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30 Cards in this Set
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DOC to cause bulimia
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ipecac
moa~ Stimulates the CTZ (chemoreceptor trigger zone & causes local irritation of the stomach & upper duodenum |
"If I eat a cac ("penis") I would want to throw up!!!!" (ipe-cac
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Prophylaxis for motion sickness
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Scopolamine
moa~ Blocks muscarinic receptors in the vestibular nuclei & reticular formation (anticholinergic) |
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antiemetic (for chemo)
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1. dexamethasone-very powerful
2. ondansetron-moa: -block 5-HT3 rec at vagal afferent nerve endings and/or CTZ |
Say “X” (deXa) to chemo-induced V.
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N/V from radiation (advanced CA
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dronabinol
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“Radiation is a “drone.” “
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~ Prophylaxis for motion sickness
~ Prophylaxis for N/V during pregnancy |
dimenhydrinate &
diphenhydramine (Benadryl) & meclizine moa-Antihistamine/anticholinergic Hint: “2 men (dimen) hydrate (hydrinate) themselves to prevent motion sickness and vomiting in their pregnant wives.”) -The “2 men” (dimen) are named “mec” and “liz”.” |
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~ Tx for motion sickness
~ Tx associated N/V with diarrhea |
promethazine
moa-Antihistamine/anticholinergic |
“PRO at Tx motion sickness.”
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1. n/v, anti-emetic
2. Clears stomach prior to GI endoscopy or surgery 3. Diabetic gastroparesis |
Metoclopramide
moa~ 1.Serotonin/dopamine receptor blocker; Blocks 5-HT3 recptors (vagal afferent fibers & CTZ) and D2-dopamine receptors (CTZ) 2 & 3.~ Enhance release of ACh by stimulating prejunctional 5-HT4 receptors on cholinergic fibers NOTE: blocks 5HT3 (Serotonin)-->anti-emetic stim 5HT4 (Ach)-->clears stomach |
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~ Prophylaxis for N/V during pregnancy
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ondansetron
moa~ Block 5-HT3 receptors at vagal afferent nerve endings and/or the CTZ |
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~ GERD
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1. cisapride
2. tegaserod pharm: ~ Incr LES pressure |
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~ Tx of irritable bowel syndrome primarily associated w/ constipation
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tegaserod
moa-Enhance release of ACh by stimulating prejunctional 5-HT4 receptors on cholinergic fibers ~ Tegaserod also stimulates the release of calcitonin gene-related peptide (CGRP) from sensory neurons in the GI tract |
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Tx of constipation
-maintain a soft stool in patients who should avoid straining during defecation (patients w/ hemorrhoids, |
1. methylcellulose
2. psyllium 3. Ca polycarbophil 4. lactulose 5. docusate sodium 1&2.moa****"Bulk laxatives"****~ Attract water to form a HYDROGEL w/ feces in the large bowel--hydration incr the bulk by 30x ~ Psyllium also binds to bile acids (more are excreted in feces…lowers Tc & LDL)??? 4. lactulose moa-Bacteria in bowel degrade lactulose into lactic, acetic & organic acids which exert an osmotic effect drawing H2O pharm-bowel distention ~ Acidification of the colonic contents also causes NH3 in blood to be trapped & excreted as NH4+ 5. =soap; ~ An anionic surfactant: the detergent action lowers surface tension of feces to allow penetration of water |
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add to Fe supplements
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docusate sodium
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GI exam
Evacuate the bowel prior to radiological or sigmoidoscopic exam |
1.Bisacodyl 2.magnesium (hydroxide, citrate & sulfate)
3.polyethyleneglycol 1. moa~ (“bis brings water into the colon (codyl) only.”) Irritant action increases the accumulation of water & electrolytes in lumen of colon (ONLY) ~ Keeton: don’t use much!! "Bad" 2&3.~ Hypertonic solutions that create osmotic forces which draw water into large bowel pharm~ Bowel distention activates stretch receptors, which increases peristalsis s/e=* Laxative dependence!!! |
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irritable bowel syndrome (IBS)
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1. bulk laxatives:
methylcellulose psyllium Ca polycarbophil lactulose docusate sodium Bulk laxatives MOA-Expands the large bowel via * & thus prevents the alternating segmental contractions of vsm--antegrade peristalsis is restored *Attract water to form a HYDROGEL w/ feces in the large bowel--hydration incr the bulk by 30x 2. dicyclomine (musc rec -), moa-prevent bowel spasm 3. tegaserod (prokinetic) |
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IBD (UC and CD)
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1. methylprednisone-
*moa-corticosteroid, inhibits syn of PGs and LTs & locally alters immune fxn 2,3,4 are NSAIDS: Keeton: "5-ASA (5-aminosalicylic acid) is used as po therapy to tx UC & CD (bc inhibits PGs & LTs (5-ASA inhibits COX 1,2 & lipooxygenase, which are precursors for PG and LT, respectively)) - I expect you to know that!" 2. sulfaSALazine=DOC, conjugate of SULFApyridine and 5-aminoSALIcylic acid (5-ASA) 3. meSALamine-capsule slowly releases 5-ASA as move thru bowel 4. oSALazine: two 5-ASA mcs joined by azo bond (conjugate) that is cleaved by bact enzymes in lg bowel |
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diarrhea (non-bacterial)
