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103 Cards in this Set
- Front
- Back
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These agents are used to reduce intragastric acidity
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antacids
H2 receptor antagonist PPI |
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These agents are used as mucosal protective agents
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sucralfate
prostaglandin analogs bismuth compounds |
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What class of drug am I:
MOA: bases that react with stomach HCl to form a salt and water, thus raising the pH of gastric contents |
antacids
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Which of the following cause diarrhea?
a. magnesium containing antacids b. aluminum containing antacids c. sodium bicarb |
a. magnesium containing antacids
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Which of the following cause constipations?
a. Mg-containing antacids b. Al-containing antacids c. sodium bicarb |
b. Al-containing antacids
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Which of the following can cause sodium overload and liberate CO2 causing systemic alkalosis on long term use
a. Mg-containing antacids b. Al-containing antacids c. sodium bicarb |
c. sodium bicarb
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Which of the following are not antacids?
magnesium hydroxide aluminum hydroxide algenic acid + Mg(OH) + Al(OH)3 calcium carbonate sodium bicarb magaldrate bismuth |
bismuth
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Which of the following cause constipation and bind to phosphate in the gut?
a. Ca-containing antacids b. Mg-containing antacids c. Al-containing antacids |
a. Ca-containing antacids
(Al-containing antacids do not bind to phosphate in the gut) |
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Which of the following can cause acid rebound by stimulating gastrin release which increases HCl production?
a. Mg-containing antacids b. Al-containing antacids c. calcium carbonate |
c. calcium carbonate
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Antacids form chelates with and decrease the bioavailability of these two drugs
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tetracycline
fluroquinolones |
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What class of drug am I:
MOA: block H2 receptors on the surface of parietal cell whihc leads to reduced acid production |
H2 receptor antagonist
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Adverse effects occurs most commonly with this H2 receptor antagonist
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cimetidine
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Cimitidine is a potent inhibitor of this enzyme system
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P450
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Parietal cells contain these receptors. Activation of each of these receptors activates the proton pump and increase HCL secretion.
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gastrin receptors
histamine receptors acetylcholine receptors |
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Activation of this receptor activates the cAMP dependent pathway which ultimately activates the H+K+ ATPase.
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Histamine receptor
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Activation of these receptors activates the Ca-dependent pathways which ultimately activates the H+K+ ATPase.
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acetylcholine receptor
gastrin receptor |
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Which of the following are not H2 receptor antagonist?
cimetidine ranitidine nizatidine famotidine pantoprazole |
pantoprazole
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What class of drug am I:
MOA: block the proton pump (H+/K+ ATPase) in the parietal cells suppressing the secretion of H+ into the gastric lumen |
PPI
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Which of the following provides faster symptom relief and ulcer healing?
a. PPI b. H2 receptor antagonist c. antacids |
a. PPI
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Which of the following are not PPI?
Omeprazole pantoprazole lansoprazole esomeprazole rabeprazole fluconazole |
fluconazole
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PPI reduce the absorption of this vitamin
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vit B12
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Omeprazole inhibit this enzyme system
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p450
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Which of the following dose misoprostol fall under?
a. sucralfate b. prostaglandin analogs c. bismuth compounds |
b. prostaglandin analogs
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What is sucralfate indicated for?
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GERD
Peptic ulcer disease |
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What class of drugs am I:
MOA: react with HCl in stomach to form cross-linking, viscous, paste-like material that restricts further caustic damage and stimulates mucosal prostaglandin and bicarb secretion |
sucralfate
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This class of drugs is a salt of sucrose complexed to sulfated aluminum hydroxide
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sucralfate
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What are the indications for bismuth compound?
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GERD
in combination therapy for the treatment of PUD traveler's diarrhea |
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What class of drugs am I:
MOA: undergo rapid dissociated within the stomach allowing absorption of salicylate. Coats ulcers and erosions against acid and pepsin. Binds enterotoxins Reduces stool liquidity and frequency |
Bismuth compounds
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What percent of bismuth is absorbed?
a. 1% b. 10% c. 100% |
a. 1%
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_______ of bismuth subsalicylate coats ulcers and erosions to protect agaisnt acid and pepsin. Also binds to enterotoxins.
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Bismuth
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_______ of bismuth subsalicylate provides antisecretory effects to reduce stool liquidity and frequency. Also has anti-inflammatory action.
