Pharm2:naus/vom/ibd

Front 1

two controls centers of naus/ vom

Back 1

1. CTZ =5HT3, D2, opioid 2. vomiting center in medulla-enkephalin, H1, cholinergic some 5HT3

Front 2

the CTZ has a high concentrations of 5HT3 and D2 receptors. Give 4 drugs that reduces vomiting by targeting these receptors

Back 2

1 and 2. ondansetron, granisetron=5HT3 antagonists 3. Prochlorperazine-D2 antagonist 4. metoclopramide-5HT, prokinetic

Front 3

where does scopolamine act to reduce vomiting, when is it indicated

Back 3

anti-cholinergic agent, acts in the inner ear and vomiting center of the medulla, used for motion sickness

Front 4

anti-cholinergic agent that acts in the inner ear and vomiting center, used prophylatically to prevent motion sickness, batch or injected.

Back 4

scopolamine

Front 5

where does dimenhydrinate act to prevent vomiting. when is it used

Back 5

H1 blocker, works in vomiting center of medulla, used for motion sickenss and post op

Front 6

an H1 blocker used to treat motion sickness and post-op nausea, and vestibular disorders

Back 6

dimenhydrinate

Front 7

where do ondansetron and granisetron act to prevent vomiting, when are they used

Back 7

5HT3 receptors in the CTZ and vagal afferents, used for chemotherapy, radiation, or post-op nausea

Front 8

two 5HT3 receptor antagonists used to treat nausea associated with chemo, rad, post-op

Back 8

ondansetron, granisetron

Front 9

where does prochlorperazine act to prevent nausea. when is it used

Back 9

D2 receptor antagonist, acts in CTZ,  some anti chonlinergic/ histamine activity general use

Front 10

a D2 receptor antagonist used to treat general mild to moderate nausea, also has som anti cholineric/ histamine activity

Back 10

prochlorperazine

Front 11

where does dronabinol act to reduce vom? use?

Back 11

THC receptor, used for chemo naus not tx'ed with other drugs, many side effects (weed)

Front 12

acts on the THC receptor to reduce nausea in chemo pts

Back 12

dronabinol

Front 13

where does dexamethasone act  to reduce vom? use?

Back 13

glucocorticoid, has anti-emetic effect when given with other drugs, used in chemo

Front 14

a glucocorticoid that has anti-emetic effects when used in combo with others in chemo

Back 14

dexamethasone

Front 15

where does aprepitant act to reduce vomiting? use?

Back 15

substance P/NK receptor antagonist, use in combo for acute and dealyed naus w/ chemo, post-op

Front 16

a substance P receptor antagonist used in combo for chemo and post op nausea

Back 16

aprepitant

Front 17

where does metoclopramide act to reduce vomiting. What are it's other uses

Back 17

prokinetic agent, D2 antagonist, 5HT in CTZ, promotes gastric emptying by enhancing Ach release in myenteric plexus used for mild to moderate naus/vom, diabetic induced gastroparesis, GERD, best with GI motility disordrs

Front 18

a prokinetic agent D2 receptor antagonist, 5HT antagonist used for  mild to moderate naus/vom, diabetic induced gastroparesis, GERD, best with GI motility disordrs

Back 18

metoclopramide

Front 19

where does erythormycin act to tx diabetic gastroparesis

Back 19

activates motlin receptors in gastric antrum and duodenum

Front 20

activates motilin receptors in gastric antrum and duodenum, used to tx diabetic gastroparesis

Back 20

erythromycin

Front 21

two drugs used to tx diabetic gastroparesis

Back 21

metoclopramide (D2/5HT antagonist, enhances Ach release), erythromycin (activates motilin receptors)

Front 22

4 classes of drugs used to treat diarrhea give examples and use

Back 22

1. opoid derivaties-Loperamide, Diphenoxylate, 2. bulk forming agents 3. antibiotics-Bismuth subsalicylate 4. Octreotide-somatostatin analog for carcionoid syndrome associated diarrhea

