Gi Drugs

Front 1

Lateral hypothalamus and ventromedial hypothalamus are stimulated by what neurotransmitters?

Back 1

NE and 5HT

Front 2

What meds stimulate the lateral and ventromedial hypothalamus?

Back 2

Amphetemines, TCAs, SSRI's

Front 3

Amphetamines
MOA:
uses:
S/E:

Back 3

MOA: are taken up presynaptically, causing release of catecholamines (DA, NE, 5HT)
uses: ADHD, nacrolepsy, weight loss
S/E: n/v (via stimulation of DA rec), tics (via stimulation of basal ganglia with DA), vertical nystagmus

Front 4

Amphetamine
1st line for ADHD

Back 4

Methylphenidate (ritilan)

Front 5

Amphetamine
OTC for wt loss

Back 5

Dexadrine

Front 6

Amphetamine
causes hallucinations, slow, lazy

Back 6

LSD

Front 7

Amphetamine
causes hallucinations, violent, aggressive

Back 7

PCP

Front 8

Amphetamine
causes hallucinations and high thirst

Back 8

ecstasy

Front 9

Patients in ICU always get what medicine?

Back 9

PPI blocker, to prevent stress ulcers

Front 10

How do parasympathetic (cholinergic) meds affect salivary glands?

Back 10

More saliva, with more salt (thicker)

Front 11

How do sympathetic (adrenergic) meds affect salivary flow?

Back 11

less quantity, more salt, thicker

Front 12

CF
-dx?
-rx?

Back 12

dx: pilocarpine (sweat test >60)
rx: n-acytelcysteine (breaks disulfide bonds)

Front 13

Treatment or eating disorders?

Back 13

SSRI

Front 14

H2 blockers
ex:
MOA:
uses:
S/E

Back 14

Ex: Cimetidine, Ranitidine, Famotidine, Nizatidine
"H2 blockers are -tidine. Think: to-dine, table for 2"

MOA: reversible block of H2 rec (leads to dec H secretion by parietal cells)
uses: PUD, gastritis, mild reflux
S/E:
1) cimetidine inhibits P450
2) antiandrogenic (induces prolactin release, gynecomastia, impotence,
dec libido)
3) cross BBB less than H1 blockers (dizzy, HA) and placenta
4) Cimetidine and Ranitidine dec renal excretion of Cr
"C&R messes with cr"

Front 15

PPI's
ex's
MOA:
uses:

Back 15

Omeprazole.... -prazole

MOA: IRREVERSIBLY in H/K ATPase in parietal cells
uses: Peptic ulcer, gastritis, reflux, ZES

Front 16

Atropine
MOA:
uses in GI:

Back 16

?

Front 17

COX-1 vs COX-2

Back 17

?

Front 18

Misoprostol
MOA:
uses:
toxicity:
CI:

Back 18

MOA: PGE1 analogue; inc production of mucous barrier; dec acid production
uses: NSAID induced ulcers, induce uterine contractions, induce cervical effacement, keep ductus arteriosus patent.
toxicity: diarrhea
CI: women of childbearing age

Front 19

Where does MALT lymphoma occur most often?
How do you treat?

Back 19

gastric antrum
Rx: 1st line= Abx
(chemo if refractive)

Front 20

Rx for sliding hiatal hernia

Back 20

1st line: wt loss, H2 blockers
2nd line: Nissen fundoplication

Front 21

Rx for rolling hiatal hernia

Back 21

surgery

Front 22

Rx of bezoar

Back 22

endoscopy and removal

Front 23

4 causes of severe abdominal pain

Back 23

Panceatitis
Appendicitis
Ischemic bowel
Kidney stone

Front 24

Mgmnt of sever abdominal pain

Back 24

1) NPO
2) NG tube
3) IV nl saline
4) meperidine
5) CT scan

Front 25

Rx for necrotic pancreatitis

Back 25

Amp + Gent + metronidazole

Front 26

Rx for asxtic gallstones

Back 26

1st: Ursodeoxycolic acid (dissolves stones)

2nd: schedule for surgery

Front 27

Rx of type 1 HLD

Back 27

diet alone!

Front 28

Bismuth, sucralfate
MOA:
uses:

Back 28

MOA:
bind to ulcer base--> physical protection (allows for HCO3 secretion, thus re-establishes pH)

uses: ulcers, traverler's diarrhea

Front 29

Hpylori regimen

Back 29

?