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salicylate
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What are bismuth compounds contraindicated in?
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children and nursing mothers recovering form Flu or chicken pox - may cause Reye's syndrome
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In the treatment of H. pylori infections, what makes up the triple and quadruple therapy?
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triple: 2 antibiotics + PPI
quadruple: 2 antibiotics + PPI/H2 antagonist + bismuth subsalycilate |
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These two drugs stimulate GI motility. They are also known as gastroprokinetic agents.
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metoclopramide
neostigmine |
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What drug am I:
MOA: D2 receptor antagoinst - removes inhibition of Ach neurons in enteric nervous system increase esophageal peristaltic activity and enchance GI emptying |
metoclopramide
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What is metoclopramide indicated for?
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Gastric paresis
treatment of delayed gastric emptying |
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True or False:
metoclopramide effects the small intestine and colonic motility |
False
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What are the major adverse effects of metoclopramide?
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parkinson-like symptoms
galactorrhea and gynecomastia from increased prolactin release |
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What is neostigmine indicated for?
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acute colonic pseudo-obstruction in hospitalized patients
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What drug am I:
cholinertase inhibitor - enhance gastric, small intestion, and colonic emptying |
neostigmine
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What are laxatives indicated for?
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constipation
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True or False: the majority of patients with constipation do not require laxatives
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True
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What are the non drug therapy that should be used, instead of drug therapy, for intermittent constipation?
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high fiber diet
adequate fluid intake exercise |
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The following drugs fall under what category of laxatives?
psyllium seed methycellulose calcium polycarbophil malt soup extract |
bulk forming laxatives
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What class of laxatives am I:
MOA: indigestible hydrophilic polysacharide derivative that absorbs liquid in the intestines and swell to form a soft bulky stool. The bulky mass stimulates the intestinal muscles and facilitates peristalsis and elimination |
bulk forming laxatives
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How long will it take for the effects of bulk forming laxative to be seen?
a. hours b. days c. weeks |
b. days
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What class of laxative do the following drugs fall under?
docusate |
stool surfactant agents
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What are stool surfactant agents indicated for?
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patients who need to avoid straining during defecation
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What class of laxative am I:
MOA: act as a surfactant to reduce surface tension of the oil-water interface of the stool resulting in enhanced incorporation of water |
stool surfactant agents
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How long does it take to see the effects of stool surfactant agents?
a. hours b. days c. weeks |
b. days
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What is contraindicated with the use of stool surfactant agents?
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concurrent use of mineral oil
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The following fall under what class of laxatives?
mineral oil |
lubricant laxatives
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What are lubricant laxatives indicated for?
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temporary relief of occassional constipation
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What class of laxative am I:
ease passage of stool by decreasing water absorption and lubricating intestine. Retards colonic absorption of water. |
lubricant laxatives
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How long does it take to see the effects of lubricant laxatives?
a. hours b. days c. weeks |
a. hours
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lubricant laxatives may decrease the absorption of these vitamins
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fat-soluble vitamins (A, K, E, D_
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What are lubricant laxatives contraindicated in?
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children and elderly due to risk of aspiration and lipid pneumonia
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The following fall under what class of laxatives?
magnesium hydroxide magnesium citrate magnesium sulfate sodium phosphate glycerin lactulose |
osmotic laxatives
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What are osmotic laxatives indicated for?
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acute constipation
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What class of laxatives am I:
MOA: soluble compounds that create an osmotic gradient to pull water into the intestine resulting in stool liquidity |
osmotic laxatives
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This is a nonabsorbed disaccharide metabolized by GI bacteria into acetic and formic acids that exert osmotic effect
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lactulose
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How long does it take to see the effects of osmotic laxatives?
a. hours b. days c. weeks |
a. hours
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What are contraindicated in Mg-containing osmotic laxatives?
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patients with renal insufficiency
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What are contraindicated in Na-containing osmotic laxatives?
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patients with HTN
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The following fall under what class of laxatives?
senna bisacodyl |
stimulant laxatives
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What are stimulant laxatives indicated for?
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short term constipation
evacuation of colon for bowel or rectal exam |
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What class of laxative am I:
stimulate bowel motility via direct stimulation of the enteric nervous system and colonic electrolyte and fluid secretion |
stimulant laxatives
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What is castor oil indicated for?
