Pharm Gi

Front 1

TQ Cromolyn Sodium

Back 1

inhibitor of mast cell degranulation; prevent intracellular increase Ca conc caused by formation of IgE bridges; otc nasal allergy med require reg use before effective

Front 2

TQ Otopatadine

Back 2

prevent mast cell degranulation & block H1 recept; prevent intracellular increse Ca conc cuased by formation of IgE bridges; opthalmic for allergy

Front 3

TQ Seasonal and allergic rhinitis tx

Back 3

newer non-sedating drugs; cetirizine, fexofenadine, loratadine; H1 blocker specific w/ reduced cholinergic blocking

Front 4

Acute hypersensitivity rxn

Back 4

epinephrine doc; H1 blocker; stim B2 recept increases cAMP which increases Ca conc inhibiting H1

Front 5

Motion sickness

Back 5

prophylaxis-dimenhydrinate and meclizine, scopolamine; tx-promethazine; mainly by cholinergic blocker effects, also has H1 blocker effects

Front 6

TQ Vertigo (mesieres dx)

Back 6

dimenhydrinate and meclinizine; cholinergic blocker effects, also has H1 blocker effects; reduce vestibular origin nausea, ataxia, and nystagmus

Front 7

Terfenadine

Back 7

precursor form fexofenadine; conversion inhibited by erythro/clarithromycin; parent compound block K repolarization, prolong QT interval, lead to torsade de pointes and v. tach

Front 8

Doxylamine

Back 8

H1 blocker in otc nightime medication

Front 9

H2 blockers

Back 9

FRNC end in -tidine; inhibit gastric acid secretion; tx ulcers, gerd, viral warts and skin lesions; cimetidine inhib cyp450, others DONT

Front 10

5-HT1 blockers

Back 10

end in -triptan; stim vascular 5-HT1b recept consctrict large extracerebral arteries, anastamosis, and coronary arteries (bad in CAD); stim 5-HT1b&d inhib proinflamatory peptides from trigeminal nerve

Front 11

TQ 5-HT3 blockers

Back 11

end in -setron; stim dermal and visceral sensory fibers of vagus, *emesis via direct stim of CTZ

Front 12

TQ Carcinoid syndrome

Back 12

Tumors of enterochromaffin cells secrete seritonin autonomously or in response ot stim; cause bronchospasm, intestinal cramp/diarrhea, steatorrhea, flushing skin trunk and neck; *tx-cyproheptadine blocks 5-HT1 or 5-HT2

Front 13

Cisapride

Back 13

5-HT4 blocker; enhance Ach release in GI; increase LES pressure and enhance gastric emptying prior surgery; off-market b/c possible torasad

Front 14

Migraine headache

Back 14

Intense headache, unilateral, normal activity lasting 4-72hrs; "want to lie still in dark room"; *tx-sumatriptan; 5-HT1b/d blocker

Front 15

Cluster headache

Back 15

Occur in clusters of time w/ one eye and adjacent temple cheek and forehead, occur during sleep, last .5-2hrs; "want to pace"; *tx-sumatriptan; 5-HT1b/d blocker

Front 16

Metaclopramide

Back 16

5-HT4 agonist enhance Ach of LES and stomach stim GI, 5-HT3 blocker of vagal and CTZ and D2 blocker of CTZ; increase LES (maybe), empty stomach before surgery, prevent nausea and vomiting for chemo; s/e D2 block result dystonia/parkinsons symptoms

Front 17

Ondansetron

Back 17

po or iv; 5-HT3 blocker of vagal or CTZ; equally effective as dexamethasone in treating nausea and vomiting of chemo pts, morning sickness of pregos

Front 18

Cyproheptadine

Back 18

5-HT1 and 5-HT2 blocker, H1 blocker, Muscarinic blocker (s/e's); tx-*carcinoid syndrome (decrease gi hypermotility, hypersecretion and diarrhea; tx-appetite stimulant, allergic diseases, *PTSD (prevent nightmares)

