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49 Cards in this Set

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_____ cells are predominatly found in the antrum and _________ cells are predominatly found in the fundus.
Gastrin cells are predominant in the antrum and parietal cells are predominant in the fundus.
What are the 3 main stimuli of acid secretion?
Ach, histamine, gastrin
Gastrin stimulates the ECL cells to secrete histamine that stimulates ______ cells. Gastrin also activate the ______ cells to increase expression of _______ that increases ______secretion.
Gastrin stimulates the ECL cells to secrese histamine that stimulates parietal cells. Parietal cells are also activated by gastrin to increase the expression of the H,K ATPase that increases acid secretion.
This type of drug acts by inhibiting M1 and M3 receptors on ECL cells and Parietal cells, respectively.
muscarinic antagonists block M1 receptors in ECL cells and M3 receptors in parietal cells.
This type of drug inhibits the ability of the ECL cell to stimulate acid secretion by interfering with the _____ receptor.
H2 blocker inhibits the ability of the ECL cell to stimulate acid secretion by interfering with the parietal H2 receptor.
The most direct way of inhibiting acid secretion is by using this type of drug which acts on this enzyme.
the most direct way of inhibiting acid secretion is by using proton pump blockers which inhibit the H,K ATPase on parietal cells.
____________ acts by binding to the ulcer and increasing its healing. It may interfere with drug absorption in the stomach.
sucralfate binds to the ulcer base and provides physical protection. It allows HCO3- secretion to reestablish pH gradient in the mucus layer.
What hormone binds ECL cells and decreases acid secretion?
somatostatin
These type of drugs used to increase pH in the stomach.
antacids….duh….jk. (I was instructed to make a question of every word)
____________, ___________, ___________, and ___________ are examples of H2 blockers and they act by (reversibly/irreversibly)
cimetedine, ranitidine, famotidine, nizatidine reversilbly block H2 receptors.
This H2 blocker is the only one that has many side effects which include potent inhibition of ______, _____ effects, and _____ renal excretion of creatinine.
cimetedine is a potent inhibitor of P450, it has antiandrogenic effect and decrease renal excretion of creatinine. Other H2 blockers are relatively free of these effects.
_________ and _________ (reversibly/irreversibly) inhibit the H/K ATPase in the stomach _______cells.
Omeprazole and Iansoprazole irreversibly inhibit the H/K ATPase in stomach parietal cells
Proton pump inhibitors are indicated for peptic ulcer, ________, _______, and _________ syndrome
peptic ulcer, gastritis, esophageal reflux, and Zollinger-Ellison syndrome
T/F: Bismuth and sucralfate allow HCO3- secretion.
True: bismuth and sucralfate bind to ulcer base and provide physical protection, and allow HCO3- secretion to reestablish pH gradient in the mucus layer=increased ulcer healing
T/F: misoprostol is a PGE2 analog and increases the production and secretion of gastric mucous barrier.
False: misoprostol is a PGE1 analog and it increases the production and secretion of gastric mucous barrier.
What are the 3 indications for misoprostol?
prevention of NSAID-induced peptic ulcers, maintains a PDA and used to induce labor
In what population is misoprostol contraindicated?
women of childbearing potential (abortifacient). It also casues diarrhea
Infliximab is ___________ against ______.
monoclonal antibody to TNFa
The clinical indication for Infliximab is:
Crohn's, along with fistula healing
T/F: Infliximab can cause respiratory infection, fever, hypotension
TRUE
This drug offers both anitbacterial action and anti-inflamatory effects. It is used for 2 inflammatory GI diseases ______ and _______.
sulfasalazine: combination of sulfapyridine (antibacterial) and mesalamine (anti-inflammatory effects). It is used for Ulcerative colitis and remission of Crohn's.
T/F: Side effects of sulfasalazine include: malaise, sulfonamide toxicity, neutropenia
false: side effects: malaise, nausea, sulfonamide toxicity
___________ is a powerful central-acting antiemetic. It acts by antagonizing the______ receptor.
Ondansetron: is a powerful antiemetic.
Antagonizes 5-HT3 receptor
Think: you will not vomit with ondansetron, so you can go on dancing.
T/F Odansetron is used to treat vomiting preoperatively and for cancer chemo therapy pts.
