Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
103 Cards in this Set
- Front
- Back
These agents are used to reduce intragastric acidity
|
antacids
H2 receptor antagonist PPI |
|
These agents are used as mucosal protective agents
|
sucralfate
prostaglandin analogs bismuth compounds |
|
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
|
|
Which of the following cause diarrhea?
a. magnesium containing antacids b. aluminum containing antacids c. sodium bicarb |
a. magnesium containing antacids
|
|
Which of the following cause constipations?
a. Mg-containing antacids b. Al-containing antacids c. sodium bicarb |
b. Al-containing antacids
|
|
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
|
|
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
|
|
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) |
|
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
|
|
Antacids form chelates with and decrease the bioavailability of these two drugs
|
tetracycline
fluroquinolones |
|
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
|
|
Adverse effects occurs most commonly with this H2 receptor antagonist
|
cimetidine
|
|
Cimitidine is a potent inhibitor of this enzyme system
|
P450
|
|
Parietal cells contain these receptors. Activation of each of these receptors activates the proton pump and increase HCL secretion.
|
gastrin receptors
histamine receptors acetylcholine receptors |
|
Activation of this receptor activates the cAMP dependent pathway which ultimately activates the H+K+ ATPase.
|
Histamine receptor
|
|
Activation of these receptors activates the Ca-dependent pathways which ultimately activates the H+K+ ATPase.
|
acetylcholine receptor
gastrin receptor |
|
Which of the following are not H2 receptor antagonist?
cimetidine ranitidine nizatidine famotidine pantoprazole |
pantoprazole
|
|
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
|
|
Which of the following provides faster symptom relief and ulcer healing?
a. PPI b. H2 receptor antagonist c. antacids |
a. PPI
|
|
Which of the following are not PPI?
Omeprazole pantoprazole lansoprazole esomeprazole rabeprazole fluconazole |
fluconazole
|
|
PPI reduce the absorption of this vitamin
|
vit B12
|
|
Omeprazole inhibit this enzyme system
|
p450
|
|
Which of the following dose misoprostol fall under?
a. sucralfate b. prostaglandin analogs c. bismuth compounds |
b. prostaglandin analogs
|
|
What is sucralfate indicated for?
|
GERD
Peptic ulcer disease |
|
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
|
|
This class of drugs is a salt of sucrose complexed to sulfated aluminum hydroxide
|
sucralfate
|
|
What are the indications for bismuth compound?
|
GERD
in combination therapy for the treatment of PUD traveler's diarrhea |
|
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
|
|
What percent of bismuth is absorbed?
a. 1% b. 10% c. 100% |
a. 1%
|
|
_______ of bismuth subsalicylate coats ulcers and erosions to protect agaisnt acid and pepsin. Also binds to enterotoxins.
|
Bismuth
|
|
_______ of bismuth subsalicylate provides antisecretory effects to reduce stool liquidity and frequency. Also has anti-inflammatory action.
|
salicylate
|
|
What are bismuth compounds contraindicated in?
|
children and nursing mothers recovering form Flu or chicken pox - may cause Reye's syndrome
|
|
In the treatment of H. pylori infections, what makes up the triple and quadruple therapy?
|
triple: 2 antibiotics + PPI
quadruple: 2 antibiotics + PPI/H2 antagonist + bismuth subsalycilate |
|
These two drugs stimulate GI motility. They are also known as gastroprokinetic agents.
|
metoclopramide
neostigmine |
|
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
|
|
What is metoclopramide indicated for?
|
Gastric paresis
treatment of delayed gastric emptying |
|
True or False:
metoclopramide effects the small intestine and colonic motility |
False
|
|
What are the major adverse effects of metoclopramide?
|
parkinson-like symptoms
galactorrhea and gynecomastia from increased prolactin release |
|
What is neostigmine indicated for?
|
acute colonic pseudo-obstruction in hospitalized patients
|
|
What drug am I:
cholinertase inhibitor - enhance gastric, small intestion, and colonic emptying |
neostigmine
|
|
What are laxatives indicated for?
|
constipation
|
|
True or False: the majority of patients with constipation do not require laxatives
|
True
|
|
What are the non drug therapy that should be used, instead of drug therapy, for intermittent constipation?
|
high fiber diet
adequate fluid intake exercise |
|
The following drugs fall under what category of laxatives?
psyllium seed methycellulose calcium polycarbophil malt soup extract |
bulk forming laxatives
|
|
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
|
|
How long will it take for the effects of bulk forming laxative to be seen?
a. hours b. days c. weeks |
b. days
|
|
What class of laxative do the following drugs fall under?
docusate |
stool surfactant agents
|
|
What are stool surfactant agents indicated for?
|
patients who need to avoid straining during defecation
|
|
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
|
|
How long does it take to see the effects of stool surfactant agents?
a. hours b. days c. weeks |
b. days
|
|
What is contraindicated with the use of stool surfactant agents?
|
concurrent use of mineral oil
|
|
The following fall under what class of laxatives?
mineral oil |
lubricant laxatives
|
|
What are lubricant laxatives indicated for?