Front 19

Pregnancy nausea and vomiting

Back 19

prophylaxis-ondansetron, dimenhydrinate and meclizine

Front 20

Bulk lax and lactulose

Back 20

Draw water into bowel causing bowel distention and activate stretch receptors; methylcellulose, psyllium, calcium polycarbophil, lactulose; NO lax dependence

Front 21

Ducusate sodium

Back 21

stool softener; anionic surfactant detergent action; NO lax dependence

Front 22

Osmotic purgative agents

Back 22

Osmotically draw water into bowel and activate stretch receptors; cause GI colic and lax dependence; Magnesium hydroxide/citrate/sulfate, polyethylene glycols; Avoid

Front 23

Tx of constipation

Back 23

Bulk laxatives (methylcellulose, psyllium, polycarbophil, lactulose) and stool softeners (sodium docusate); NO lax dependence

Front 24

Tx of IBS (alternating constipation and diarrhea)

Back 24

Bulk laxatives (methylcellulose, psyllium, polycarbophil, lactulose) and muscarinic blocker may prevent bowel spasm (dicyclomine, tagaserod)

Front 25

TQ DOC slow bowel to allow absorption fluids and consolidate feces (anti-diarrhea)

Back 25

Loperamide (no risk abuse), diphenoxylate (w/ atropine avoid abuse); slow colonic transit rate by direct/indirect inhibition GI motility despite GI muscle tone increase

Front 26

Bismuth subsalicylate

Back 26

antiulcer-protective coating, increase PGE synthesis and alkali secr, antibacterial-prevent binding bact; stool interferes w/ xray (radioopaque) and stool gray-black (not melena)

Front 27

Octreotide

Back 27

stim soatostatin receptors; reduce diarrhea/flushing w/ metastatic carcinoid synd; used stop GI bleeding pts w/ esophageal varices

Front 28

TQ Tx duodenal/gastric ulcers

Back 28

antibiotic triple therapy (say CAiO to ulcers); clarithromycin, amoxacillin, omeprazole; 95% cure rate

Front 29

Antacids

Back 29

aluminum hydroxide (all stoped up; s/e constipation); Magnesium hydroxide (s/e diarrhea); weak bases neutralize acid

Front 30

Proton pump inhibitors (PPI)

Back 30

Inhibit gastric H-K ATPase for 24-72 hrs; end in -prazole

Front 31

Misoprostol

Back 31

stable anolog of PGE1; stim gastric parietal cells inhibits acid secretion, protective effects gastric mucosa; DO NOT USE poss pregnant women

Front 32

TQ Tx ulcers in ventilated pts

Back 32

Sucralfate; sticky viscous gel form protective layer on ulcer; protective effects w/o increase in stomach pH; avoid pneumonia b/c reduce g- protection w/o acidic pH

Front 33

TQ Tx ulcers by NSAIDs, aspirin or corticosteroids

Back 33

Misoprostol-oral PGE replacement therapy that was affected; may be used for prophylaxis w/ coticosteroids for chronic immunosupressive therapy

Front 34

TQ Tx of crohns dx (IBD)

Back 34

Masalamine-5-ASA, Olsalazine-two 5-ASA joined and cleaved by bacteria, Sulfaslazine; 5-ASA block PG and LT synthesis by inhibiting cox and lox

Front 35

TQ Tx of gallstones medically

Back 35

Ursodiol; increase ration bile acid and phospolipid:cholesterol, inhib HMG CoA reductase, increase solubility cholesteral, stones are disolved; may require surgery

Front 36

TQ Tx of primary biliary cirrhosis (PBC)

Back 36

Urosdiol; daily therapy slow progression of autoimmune dx destroying bile ducts

Front 37

TQ Tx of porteal systemic encephalopathy w/ chronic hepatic dx

Back 37

Lactulose; both acute and chronic therapy, decreases plasma ammonia and improves mental state/EEG; ammonia trapped inside bowel and excreted in feces