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prepartation for rectal or bowel exam or surgery
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What am I:
MOA: ricinoleic acid is the main component; acts primarily in the small intestin and reduces net absorption of fluid and electrolyes and stimulates peristalsis |
castor oil
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True or False: Castor oil is a derivative of prostaglandins
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True
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What class of laxatives does lubiprostone fall under?
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chloride channel activator
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What are chloride channel activators indicated for?
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treatment of chronic idiopathic constipation
constipation-predominant irritable bowel syndrome |
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What class of laxative am I:
PGE1 derivative stimulates chloride channels in the small intestine to increase chloride-rich fluid secretions in the intestine. This softens stool, increase motility,and promotes spontaneous bowel movements |
chloride channel activator
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How long does it take to see the effects of chloride channel activator?
a. hours b. days c. weeks |
hours
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methynaltrexone and alvimopan fall under what class of laxative?
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opioid receptor antagonist
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What are opioid receptor antagonists indicated for?
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treatment of opioid induced constipation in patients with advanced illness receiving palliative care with inadequate response to conventional laxative regimens
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What class of laxatives am I:
Peripheral acting opioid antagoinst does not cross BBB inhibits opioid induced decrease in GI motility and delay in GI transit time |
opioid receptor antagonist
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What are antidiarrheal agents indicated for?
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mild to moderate acute diarrhea
chronic diarrhea caused by irritable bowel syndrome or inflammatory bowel disease |
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What is contraindicated in antidiarrheal agent?
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patients with bloody diarrhea, high fever, or systemic toxicity
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What are the non drug therapy for diarrhea?
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oral rehydration
avoiding spicy, fatty, or high sugar food |
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opioid agonst, colloidal bismuth compounds, and octreotide are what type of agent?
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antidiarrheal
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What class of antidiarrheal agents do the following fall under?
loperamide diphenoxylate |
opioid agonist
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What class of antidiarrheal agent am I:
opioid receptor agonist that act on the large intestine to inhibit excessive GI motility and propulsion |
opioid agonst
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Which opioid agonist am I:
dose not cross BBB no analgesic activity no CNS ADR no potential for addiction |
loperamide
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Which opioid agonist am I:
crosses BBB at high concentrations long term use can lead to dependence |
diphenoxylate
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What drug is added to diphenoxylate in subtherapeutic doses to discourage abuse?
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atropine
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What is octreotide indicated for?
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treatment of AIDS-associated diarrhea
chemotherapy induced diarrhea GIT tumor-associated diarrhea |
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What drug am I:
somatostatin analoge inhibit secretion of different hormones including gastrin, CCK, secretin reduce intestinal fluid secretion and slows GI motility |
octreotide
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What are the ADR of octreotide?
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GI - constipation
CV - bradycardia hormonal imbalance - hypothyroidism steatorrhea injection site reactions |
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What are the drugs used in the treatment of irritable bowel syndrome?
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antispasmodics
serotonin antagonist chloride channel activator |
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dicyclomide and hyoscyamine fall under what class of drugs?
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antispasmodics
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What are antispasmodics indictated for?
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acute spasmodic attacks
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What class of drugs am I:
relieves muscle spasms and cramping in the GI tract by blocking the activity of acetylcholine on muscarinic receptors on surface of muscle cells of the intestine |
antispasmodics
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alosetron fall under what class of drug?
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serotonin receptor antagonist
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What GI disease are serotinin antagonists indicated for?
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diarrhea-predominant IBS in women
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What drug am I:
selectively blocks serotonin receptors on enteric neurons of the GI tracts resulting in reduced pain, abdominal discomfort, urgency, and diarrhea |
serotonin antagonist
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In the treatment of IBS what are chloride channel activator indicated for?
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constipation-predominant IBS in women
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What are the two distinct disorders that make up IBD?
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ulcerative colitis
crohns disease |
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Which IBD may affect any part of the GI tract, not just the intestine?
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crohn's disease
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What class of drugs are used to treat IBD?
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aminosalicylates
antibacterial corticosteroids immunosuppressive agents antimetabolites immunomodulators |
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In the treatment of IBD, what are aminosalicylates indicated for?
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mild to moderate ulcerative colitis
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What class of drug am I:
act locally in the colon to decreae inflammatory response modulate local chemical mediators of the inflammatory response act as a free radical scavenger |
aminosalicylate
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This metabolite mediated most of the adverse effects of sulfasalazine
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sulfapyridine
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