Gi Block One Pharm

Front 1

Somatostatin is produced by (function?)

Back 1

produced by D cells, inhibits gastrin release, H. pylori decreases somatostatin release

Front 2

What is the major pathway for Gastrin?

Back 2

on the ECL cell to secrete histamine

Front 3

What negatively regulates the H+/K+ pump that works on epithelial cells to secrete mucous and bicarb?

Back 3

Prostaglandins PGI2 and PGE2

Front 4

H+/K+ ATPase Pump inhibitors (uses)
Omeprazole
Esomeprazole
Lansoprazole

Back 4

Gastric and duodenal ulcers, GERD, mainstay for pathological hypersecretory conditions (Zollinger-Ellison Syndrome)

Front 5

How are the PPi's activated?

Back 5

diffuse into gastric parietal cells and secreted into the acidic secretory CANALICULI
Catalyzed to a sulfonamide (traps drug in canaliculi)
Binds with cysteine sulfhydryl groups in the pump IRREVERSIBLY INACTIVATING THE PUMP MOLECULE

Front 6

H+/K+ ATPase Pump inhibitors (side effects)
Omeprazole
Esomeprazole
Lansoprazole

Back 6

Few (nausea, ab pain, constipation, flatulence, and diarrhea) increase risk of fracture and infections
P450 metabolized

Front 7

Main drug in this unit that inhibits hepatic cytochrome P450

Back 7

Cimetidine

Front 8

Histamine H2 receptor Antagonists
Cimetidine
Ranitidine

Back 8

Decreases BASAL (nocturnal) secretion to treat ulcers
Create tolerance

Front 9

A methyl PGE1 derivative

Back 9

Misoprostol

Front 10

Misoprostol (use and side effects)

Back 10

To prevent NSAID-induced mucosal injury
Abortifacient (can cause uterine contractions), abdominal cramping and diarrhea

Front 11

Forms a polymer gel in acid; adheres to epithelial cells and ulcer craters and protects the ulcer from pepsin hydrolysis

Back 11

Sucralfate
inhibits the absorption of some drugs

Front 12

What antacid causes gas, bloating/belching?

Back 12

Calcium Carbonate
Rapid onset long duration
Good cheap calcium supplement

Front 13

Aluminum Hydroxide

Back 13

Antacid
Al(OH)3; constipation decrease motility

Front 14

Magnesium hydroxide

Back 14

Antacid and Laxative
Increase gastric motility
often combined with Al in antacid prep

Front 15

What do you avoid with antacids?

Back 15

concurrent admin of antacids and drugs for systemic absorption

Front 16

Bismuth subsalicylate (mech SE)

Back 16

Promotes mucin and bicarb production and has antibacterial effects; anti diarrheal (travelers diarrhea)
SE-black stools, black tongue, can cause Reye's syndrome

Front 17

Scopolamine (mech, use)

Back 17

Motion sickness; muscarinic receptor antagonist
can cause dry skin/mouth, headache

Front 18

Dimenhydrinate (mech, use)

Back 18

Anti-emetic/car sickness; Histamine H1 blocker; vestibular afferents; has anti-muscarinic activity also

Front 19

Serotonin-receptor antagonists (mech, use, name the two)

Back 19

Works on CNS and peripheral nerves
Used for Chemo nausea
Ondansetron
Granisetron

Front 20

Prochlorperazine (mech, use)

Back 20

Dopamine2 antagonist; used for general use anti-emetic; site of action is CTZ
SE-->restlessness

Front 21

Dexamethasone (use)

Back 21

Used in conjunction with other anti-emetics for chemo

Front 22

Dronabinol (mech, use)

Back 22

CB1 receptor agonist; prophylaxis of refractory, chemo induced vomiting

Front 23

substance P, (NK1) receptor antagonist; used for acute and delayed chemo nausea; usually given with a 5-HT3 antagonist and a corticosteroid

Back 23

Aprepitant (mech, use)

Front 24

Metoclopramide (mech, use)

Back 24

Prokinetic agent-enchance GI motility; D2 antagonist, 5-HT receptor, enhanced gastric emptying by enchancing Ach release in the myenteric plexus
TX) DIabetic gastroparesis and GERD
dont give to someone with parkinsons

Front 25

Erythromycin

Back 25

Prokinetic agent; acts similary to motilin; tx for diabetic gastroparesis
SE=cramping!

Front 26

What is required for rehydration in a diarrhea patient?

Back 26

Balance of glucose and salts
for diarrhea, you treat the sx not the cause

Front 27

Diphenoxylate (mech, use)

Back 27

active agent is difenoxin; opioid derivative; can enter CNS (give with atropine)
Treat diarrhea

Front 28

Loperamide

Back 28

Opioid derivative; anti diarrheal; u receptor agonist; poorly penetrates into CNS

Front 29

Increases bulk, may bind toxins; anti-diarrheal

Back 29

Fiber

Front 30

Octreotide (mech uses)

Back 30

Somatostatin analog; tx of diarrhea associated with CARCINOID syndrome; inhibits hormone secretion

Front 31

Fiber fermentation...

Back 31

increases stool bacterial mass, side effect is gas; increases water solubility

Front 32

Lactulose (mech, use)

Back 32

Osmotic laxative, Unabsorbed carb-metabolized to short chain fatty acid by gut bacteria
SE: Gas and Cramping
can decrease ammonia levels

Front 33

Not absorbed remain in lumen; retain water d/t osmotic grade; prevent electrolyte imbalance
Laxative

Back 33

Polyethylene Glycol

Front 34

Anionic surfactant-lower surface tension
Laxative

Back 34

Ducosate salts

Front 35

Bisacodyl (use)

Back 35

Contact cathartics-cause mucosa irritation/inflammation
ACTS on Large Intestine

Front 36

Lubiprostone (mech use)

Back 36

activates chloride channels in the intestine
Treatment of adult chronic constipation and women with IBS!!

Front 37

Methylnaltrexone use

Back 37

to treat opioid constipation

Front 38

For moderate to severe acute attacks of UC and Crohns

Back 38

Prednicone (some respond some dont)

Front 39

An enteric release steroid used for Crohn's to target inflammed gut

Back 39

Budesonide

Front 40

5-aminosalicylates (use and mech SE)
Mesalamine
Olsalazine
Sulfasalazine
(bottom two are prodrugs)

Back 40

Prophylaxis and acute tx of recurring milde to moderate UC!
Inhibits IL-1 and TNF production
fever, malaise, vomiting
CI in pts allergic to salicylates

Front 41

Infliximab

Back 41

Immunoglobulin against TNFa; used for SEVERE Crohn's and UC
SE-increased respiratory infections and NHL!