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18 Cards in this Set

  • Front
  • Back
Name the "aggressive factors" that lead to ulcers and gastritis
H. pylori, NSAIDs, acid, pepsin and smoking
What "defensive factors" do our stomachs possess?
blood flow
Name the fibric acid derivatives used to treat hyperlipidaemia
Clofibrate, gemfibrozil, fenofibrate, ciprofibrate and bezafibrate
Which statin inhibits HMG-CoA reductase long term?
This may be the reason that there's no benefit in taking atorvastatin at night.
What are the indications for statins?
symptomatic atherosclerotic disease
those with increased risk of coronary artery disease because of elevated serum cholesterol, esp with other risk factors

(other indications as seen from the PBS criteria for starting statins (or fibrates) in very high risk patients can be found in AP notes, and include diabetes mellitus with microalbuminuria, peripheral vascular disease, and post bypass surgery)
What's the MOA of omeprazole?
Irreversible inhibiton of the H+K+ATPase in parietal cells (the proton pump).
It's activated by acidity of the parietal cells, and accumulates in areas with the lowest pH.
What mucosa-protecting agents are useful in PUD?
Sucralfate - creates a protective barrier
Misoprostol - suppresses acid secretion and promotes secretion of bicarbonate and mucus
bismuth chelate - may inhibit adherence of H. pylori to mucosa and coats ulcer base
Carbenoxolone - promotes mucus production
Why has ranitidine replaced cimetidine? Include ADRs of cimetidine.
Ranitidine is more potent and since it has poor access to the CNS it doesn't cause confusion, hallucinations and CNS depression/excitation like cimetidine, and it has no anti-androgenic effects like gynaecomastia, reduced libido or impotence. There are also fewer drug interactions with ranitidine.
What agents could be used to increase gastric emptying for patients whose GE is so slow that eventually food is pushed back up into the oesophagus (GORD)?
Domperidone - D2-receptor antagonist
Metoclopramide - D2-receptor antagonist
Cisapride - serotonin 5-HT4 agonist (however it causes arrhythmias)
What types of drugs are used in Ulcerative colitis and Crohn's disease?(both believed to be autoimmune diseases)
Other immunosuppressants such as azathioprine, mercaptopurine
What adverse effects are associated with fibrates?
Myositis, sometimes rhabdomyolysis
GIT irritation
Clofibrate linked with gall stone formation
Pros and cons of bile acid binding resins?
Effectively lower plasma cholesterol by decreasing absorption of exogenous cholesterol, increasing metabolism of endogenous cholesterol into bile acids and increasing expression of LDL receptors on the liver.

Cons: Need to be taken 2-3x daily, unpleasant taste; nausea, bloating, constipation/diarrhoea common; reduce absorption of fat-soluble vitamins and drugs - give one hour before or 4-6 hours after dose.
List the effects of morphine on respiration and motor control.
- respiratory depression (rate and volume) by directly depressing CNS respiratory centres

- muscular rigidity results from high doses
What effects does morphine have on body temperature and the cardiovascular system?
- causes hypothermia by direct action on hypothalamus

- dilates peripheral blood vessels (causing postural hypotension)
- may release histamine
What type of hormonal effects does morphine have on humans?
- increasing circulating levels of ADH, PRL (prolactin), growth hormone, somatotropin

- decreasing levels of LH, corticotropin, pituitary gonadotropin

-> decreased libido and menstruation
We have three exclusive opioid receptors: mu, kappa and delta. Why isn't it beneficial to have selectivity for kappa receptors?
This is due to kappa receptors being commonly associated with dysphoria (being in an unpleasant mood). Mu receptors do not experience this, but have many other side effects.
A problem with morphine is that it causes respiratory depression - especially in pregnancy when it can cross the placental barrier. What implications does this lead to in the baby?
As a foetus, it develops opioid tolerance. After childbirth, the baby experiences 'withdrawal' and has problems starting to breathe
You see someone with a possible heroin overdose. How would you be certain of this, and what could you administer to save their life?
Heroin/morphine causes pupillary constriction, a sign resistant to tolerance. Administer a short-action opioid antagonist such as naloxone to prevent respiratory depression.