Br Pharmacology: Gi Drugs

Front 1

What the most popular antacids? What is the effect of each?

Back 1

1) aluminum hydroxide = constipating action
2) magnesium hydroxide = laxative effect

Front 2

How do NaHCO3 and CaCO3 differ from AlOH and CaOH2?

Back 2

1) NaHCO3 and CaCO3 are absorbed from gut and can have systemic effects
2) can lead to hypercalcemia and rebound acid increase

Front 3

Which drugs are H2 antagonists?

Back 3

1) cimetidine
2) ranitidine
3) famotidine
4) nizatidine

Front 4

Which drugs are the proton pump inhibitors?

Back 4

1) omeprazole
2) esomeprazole
3) lansoprazole
4) pantoprazole
5) rabeprazole

Front 5

How do the PPIs work?

Back 5

1) they are lipophilic bases that diffuse into parietal cell canaliculi and become protonated
2) They then irreversibly inactivate the parietal cell H+/K+ ATPase

Front 6

which drug is used in treatment of zollinger-ellison?

Back 6

PPI

Front 7

What can chronic treatment with PPIs result in?

Back 7

1) hypergastrinemia
2) osteomalacia

Front 8

What can PPIs limit the absorption of?

Back 8

1) vitamin B12
2) drugs needing acidity for absorption (ketoconazole and digoxin)

Front 9

The risk of what types of infection may be slightly increased from taking a PPI?

Back 9

1) enteric infections
2) respiratory infections

Front 10

What is the MOA of sucralfate? what does it help with?

Back 10

1) poorly soluble that polymerizes in acid environment
2) forms protective coating over ulcer beds
3) accelerates healing of peptic ulcers and reduces recurrence rates

Front 11

What is the MOA of misoprostol?

Back 11

1) PGE1 analog
2) increases mucosal protection and inhibits acid secretion

Front 12

What is misoprostol used for in GI? What can it cause?

Back 12

1) reduce risk of ulcers in chronic NSAID users
2) can itself cause GI upset

Front 13

What are the actions of colloidal bismuth?

Back 13

1) form protective coating over ulcers
2) stimulate mucosal protective effects
3) direct antimicrobial effects
4) sequestration of enterotoxins

Front 14

What is colloidal bismuth sold for in US? How does stool look when taken?

Back 14

1) reduce stool frequency and liquidity in infectious diarrhea
2) Causes black stool

Front 15

What are two lines of therapy for H pylori?

Back 15

1) PPI + bismuth + tetracylcine + metronidazole
2) PPI + amoxicillin + clarithromycin

Front 16

What drug is used in patients with acute large bowel distention?

Back 16

Neostigmine

Front 17

What does dopamine do in GI? What is metoclopramide used for in GI?

Back 17

1) inhibits cholingergic stimulation of smooth muscle
2) D2 antagonist that promotes GI motility
a. increases resting tone
b. enhance gastric emptying with out effecting motility
c. increase LES tone
d. no effect on motility
3) is anti-emetic by inhibiting D2 receptors in area postrema

Front 18

What are metoclopramides effects in CNS?

Back 18

1) D2 blocker in area postrema
2) used to prevent emesis after surgical anesthesia and emesis from cancer chemo

Front 19

What can methoclopramide cause when used chronically?

Back 19

1) parkinsons
2) extrapyramidal effects
3) hyperprolactinemia
4) drug interaction with digoxin and diabetic agents

Front 20

What are 5-HT3 antagonists that are used as antiemetics?

Back 20

1) ondansetron
2) granisetron
3) dolasetron

Front 21

What is the MOA of aprepitant? What is it approved to treat?

Back 21

1) antagonist of neurokinin 1 (NK1) receptor in area postrema of CNS
a. NK1 is activated by substance P and other tachykinins
2) used in combination therapy for nausea and vomiting in highly emitogenic chemotherapeutic regimens

Front 22

How is IBS characterized?

Back 22

relapsing episodes of abdominal discomfort (pain, bloating, distention or cramps) plus diarrhea or constipation or both

Front 23

What is alosetron used for? What are side effects?

Back 23

1) potent 5-HT3 antagonist used in women with severe IBS with diarrhea
2) can cause constipation and rarely ischemic colitis
Note: channel is permeable to sodium, potassium, and calcium ions

Front 24

What is the MOA of tegaserod?

Back 24

1) 5-HT4 agonist
2) promotes gastric emptying and enhances small and large bowel transit with no effect on esophagous
3) increases stool liquidity by increasing Cl- secretion
Note: this receptor is Gs and increases cAMP

Front 25

What is tegaserod used for? Why has it been discontinued?

Back 25

1) IBS with chronic constipation
2) cardiovascular toxicities

Front 26

what is sulfasalazine activated by in GI? What is it used for? What are toxic effects?

Back 26

1) activated by colonic bacteria
2) UC and crohns
3) Toxicities:
a. arthralgias
b. reversible oligospermia
c. myalgias
d. bone marrow suppression
e. hypersensitivity

Front 27

What are two pancreatic enzyme replacements?

Back 27

1) pancreatin
2) pancrelipase

Front 28

What are opioid antidiarrheal agents?

Back 28

1) diphenoxylate
2) loperamide
note: both have little analgesic effects

Front 29

what are drugs used to inhibit gallstone formation?

Back 29

1) chenodiol - reduces secretion of bile acids from liver
2) ursodiol

Front 30

What are bulk forming agents?

Back 30

1) psyllium
2) methylcellulose
3) polycarbophil

Front 31

What are stool softening agents?

Back 31

1) docusate
2) glycerin
3) mineral oil

Front 32

What are osmotic agents?

Back 32

1) magnesium oxide
2) sorbitol
3) lactulose
4) polyethylene glycol

Front 33

What are GI stimulating agents?

Back 33

1) aloe
2) senna
3) cascara
4) castor oil

Front 34

Anti-rheumatic agent also used for ulcerative colitis

Back 34

Sulfasalazine

Front 35

5HT-3 antagonist used in chemotherapeutic induced emesis

Back 35

"Ondansetron, granisetron,
dolasetron and alosetron "

Front 36

What are toxic effects of cemitidine?

Back 36

1) P-450 inhibitor
2) anti-androgenic (prolactin release, gynecomastia, impotence, decreased libido in men)
3) cimitidine and ramantidine can decrease renal excretion of creatinine

Front 37

drug used to maintain patent PDA and induce labor?

Back 37

misoprostol

Front 38

Which muscarinic antagonists are used occasionally for peptic ulcers?

Back 38

1) pirenzepine
2) propantheline
3) methscolpolamine

Front 39

Which muscarnic receptor is on ECL cells? What does activation do?

Back 39

1) M1 = release of histamine
Note: M1 = Gq

Front 40

What muscarinic receptor is found on parietal cells? what is function

Back 40

1) M3 = increase H+ secretion
Note: M3 = Gq

Front 41

what are toxic effects of AlOH?

Back 41

1) constipation
2) hypophosphatemia
3) proximal muscle weakness
4) osteodystrophy
5) seizures

Front 42

What are toxic effects of MgOH?

Back 42

1) diarrhea
2) hyporeflexia
3) hypotension
4) cardiac arrest

Front 43

Which conditions is infliximab used for?

Back 43

1) crohns
2) RA