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*loperamide (Imodium)=DOC
-diphenoxlate moa-opiates! -Slow colonic transit rate by direct/indirect inhibition of GI motility |
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bacterial diarrhea
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1. kaopectate
moa**** Absorbent Powder **** ~ A hydrated aluminum silicate CLAY ("kao") + a complex carbohydrate PECTIN ("pectate") ~ Large SA of the clay (which has a negative charge) absorbs bacterial toxins & the pectin becomes hydrated to form a viscous colloid solution, which helps consolidate stool 2. Bismuth subsalicylate (Pepto-Bismol) moa-**** Coating Agent **** ~ Bismuth is not absorbed, but 90% of the salicylate is absorbed Anti-bact: * Binds to -SH groups of microbial proteins to destroy their 3° structure Anti-ulcer: Incr PG synthesis & alkali secretion * Anti-proteolytic action counteracts breakdown of mucus coat by pepsin & H.pylori protease (preserves mucus coat) S/E: salicylate toxicity |
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kaopectate
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moa**** Absorbent Powder ****
~ A hydrated aluminum silicate CLAY ("kao") + a complex carbohydrate PECTIN ("pectate") ~ Large SA of the clay (which has a negative charge) absorbs bacterial toxins & the pectin becomes hydrated to form a viscous colloid solution, which helps consolidate stool |
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Bismuth subsalicylate
(Pepto-Bismol) |
moa-**** Coating Agent ****
~ Bismuth is not absorbed, but 90% of the salicylate is absorbed Anti-bact: * Binds to -SH groups of microbial proteins to destroy their 3° structure Anti-ulcer: Incr PG synthesis & alkali secretion * Anti-proteolytic action counteracts breakdown of mucus coat by pepsin & H.pylori protease (preserves mucus coat) S/E: salicylate toxicity |
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octreotide
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Tx:
-reduce D d/t metastatic carcinoid syndrome & VIPomas -stop bleeding d/t esoph varices moa-SMS + pharm-constricts splanchnic arterioles to DEC splanchnic BF & thus portal venous press |
Donna: "I want a Treo, STAT!!!" (octreotide, somatostatin agonist)
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PUD
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*Abx triple therapy (2 Abx + PPI)
1. Clarithromycin 2. Amoxicillin 3. OmePRAZOLE (PPI) |
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PUD
Stress ulcers Heartburn GERD |
Al hydroxide
S/E: constipation Mg hyroxide S/E: diarrhea Al/Mg hydroxide **** Antacids **** (makes sense that antacids are hydroxides b/c hydroxides neutralize gastric acids -temporarily raises pH of gastric contents to 3-4 |
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~ Zollinger-Ellison syndrome (drug tolerance & 25%-50% failure rate)
~ PUD ~ Stress ulcers ~ Heartburn ~ GERD |
"Every girl wants TO DINE w.a guy who drives an H2!"
*H2 Rec (-) 1. cimeTIDINE 2. raniTIDINE 3. famoTIDINE s/e: inhibit CYP450--> *inc half-life of Rx like warfarin *gynecomastia (b/c dec estrogen metabolism) *Pregnancy Category B |
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~ Zollinger-Ellison syndrome (no drug tolerance)
~ PUD ~ GERD |
*PPI
*Inhibits gastric H+-K+ ATPase (proton pump) to block acid secretion 1. esomePRAZOLE 2. lansoPRAZOLE pharm-inc gastric pH to 4-5 -partially - abs of Vit B12 |
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~ NSAID induced gastropathy
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misoprostol
(stable analog of PGE1) "Me so prostaglandin" (misoprostol, PG agonist) *** NSAID induced gastrophay has Nothing to do w/ H. pylori--so DONT TX w/ antibiotics moa-**** PGE1 Agonist **** ~ Stimulates PGE1 receptors on gastric parietal cells to inhibit acid secretion |
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~ PUD
~ Stress ulcers in ventilated pts (bc elevated gastric pH may incr risk of nosocomial pnia in ventilated pts since low pH has antibiotic action--sucralfate prevents ulcers w/o changing gastric pH) ~ NSAID induced gastropathy ~ GERD |
SucrALfate (AL=AL OH; sucralfate=sucrose sulfate)
“S(tress) UCRAL (ulcers)” moa-**** Coating Agent **** (protective barrier) pharm-Water insoluble complex of AlOH & sucrose sulfate which polymerizes (when pH <4) to form sticky viscous gel which forms a protective layer on the ulcer (coats ulcer) ~ The gel binds tightly to ulcerated gastric mucosa, & gel refluxed into the lower esophagus aids in the tx of GERD ~ Does NOT neutralize stomach acid or inhibit acid secretion |
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-dissolving gallstones (but you do need a functioning GB)
~ Primary biliary cirrhosis |
Ursodiol
"Hey gallstones, ur so die!" (dead)--ursodiol DOC for dissolving gallstone ~ Increases the ratio of (bile acids & phospholipids) : cholesterol by: * Decreasing cholesterol synthesis (inhibits HMG CoA reductase) * Decreasing the GI absorption of cholesterol * Decreasing the biliary secretion of cholesterol |
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~ Hyperlipoproteinemia
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Psyllium
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hyperlipoproteinemia
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Psyllium
(works same as resins did!!) ~ Psyllium binds bile acids-->Fecal excretion of bile acids ~ This loss of bile acids decreases the intrahepatic concentration of the "sterol" pool leading to upregulation of hepatic LDL receptors via the "sterolstat" |
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DOC for IBD (CD and UC)
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DOC=sulfasalazine
*conjugate of SULFApyridine and 5-aminoSALIcylic acid (5-ASA) |
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