!! Cardia arrhythmias when used in higher than recommended doses
85
Antisecretory Product name onset
Bismuth subsalicylate 4-24hr
86
Antisecretory action
Prevent secretions into the bowel, antibiotic
87
Antisecretory a) ADRs b) Comments
Temporary darkening of tongue Salicylate allergy
88
What is the Salicylate allergy?
Salicylates are a type of drug found in many over-the-counter and prescription medicines. Aspirin is the most common type of salicylate. Asthma-like symptoms, such as wheezing and trouble breathing
89
What medication can cause an electrolyte imbalance and should therefore be used with caution in renal patients?
Polyethylene glycol (MiraLAX) Constipation med
90
The drug that treats diarrhea the fastest is?
Loperamide 45-60mins

Pharmacology (34 decks)

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