Pharmacology Ch. 62: Gi Drugs

Front 1

Weak bases that neutralize stomach acid by reacting with protons in the lumen of the stomach

Back 1

Antacids: MgOH2 and AlOH3

Front 2

Antacid that has a strong laxative effect? Constipating action?

Back 2

MgOH2
AlOH3

Front 3

MOA of H2 antagonists

Back 3

Block histamine receptors on parietal cell of oxyntic glands

Front 4

H2 antagonists

Back 4

Cimetidine, ranitidine, famotidine, nizatidine

Front 5

MOA of Proton Pump Inhibitors

Back 5

Irreversibly inactivate the parietal cell H+/K+ ATPase

Front 6

1st line txmt for GERD, peptic ulcers, Zollinger-Ellison Syndrome, prevention of stress-releated mucosal bleeding, and nonulcer dyspepsia

Back 6

PPI's

Front 7

Proton-Pump Inhibitors

Back 7

Omeprazole, esomprazole, lansoprazole, pantoprazole, and rabeprazole

Front 8

Side effects of long term use of PPI's

Back 8

Decrease the oral bioavailability of B12 and certain drugs that require acidity for their GI absorption (digoxin and ketoconazole)

Front 9

68 y/o man presents with GERD. You wish to give him a PPI, however, he has a hx of Atrial Fibrillation. What should you be mindful of?

Back 9

If he is taking digoxin, PPI's could decrease the oral bioavailibility due to decreased GI acidity.

Front 10

Drug that polymerizes in stomach acid and binds to injured tissue and forms a protective coating over the ulcer bed

Back 10

Sucrasulfate

Front 11

Analog of PGE1 that increases mucosal protection and inhibits acid secretion? It is useful in reducing the risk of ulcers in pts who use?

Back 11

Misoprostol
NSAIDs

Front 12

Actions of Bismuth

Back 12

Formation of a protective coating on ulcerated tissue, stimulation of mucosal protective mechanisms, direct antimicrobial effects, and sequestration of enterotoxins.

Front 13

Drugs used for post-op gastric emptying delay and gastroparesis

Back 13

Pro-Kinetic drugs:
Neostigmine(anti-cholinesterase inhibitor)
Metoclopramide (D2 antagonist)

Front 14

Mucosal protective agents

Back 14

Sucrasulfate
Bismuth subsalicylate
Misoprostol

Front 15

Antibiotics for H pylori

Back 15

Tetracycline, metronidazole, amoxicillin, and clarithromycin

Front 16

Anticholinesterase inhibitor used in hospitalized pts for acute large bowel distention

Back 16

Neostigmine

Front 17

Function of dopamine in the enteric nervous system

Back 17

Inhibits cholinergic stimulation of smooth muscle contraction.

Front 18

D2 receptor antagonist. Whats its main use? What else may it be used for?

Back 18

Metaclopramide:
Promotes GI motility
Blocks D2 receptors in the area postrema, which helps to prevent emesis after surgical anesthesia or chemotherapy

Front 19

Chronic use of this drug causes extra-pyramidal symptoms, parkinson-like symptoms, and hyperprolactinemia

Back 19

Metoclopramide

Other useful anti-emetics?

Hint 19

Useful antiemetic drugs:
Ondansetron
Aprepitant
Metoclopramide
Diphenhydramine
Scopolamine
Dronabinol

Front 20

5-HT3 receptor antagonists

Back 20

Ondansatron, granisetron, dolasetron, and palosetron

Front 21

MOA of 5-HT3 receptors

Back 21

Receptors are found in the CNS, especially the chemoreceptive area and vomiting center, and enteric nerves. These receptors mediate excitation via a gated cation channel. Antagonists are anti-emetics

Front 22

MOA of Aprepitant

Back 22

Neurokinin-1 receptor antagonist, that is found in the area postrema of the CNS. It is a new anti-emetic that Prevents N/V in chemo txmt.

Front 23

Anti-emetic drug who works via CYP3A4 and therefore may have many interactions

Back 23

Aprepitant

Front 24

Anti-diarrheal drugs

Back 24

Loperamide(OTC) and Diphenoxylate

Front 25

Drugs used for IBS

Back 25

Alosetron- For IBS w/ diarrhea
Tegaserod: For IBS w/ constipation

Front 26

MOA of Alosetron

Back 26

potent 5HT-3 receptor antagonist. Approved for use with women who have IBS w/ diarrhea

Front 27

Tegaserod

Back 27

Partial agonist of 5-HT4 receptors, that promotes gastric emptying and motility, and increases stool liquidity by increasing chloride secretion in the colon. Approved for use in women with IBS and constipation.

Front 28

SE of this drug include constipation, and in severe cases ischemic colitis

Back 28

Alosetron

Front 29

Recently discontinued due to increased risk of cardiovascular events

Back 29

Tegaserod:
5HT4 partial agonist used for IBS

Front 30

Drugs used in the txmt of ulcerative colitis and crohn's

Back 30

Glucocorticoids(Prednisone)
Immunosupressant antimetabolites(Azathioprine, methotrexate, 6-mercaptopurine)
Anti-TNF-alpha antibody (Infliximab)
Aminosalicylates (Mesalamine)

Front 31

MOA of aminosalicylates

Back 31

In the small intestine, they release 5-aminosalicylic, which inhibits the synthesis of both prostaglandins and inflammatory leukotrienes.

Front 32

Pancreatic lipase used in steatorrhea

Back 32

Pancreatin

Front 33

Bulk forming laxatives

Back 33

Psyllium, methylcellulose, polycarbophil

Front 34

Stool Softening laxatives

Back 34

Ducosate, glycerin, mineral oil

Front 35

Osmotic laxatives

Back 35

Magnesium oxide, sorbitol, lactulose, and polyethylene glycol

Front 36

Stimulating laxatives

Back 36

Aloe, senna, castor oil, cascara

Front 37

Cholinomimetic agonist used for postoperative and neurogenic ileus and urinary retention

Back 37

Bethanechol