False: it is used to treat vomiting postoperatively.
Headache and __________ are side effects of ondansetron
constipation (can't vomit or poop)
Antacid overuse can affect:_________, __________, or ______ excretion of other drugs by altering ______ and ______ pH or by delaying gastric _________.
Antacid overuse can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.
Constipation and (hypo/hyper) phosphatemia is seen with overuse of ________________ antacids
hypo, aluminum hydroxide - AluMinimum amt. of feces
Magnesium hydroxide overuse = ___________
diarhea; Mg = Must go to the bathroom
Calicium carbonate= hypercalcemia and (increase/decreased) acid
causes hypercalcemia and rebound acid.
T/F: hyperkalemia can be seen with AlOH, MgOH, CaCO2
False! hypokalemia
heparin Catalyzes activation of ____________, decreases ________ and __________. It has a ____t1/2. check PTT
catalyzes the activation of antithrombin III, decreases thrombin and Xa. It has a short t1/2
heparin It is used for immediated anticoagulation for pulmonary embolism,_______, _______, MI, and ________. Follow PTT
used for pulmonary embolism, stroke, angina, MI, and DVT.
heparin T/F: Is used during pregnancy
true: it is used during pregnancy because it does not cross the placenta.
heparin It can cause bleeding,___________, and drug-drug interactions.
thrombocytopenia
___________ is used for rapid reversal of heparization (it is a _______ charged molecule that binds the ________ charged heparin)
protamine sulfate is used for rapid reversal of heparinization (it is a positively charged molecule that binds the negatively charged heparin).
heparin Newer________________ (enoxaparin) act more on _____, have better bioavailability and 2-4 times longer t1/2. Can be administered subcut and (with/without) lab monitoring.
lower-molecular-weight heparins (enoxaparin) act more on Xa, have better bioavailabitlity and 2-4 times longer half-life. Can be adm. Subcut and without lab monitoring.
warfirin (coumandin) Interferes with normal synthesis and gamma-carboxylation of vitamin K-dependent factors ___, ___, ___, and ___, also, ___ and ___ via ______ antagonism.
Interferes with normal synthesis and gamma-carboxylation of vitamin K-dependent clotting factors II, VII, IX, and X, protein C and S via vitamin K antagonism.
warfirin (coumandin) t1/2 (short/long)
long
warfirin (coumandin) Affects _______ pathway. Follow (PT or PTT)
WEPT - Warfirin affects the Extrinsic pathway and prolongs PT
warfirin (coumandin) T/F: is used during pregnacy
False! (warfarin, unlike heparin, can cross the placenta).
warfirin (coumandin) Toxicity: bleeding, _________, drug-drug interactions
teratogenic
Heparin is a (large/small) _____charged acicid polymer while Warfarin is (large/small) (charged/neutral) molecule
Heparin is a large negatively charged acidic polymer while Warfarin is a small neutral charged lipid-soluble molecule
T/F: Heparin is given orally while warfarin is given SC/IV
False! Heparin is given IV/SC and warfarin is give oral
Site of action: heparin _________, warfarin ______
heparin's site of action is the blood; warfarin's site of action is the liver (synthesises clotting factors)
(heparin/warfarin) Onset of action of _________ is slow; the onset of action of ______ is rapid
onset of action of heparin is rapid (secs) and the onset of action of warfarin is slow, limitd by t1/2 of normal clotting factors.
Warfarin works by imparing the synthesis of _______ dependent factors __, ___, ___, and ___ also _____, and ____; heparin activates _____
Warfarin works by imparing the synthesis of vitamin K dependent factors II, VII, IX, and X also protein S and protein C; heparin activates ATIII
Heparin 's duration of action is (acute/chronic); warfarin's duration of action is (actue/chronic)
Heparin's duration of action is actute and warfarin's duration of action is chronic.
Tx of acute OD: Heparin = _________; warfarin=______
Tx of heparin OD is protamine sulfate; Tx of warfarin= IV vit. K and fresh frozen plasma.
Warfarin is monitored by _________ while Heparin is monitored by ___________.
Warfrin is monitored by PT (extrinsic pathway) (WEPT) and heparin is monitored by PTT (intrinsic pathway)