|
temporary relief of occassional constipation
|
|
What class of laxative am I:
ease passage of stool by decreasing water absorption and lubricating intestine. Retards colonic absorption of water. |
lubricant laxatives
|
|
How long does it take to see the effects of lubricant laxatives?
a. hours b. days c. weeks |
a. hours
|
|
lubricant laxatives may decrease the absorption of these vitamins
|
fat-soluble vitamins (A, K, E, D_
|
|
What are lubricant laxatives contraindicated in?
|
children and elderly due to risk of aspiration and lipid pneumonia
|
|
The following fall under what class of laxatives?
magnesium hydroxide magnesium citrate magnesium sulfate sodium phosphate glycerin lactulose |
osmotic laxatives
|
|
What are osmotic laxatives indicated for?
|
acute constipation
|
|
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
|
|
This is a nonabsorbed disaccharide metabolized by GI bacteria into acetic and formic acids that exert osmotic effect
|
lactulose
|
|
How long does it take to see the effects of osmotic laxatives?
a. hours b. days c. weeks |
a. hours
|
|
What are contraindicated in Mg-containing osmotic laxatives?
|
patients with renal insufficiency
|
|
What are contraindicated in Na-containing osmotic laxatives?
|
patients with HTN
|
|
The following fall under what class of laxatives?
senna bisacodyl |
stimulant laxatives
|
|
What are stimulant laxatives indicated for?
|
short term constipation
evacuation of colon for bowel or rectal exam |
|
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
|
|
What is castor oil indicated for?
|
prepartation for rectal or bowel exam or surgery
|
|
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
|
|
True or False: Castor oil is a derivative of prostaglandins
|
True
|
|
What class of laxatives does lubiprostone fall under?
|
chloride channel activator
|
|
What are chloride channel activators indicated for?
|
treatment of chronic idiopathic constipation
constipation-predominant irritable bowel syndrome |
|
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
|
|
How long does it take to see the effects of chloride channel activator?
a. hours b. days c. weeks |
hours
|
|
methynaltrexone and alvimopan fall under what class of laxative?
|
opioid receptor antagonist
|
|
What are opioid receptor antagonists indicated for?
|
treatment of opioid induced constipation in patients with advanced illness receiving palliative care with inadequate response to conventional laxative regimens
|
|
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
|
|
What are antidiarrheal agents indicated for?
|
mild to moderate acute diarrhea
chronic diarrhea caused by irritable bowel syndrome or inflammatory bowel disease |
|
What is contraindicated in antidiarrheal agent?
|
patients with bloody diarrhea, high fever, or systemic toxicity
|
|
What are the non drug therapy for diarrhea?
|
oral rehydration
avoiding spicy, fatty, or high sugar food |
|
opioid agonst, colloidal bismuth compounds, and octreotide are what type of agent?
|
antidiarrheal
|
|
What class of antidiarrheal agents do the following fall under?
loperamide diphenoxylate |
opioid agonist
|
|
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
|
|
Which opioid agonist am I:
dose not cross BBB no analgesic activity no CNS ADR no potential for addiction |
loperamide
|
|
Which opioid agonist am I:
crosses BBB at high concentrations long term use can lead to dependence |
diphenoxylate
|
|
What drug is added to diphenoxylate in subtherapeutic doses to discourage abuse?
|
atropine
|
|
What is octreotide indicated for?
|
treatment of AIDS-associated diarrhea
chemotherapy induced diarrhea GIT tumor-associated diarrhea |
|
What drug am I:
somatostatin analoge inhibit secretion of different hormones including gastrin, CCK, secretin reduce intestinal fluid secretion and slows GI motility |
octreotide
|
|
What are the ADR of octreotide?
|
GI - constipation
CV - bradycardia hormonal imbalance - hypothyroidism steatorrhea injection site reactions |
|
What are the drugs used in the treatment of irritable bowel syndrome?
|
antispasmodics
serotonin antagonist chloride channel activator |
|
dicyclomide and hyoscyamine fall under what class of drugs?
|
antispasmodics
|
|
What are antispasmodics indictated for?
|
acute spasmodic attacks
|
|
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
|
|
alosetron fall under what class of drug?
|
serotonin receptor antagonist
|
|
What GI disease are serotinin antagonists indicated for?
|
diarrhea-predominant IBS in women
|
|
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
|
|
In the treatment of IBS what are chloride channel activator indicated for?
|
constipation-predominant IBS in women
|
|
What are the two distinct disorders that make up IBD?
|
ulcerative colitis
crohns disease |
|
Which IBD may affect any part of the GI tract, not just the intestine?
|
crohn's disease
|
|
What class of drugs are used to treat IBD?
|
aminosalicylates
antibacterial corticosteroids immunosuppressive agents antimetabolites immunomodulators |
|
In the treatment of IBD, what are aminosalicylates indicated for?
|
mild to moderate ulcerative colitis
|
|
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
|
|
This metabolite mediated most of the adverse effects of sulfasalazine
|
sulfapyridine
|