Pharm 62 Drugs Used In Gi Disorders

Front 1

Drugs used in acid-peptic dz?

Back 1

Antacids
H2 receptor antagonists
PPIs
Sucralfate
Misoprostol
Bismuth
Antibiotics

Front 2

Antacids?

Back 2

MgOH2 - laxative
AlOH3 - constipating

weak bases, neutralize stomach acid and stimulate protective fxn of gastric mucosa, reduce recurrence of peptic ulcers

not absorbed in the bowel

Front 3

MOA H2-receptor antagonists?

Back 3

inhibit stomach acid production by blocking H2 receptors which mediate gastric acid secretion by parietal cells.

Front 4

examples of H2 receptor antagonists?

Back 4

cimetidine
ranitidine
famotidine
nizatidine

Front 5

toxicity of H2 antagonists?

Back 5

cimetidine inhibits hepatic drug-metabolizing enzymes and reduces hepatic blood flow, significant antiandrogenic effect in high doses

Front 6

MOA of PPIs?

Back 6

lipophilic weak bases that diffuse into parietal cell canaliculi and irreversibly inactivate parietal cell H/K ATPase that produces stomach acid

More effective than H2 antagonists for GERD and PUD

Front 7

Examples of PPIs?

Back 7

Omeprazole
esomeprazole
lansoprazole
pantoprazole
rabeprazole

Front 8

Result of chronic tx w/ PPIs?

Back 8

hypergastrinemia
decrease oral bioavailability of vitB12 and drugs that need stomach acidity for absorption

Front 9

drug whose polymer binds to injured peptic tissue and forms a protective coating over ulcer beds?

Back 9

Sucralfate

Front 10

drug that is an analog of PGE1, increases mucosal protection and inhibits acid secretion (esp in NSAID users), but not popular b/c multiple daily dosing and GI upset and diarrhea?

Back 10

Misoprostol

Front 11

Drug that forms protective coating on ulcerated tissue and stimulates mucosal protective mechanisms, direct antimicrobial effects and sequestration of enterotoxins?
Also reduces frequency and liquidity of stools in infectious diarrhea?

Back 11

Colloidal bismuth

Front 12

side effect of bismuth?

Back 12

dark stools

Front 13

Regimen of choice for H. pylori?

Back 13

PPI + bismuth, tetracycline and metronidazole
OR
amoxicillin + clarithromycin

Front 14

drugs that promote upper GI motility?

Back 14

Metoclopramide (D2 receptor blocker)
Cholinomimetics

Front 15

Examples of cholinomimetics?

Back 15

Bethanechol (direct-acting)
Neostigmine (indirect-acting)

Front 16

Side effect of metoclopramide?

Back 16

parkinsonism
extrapyramidal effects
hyperprolactinemia

Front 17

Drugs with antiemetic actions?

Back 17

Metoclopramide (D2 receptor blocker)
Ondansetron (5HT3 blocker)
Diphenhydramine (Histamine H1 blocker)
Scopolamine (anti-muscarinic)
Dexamethasone (corticosteroid)
Dronabinol (cannibinoid receptor agonists)
Aprepitant (neurokinin1 receptor antagonist)

Front 18

Which drugs are useful in preventing N/V after general anesthesia and after cancer chemotherapy?

Back 18

5HT3 blockers
(ondansetron)

Front 19

side effects of aprepitant?

Back 19

fatigue, dizziness, diarrhea
many drug interactions (substrate and inhibitor of CYP3A4)

Front 20

Drugs used for IBS w/ diarrhea?
Why?

Back 20

Alosetron (5HT3 blocker)
Causes constipation (sometimes severely so)

Front 21

Drug used for IBS that increases gastric emptying and intestinal transit time as well as increasing stool liquidity, but was discontinued d/t increased risk of CV events?

Back 21

Tegaserod (partial 5HT4 agonist)

Front 22

Drugs used in IBD?

Back 22

glucocorticoids (prednisone)
immunosuppressive antimetabolites (azathioprine)
infliximab (anti-TNFa monoclonal antibody)
aminosalicylates (mesalamine)

Front 23

MOA aminosalicylates?

Back 23

not absorbed after oral admin, in small intestine, release 5-ASA which inhibits synthesis of prostaglandins and inflammatory leukotrienes

Front 24

Drugs used in steatorrhea?

Back 24

pancreatic enzyme replacements
pancreatin, pancrealipase

Front 25

How must pancreatic lipase be administered to be effective?

Back 25

Enteric-coated unless pH is raised w/ antacids or PPIs/H2 blockers
(lipase is inactivated below pH 4.0)

Front 26

Bulk forming laxatives?

Back 26

psyllium
methylcellulose
polycarbophil

Front 27

stool softening laxatives?

Back 27

docusate
glycerine
mineral oil

Front 28

osmotic laxatives?

Back 28

Mg oxide
sorbitol
lactulose
polyethylene glycol

Front 29

stimulant laxatives?

Back 29

aloe
senna
cascara
castor oil

Front 30

5-HT4 receptor agonist laxatives?

Back 30

Tegaserod

Front 31

Antidiarrheal agents?

Back 31

Diphenoxylate, loperamide (opioid derivatives w/ little analgesic effect)
Difenoxin (active metabolite of diphenoxylate)

Front 32

What is diphenoxylate usually combined with?

Back 32

antimuscarinic alkaloids (atropine) to reduce likelihood of abuse

Front 33

Drugs that inhibit formation of gallstones?

Back 33

Chenodiol, ursodiol
(bile acid derivatives)

Front 34

drug that can be used as an osmotic laxative or as an antacid?

Back 34

Magnesium hydroxide

Front 35

Laxative MOA of MgOH2?

Back 35

holds water in the intestine which adds bulk and stimulates increased contractions

Front 36

Metoclopramide?

Back 36

D2 blocker
prokinetic and antiemetic

Front 37

diphenhydramine?

Back 37

H1 histamine blocker
antiemetic

Front 38

scopolamine?

Back 38

anti-muscarinic
antiemetic

Front 39

Tegaserod?

Back 39

partial agonist of 5HT4 receptors

prokinetic, used for IBS

Front 40

Loperamide?

Back 40

opioid derivative w/ weak analgesia

used as antidiarrheal

Front 41

Mesalamine?

Back 41

aminosalicylate

used for IBD

Front 42

Drug class to use in Zollinger Ellison?

Back 42

PPI's

Front 43

Infliximab?

Back 43

anti-TNF alpha monoclonal antibody

used in IBD