Gi Pharm - Minus First Page In First Aid

Front 1

What does somatostatin (octreotide) do?

Back 1

blocks histamine release from ECL cell - preventing acid release from parietal cell

Front 2

what do muscarinic antagonists do to the gastric parietal cell?

Back 2

ex. atropine - inhibits the signaling (via Ach) to the parietal cell to release H+ - inhibits M3 receptor

Front 3

Bismuth, sucralfate MOA and use

Back 3

binds to ulcer base, providing physical protection, and allow HCO3- secretion to reestablish pH gradient in mucous layer
use: increase ulcer healing, traveler's diarrhea

Front 4

what is triple therapy for?

Back 4

H.pylori ulcers
Metronidaozole, amoxicillin (or tetracycline), bismuth
or could use PPI (-prazole)

Front 5

Misoprostol MOA, use, toxicity

Back 5

A PGE1 analog. increased production and secretion of gastric mucous barrier, decreased acid production
use: prevention of NSAID induced peptic ulcers; maintenace of a PDA. used to induce labor
toxicity: diarrhea, don't use in women that are pregnant (can cause abortion)

Front 6

what do you use to keep open a PDA

Back 6

misoprostol

Front 7

What do muscarinic antagonists do in the gut? MOA, uses, toxicites

Back 7

Pirenzepine, propantheline
blocks M1 receptors on ECL cells (decrease histmaine secretion) and blocks M3 receptors on parietal cells (decreased H+ secretion)
uses: peptic ulcer (rarely used)
toxicity: tachycardia, dry mouth, difficulty focusing eyes

Front 8

antacid use

Back 8

can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying

Front 9

what are the problems associated with overuse of antacids? What do they all cause?

Back 9

All cause hypokalemia!
aluminum hydroxide overdose: constipation and hypophosphatemia; proximal muscle weakness, osteodystrophy, seizures (aluMINIMUM amount of feces)
Magnesium hydroxide - diarrhea, hyporeflexia, hypotension, cardiac arrest (Mg = Must go to the bathroom)
calcium carbonate - hypercalcemia, rebound acid increase (can chelate and decrease effectivenss of other drugs (tetracycline)

Front 10

infliximab MOA, uses, toxicity

Back 10

monoclonal antibody against TNF, proinflammatory cytokine
use: crohn's disease, RA
toxicity: respiratory infection (can reactivate latent TB), fever, hypotension

Front 11

sulfasalazine MOA, use, toxicity

Back 11

MOA - combination of sulfapyridine (antibacerial) and 5-aminosalicylic acid (anti-inflammatory). activated by colonic bacteria
use: UC and crohn's disease
toxicity: malaise, nausea, sulfonamide toxicity, reversible oligospermia

Front 12

what drug causes reversible oligospermia?

Back 12

sulfasalzine - used for UC and crohn's disease
mix of antibacterial and antinflammatory

Front 13

Ondansetron MOA, use, toxicity

Back 13

5-HT3 antatognist. powerful central acting antiemetic
use: control vomiting postop and in patients undergoing chemo
toxicity: headache, constipation
'can go on dancing'

Front 14

5-HT3 antagonist is what drug?

Back 14

odansetron - antiemetic

Front 15

Metoclopramide MOA, use, toxicity

Back 15

D2 receptor antagonist. increased resting tone, contractility, LES tone, motility. Does not influence colon transport time
use: diabetic and post surgery gastoparesis
toxicity: increase parkinsonian effects. restlessnes, drowsiness, fatigue, depression, nausea, diarrhea. drug interaction with digoxin and diabetic agents. contraindicated in patients with small bowel obstruction

Front 16

what patients can you not give metoclopramide to?

Back 16

patients with small bowel obstructions

Front 17

H2 blockers

Back 17

-tidine (cimentidine, ranitidine, famotidine, nizatidine)
reversibly block H2 receptors - decreased H+ release by parietal cells
for gastric ulcers, gastritis, and mild GERD
toxicity: inhibitor of P-450 has antiandrogenic effects (prolactin release, gynecomastia, impotence, decreased libido in males)

Front 18

PPI's

Back 18

-prazole (omeprazole, lansoprazole)
irreversibly inhibit H+/K+ pump on parietal cells - inhibit H+ release
use for peptic ulcers, gastritis, GERD, zollinger-ellison syndrome