Gastrointestinal Drugs 3Rd Test

Front 1

What is the physiology of gastric acidity?

Back 1

Pareital cells (PGE) secrete H+ in response to gastrin, ACh cholinergic (M receptor), and Histamine (H-2).
PGE inhibits gastric acid secretion.
H+/K+ ATPase proton pump secretes H+ into gastric lumen for K+.

Front 2

When the proton pump works what happens to the pH?

Back 2

It decreases

Front 3

What does a low pH lead to?

Back 3

Activates digestive protease, feeds back to inihibit futher gastrin release. controls intestinal bacteria, may cause inflammation and ulceration, protects against irritants, and drugs.

Front 4

What is secreted in the protective measure of gastric acid?

Back 4

Mucous due to PGE, Bicarbonate, and Tight Junctions at the BBB.

Front 5

What are the indications for GI drugs?

Back 5

Peptic ulcers, gastroesophageal reflux disease (GERD), and indigestion and epigastric pain.

Front 6

Indications for antacids

Back 6

Neutralize stomach acids due to increase in gastric pH.
Treats transient dyspepsia from spicy foods.
Neutralize the diarrhea and constipation.

Front 7

Side effects of antacids

Back 7

acid rebound
systemic and urinary alkalosis
drug interaction by blocking meds.

Front 8

Mechanism for H-2 Receptor Antagonists cmietidine (Tagamet)

Back 8

H-2 Receptor Antagonist by decreasing the gastric acid output in respone to histamine. It decreases the ACh and gastrin.
It is specific for H-2 receptor.
It decreases pepsin activity.

Front 9

Indications of H-2 Receptor Antagonists Cmietidine (Tagamet)

Back 9

Treatment of gastric and duodenal ulcers.
Treatment of mild gastroesophageal reflux so can be given before meals.
Most prescribed before PPIs which is good for overnight histamine problems.

Front 10

Side effects of H-2 Receptor Antagonists Cmietidine (Tagamet)

Back 10

Less effective at meal-stimulated secretions.
CNS dizziness and mental confusion.
Inhibits hepatic P450 and drug metabolism. It leads to an increased half-life and plasma levels.
Can lead to tolerance.
Can have acid rebound.

Front 11

Rantidine (Zantac)

Back 11

A H-2 receptor antagonist that is longer in duration of action and has no anti-adronergic action.
It has little effect on drug metabolizing enzymes.

Front 12

Mechanism of Action of Proton Pump Inhibitors: omeprazole (Prilosec)

Back 12

Irreversible inhibits the H+/K+ ATPase pump: efficacious and long-lasting.
Inhibits fasting, noctural and meal-stimulated GI secretion.

Front 13

Indcations for Proton Pump Inhibitors: omeprazole (Prilosec)

Back 13

May have antimicrobial and antiinflammatory action.
Most effect available for GERD.
Used for dyspepsia but not proven.

Front 14

Side effects of Proton Pump Inhibitors: omeprazole (Prilosec)

Back 14

Bioavailabity decreased by food.
Maximum effect is delayed 3-4 days.
Has a short half life but long duration.
Diarrhea, headache, B12 deficiency, increased risk of infection.

Front 15

What are the effects of antibiotics and H-2 receptor antagonists?

Back 15

Have a high cure rate due to proton pump inhibitors.

Front 16

Anticholinergics

Back 16

First anti-ulcer drug available. Can have dry mouth and cardiac/bladder problems.

Front 17

Sucralfate (Carafate)

Back 17

Binds with antacid and protects from HCl.

Front 18

What does aluminum hydroxide cause?

Back 18

Constipation

Front 19

What does magneisum hydroxide cause?

Back 19

Diarrhea

Front 20

Bismuth subsalicylate (Pepto Bismol)

Back 20

Salicylate portion is absorbed. Antidiarrhea in nature.
May increase mucus and bicarbonate secretion.
Can get a black tongue.

Front 21

Misoprostol (Cytotec)

Back 21

Mimics PGs. Will inhibit gastric secretion.
Effective for NSAID-induced ulcers.

Front 22

Antidarrheal agents: Opiods

Back 22

Decrease peristalisis, allow greater absorption of fluid and electrolytes.

Front 23

Adsorbents

Back 23

An antidiarrheal.
It binds and inhibits bacteria and toxins.
Avoid with other drugs.
Kaopectate.

Front 24

Laxatives

Back 24

Promotes evacuation and ease elimination

Front 25

Cathartics

Back 25

Purgatives
Promote rapid evacuation.

Front 26

Psyllium (Metamucil) Bulk Forming

Back 26

Absorb water and swell leading to a stretching of the bowel and stimulates peristalsis.
A more natural laxative.

Front 27

Bisacodyl (Ducolax, Correctol, Feen A Mint): Stimulants

Back 27

Have direct irritation of intestinal mucosa and have a stimulation of the nerve plexus.
Can lead to dependence and cramps

Front 28

Magnesium Hydroxide: Hyperosmotic in nature

Back 28

Poorly absorbed salts that draw water into the intestines.
Lead to a prompt evacuation which can lead to electrolyte disturbances.

Front 29

Docusate (Colace): Stool Softeners

Back 29

Detergent action on stool surface and allows water absorption into stool.
Leads to an ease of evacuation.

Front 30

Lubriancts (mineral oil)

Back 30

Coat stool to prevent loss of water. Interferes with absorption of the Fat soluble vitamins

Front 31

Emetics: ipecac

Back 31

Stimulates medullary vomitting center and stimulates stomach. It is not 100% evacuation of contents, not recommended for all toxins/drugs.

Front 32

Antiemetics Can lead to:

Back 32

Causes of nausea/vomitting.
Has drug side effects.
Infection/Pregnancy/Vestibular dysfunction

Front 33

Mechanism of Antiemetics

Back 33

Vomitting cneter in medulla.
High concentration of M,H, and 5HT receptors.
Afferent input which have a chemoreceptor trigger zone.

Front 34

Serotonin 5HT3 antagonists

Back 34

Block cholinergics afferent input to vomitting center.
Most effective for emesis initated in GI tract.
Primary drug for chemotherapy-induced N/V.