Front 23

loperamide use

Back 23

opioid derivative, anti-diarrhea, best agent b/c poorly penetrates CNS

Front 24

diphenoxylate use

Back 24

opiod derivative anti-diarrhea, note abuse potential, preps include subthereapeutic atropine

Front 25

how does bismuth subsaliylate tx diarrhea

Back 25

displaces intestinal bacteria from mucus into lumen=>lysis, may be antibacterial, good for traveler's diarrhea, tx H. pylori, causes black stools

Front 26

used for traveler's diarrhea, displaces intestinal bacteria and may be anti-bacterial

Back 26

bismuth subsalicylate

Front 27

octreotide use

Back 27

somatostatin analog, physiologically antagonizes hormone secretion, tx carcinoid syndrome associated diarrhea

Front 28

a somatostatin analog used to tx diarrhea associated with carcinoid syndrome

Back 28

octreotide

Front 29

how does magnesium hydroxide treat constipation

Back 29

causes osmotic water rentention to increase bulk and intestinal peristalsis, contraindicated w/ electrolyte imbalance, renal or cardiac disease

Front 30

an antacid that is also used to Tx constipation, causes osmotic water retention to increase bulk and peristalsis

Back 30

magnesium hydroxide (Mg=Make Go)

Front 31

how does lactulose Tx constipation

Back 31

non-abs, disaccharide, hydrolyzed to organic acid in intestine, osmotically pulls water into intestine

Front 32

non-abs, disaccharide, hydrolyzed to organic acid in intestine, osmotically pulls water into intestine

Back 32

lactulose

Front 33

how does PEG tx constipation

Back 33

polyethylene glycol. long chain PEG's are poorly abs, osmotic rentention of water, used for sugical prep

Front 34

poorly absorbed molecule that causes osmotic retention of water, used for surgical/ rad prep of colon

Back 34

PEG-polyethylene glycol

Front 35

how do docusate salts  tx constipation

Back 35

anionic surfactant=stool softner

Front 36

an anionic surfactant used to soften stool

Back 36

docusate salts

Front 37

how does bisacodyl tx constipation

Back 37

irritant laxative, causes low grade mucosal inflammation, irritation, fluid accumulation, 6 hour latent period

Front 38

irritant laxative, causes low grade mucosal inflammation, irritation, fluid accumulation, 6 hour latent period

Back 38

bisacodyl

Front 39

how does lubiprostone tx constipation

Back 39

activates choloride channels to increase secretion, used for IBS associated diarrhea in women

Front 40

activates choloride channels to increase secretion, used for IBS associated diarrhea in women

Back 40

lubiprostone

Front 41

contraindications for laxitive use

Back 41

undiagnosed Ab pain, constipation because of intestinal obstruction

Front 42

what is the role of corticosteriods in the tx of IBD, give two

Back 42

immunosupressive therapy, prednisone used for acute attacks, budesonide =enteric release, mild to moderate chron's

Front 43

used to treate acute attacks of moderate to severe IBD

Back 43

prednisone

Front 44

an enteric release corticosteroid used to treat mild-moderate acute chron's

Back 44

budesonide

Front 45

how do olsalazine, mesalamine, and sulfasalazine tx IBD

Back 45

5-aminosalicylates. Not COX related, inhibit Il-1, TNF, LOX, NFkB, free radical scavengers. Mesalamine is the acitve produc to which sulfasalazine and olsalazine are converted to, used for mild to moderate ulcerative colitis

Front 46

drugs of choice for mild to moderate ulcerative colitis

Back 46

5-aminosalicylates: olsalazine, mesalamine, sulfasalazine

Front 47

class of drugs used for chronic severe or steroid-resistant IBD. Give three examples

Back 47

antimetabolites 1. Azathioprine-purine analog 2. Methotrexate-DHFred inhibitor 3. Cyclosporine-calcineurin inhibitor, decreases IL-2=inhbits T helper cells

Front 48

used for treatment of moderate to severe chron's and ulcerative colitis, immunoglobulin

Back 48

infliximab-anti TNF