Front 30

Muscurinic rec are found on what cells in the stomach?

Back 30

ECL cells: M1
parietal cells: M3

Front 31

Antimuscurinics used in GI
ex:
MOA:
S/E:

Back 31

ex: Pirenzepine, Propantheline
MOA: block M1 rec on ECL cells (dec histamine sec), block M3 rec on parietal cells (dec H secretion)
uses: peptic ulcer (rarely)
S/E: tachyacardia, dry mouth, difficulty focusing eyes

Front 32

Antacid
ex:
S/E
toxicity:

Back 32

ex: Al-OH, Mg-OH, Ca-CO3
S/E:
alters gastric pH and urinary pH, thus affecting, absorption, bioavailability, and urinary excretion of OTHER drugs

may chelate and dec effectiveness of OTHER drugs

S/E:
Al: constipation ("all stopped up")
Mg: diarrhea ("Must Go")
Al and Mg: less likely to depolarize
Ca: more likely to deploarize

Front 33

Infliximab
MOA:
uses:
tox:

Back 33

MOA: Ab to TNF (a proinfflammatory cytokine)
uses: Chron's disease, RA
tox: respiratory infxn, ***reactivates TB, fever, hypOtension

Front 34

Salfasalazine
MOA:
uses:
tox:

Back 34

MOA: combination of sulfapyridine (abx) and mesalamine (anti-inflamm)
uses: UC, Chrons
tox: malaise, nausea, reversible oligospermia, sulfa allergy

Front 35

Ondansetron
MOA:
uses:
tox:

Back 35

MOA: 5HT3 antagonist, central-acting, antiemetic
uses: chemo nausea, post-op nausea
tox: HA, constipation

Front 36

Metoclopromide
MOA:
uses:
tox:

Back 36

MOA: D2 rec antagonist, inc LES tone, inc GI's resting tone and contractility (does not influence colon transport time)
uses: gastroparesis (post-surgery, diabetic)
tox: inc parkinsonian effects,
CI: small bowel obstrxn, digoxin, diabetic drugs

Front 37

1st line Rx for constipation

Back 37

adequate fluid intake

Front 38

Treatment of IBS

Back 38

Antidepressants

Front 39

Which UC or Chron's is treatable with surgery?

Back 39

Chrons

Front 40

Rx for Whipples

Back 40

initial course of Ceftriaxone followed by one year of TMP-SMX

Front 41

Drugs used for anti-diarrhea

Back 41

1) Bismuth
2) Ocreotide
3) Loperimide
4) Diphenoxylate

"BOLD"

Front 42

Loperimide and Diphenoxylate for anti-diarrhea
class
MOA:

Back 42

class: opiod
MOA: (mu) receptor agonist at myenteric plexus; decreases tone of longitudinal muscl; increases tone of circular muscle; lengthens transport time allowing for more absorption

Front 43

Difference bw Loperimide and Diphenoxylate

Back 43

Diphenoxylate contains atropine as well (atropine is mixed in to give pts anticholinergic side effects so that they dont overuse the med)

Front 44

Cisapride
MOA:
uses:
S/E:

Back 44

MOA: 5HT4 rec agonist--> inc Ach release from UGI's enteric nervous system; increases motility in UGI; inc tone in LES
uses: GERD, gastroparesis, constipation
S/E: long Q-T, arrhythmias, Parkinsons like synd

Front 45

What receptors do parietal cells have on them?
What are the 2nd messengers of these receptors?

Back 45

M3- Gq
H2- Gs
CCKB- Gq

Front 46

IBS treatment

Back 46

fiber supplement (psyllium)
TCA
antidiarrhea ("BOLD")
anticholinergic: dicyclomine

Front 47

ursodeoxycholic acid
MOA:
uses:

Back 47

MOA:
1) dec hepatic excretion of cholesterol
2) dec intestinal absorption of cholesterol

uses: in patients who don't want lap chole, preggos, primary sclerosing cholangitis, NASH, primary biliary cirrhosis

Front 48

Cholystyramine
MOA:
uses:

Back 48

MOA: bind bile salts (which would normally bind cholesterol so that cholesterol can be absorbed in jejunum), thus dec intestinal absorption of cholesteron
uses:

Front 49

can preggos get lap chole?

Back 49

yes in 2nd trimester, but if they dont want one, give ursodeoxycholic acid