Systems Ii Gi Drugs

Front 1

Pathophysiology of Peptic Ulcers
Factors?
manifestation?

Back 1

1. Aggressive Factors: acid/pepsin/Hpylori

vs. Mucosal defenses: bicarbonate, mucus, prostaglandin

2. Pain mediated by primary sensory neurons sensing drop in pH

Front 2

Stomach Acid Regulation mechanisms

Back 2

1. Neural-vagal ach release:
Vagal activity-->ACH on M/N receptors-->ACH on M-->increase Histamine-->H2-->cAMP-->H+ release

2.Endocrine-gastrin
Gastric R-->increase H+

3. Paracrine: histamine
Activate M/gastrin Receptor-->histamine release-->activates H2 receptors-->increase cAMP-->increase acid

Front 3

Gastric Antacids
-differences in?

Back 3

-speed potencies and side effects

Front 4

H2 Receptor Antagonist
Prototype?
Other drugs?
Sid-effects?

Back 4

-Cimetidine
-Ranitidine, famotidine, nizatidine
-Cimetidne: decrease liver metabolism for other drugs, other H2 have no side effects

Front 5

Therapy of Ulcers
Cytoprotective Drugs

Back 5

proton pump inhibitors

Sucralfate

Prostaglandin analogs

Front 6

Cytoprotective Drugs
Proton Pump Inhibitors:
-prototype?
-activated by?
-type of action?
-useful for?

Back 6

-omeprazole(prilosec), lansoprazole(Prevacid)

- low pH-->useful as inactive till gets into stomach

-irreversible inhibitor of enzyme H/K atpase.

-only need 1 pill/day, Long lasting as need to synthesize new enzymes in order to make more stomach acid

Front 7

Cytoprotective Drugs
Sucralfate
-mechanism?
-side effects?

Back 7

-forms physical cytoprotective/coating/barrier in GI tract

- inhibits other absoprtions of drugs/food so cannot give other drugs at the same time. Must give other drugs 2 hrs b4, 4 hrs after admin

Front 8

Therapy of Ulcer:
Goal?
drugs?

Back 8

-eradicate H. Pylori(90% of ulcers)
class I carcinogen in Gi tract

proton pump inhbitor
Antibiotics(multi, mono ineffective, 14 days):
-amoxicllin
-tetracycline
-clarithromycin
-bismuth: binds bacteria toxins and decreases secretions

Front 9

Therapy of Ulcers: interactions with drugs in denstiry

Back 9

Analgesics: increase bleeding and block prostalndin production-->use acetominopen or NSAID(ibuprofen) + proton pump inhibitor por things that block prostaglandins at site of inflammation only

-Cimetidine usage-decrease diazepam

-absorption of durgs impaired by gastric antacids and sucralfate(2/4)

Sedatives

Antibiotics: becareful not taking sucalfarate(antiabsorption)

Oral anticoagulants

Front 10

Inflammatory Bowel Disorders?
similar to?
characterized by?
treatment?

Back 10

1. Ulcderative Colitis: confined to colon

2. Crohns disease: not confined, ulcerations under tongue

-asthma

-inflammation,edema, diarrhea, abdominal pain

-palliative:
Pain: acetomenaphine or NSAIDs+proton pump

Diarrhea: opioids

Antibiotics, immune suppresives, corticosteroids(inflammation)

Front 11

Antidiarrheal Agents: Opioids
drugs?
solubility?
treatment for?
use when?
example?

Back 11

-diphenoxylate: CNS effects
-Loperamine: no CNS effects

low aqueous

with post operative analgesics

Tylenol-3 -->get constipation

Front 12

Antidiarrheal Agents: Bismuth subalicylate

treatement for what bacteria?
for what disease?
dose?
mechanism?

Back 12

-H. Pylori
-travelers diarrhea
-large doses(pepto) decrease Sx
-binds bacteria toxins to decrease seceretions

Front 13

Antidiarrheal Agents: Doxycycline
agent?
pharmacokinetics?
-mechanism?

Back 13

-prophy

- long 1/2 life

-excreted into bowel of lumen ending up at site of infection where it comes into effect

Front 14

Antimetic Agents
drugs classes?
acts on?

Back 14

D2 antagonists
H1 antagonist
Muscanaric antagonist
5HT3 antagonist
Corticosteroids
Cannabinoids

peripheral or CNS(not sure if inside or outside but think its outside)

Front 15

Emetic Agents

Back 15

Syrop of ipecac
apopmorphine

Front 16

Prostaglandin Analogs:
prototype?
for what kind of patients?
fxns?
side effects?

Back 16

-Misoprostol(cytotec)

-patients taking analgesics(tylenol) for relief in pain whose anti inflammatory responses block prostaglandins which can lead to increase stomach acid

-like prostaglandins, secretes mucus/ bicarbonate while inhibitng gastric acid production

-Child rearing women, prostalgandins cause uterine contractions which can induce labor or terminate pregnancy

Front 17

Cannabinoids:
used for?
useful in what patients?
act on?

Back 17

analgesia, appetite stimulaton

-cancer/HIV,Aids patients

-CNS within BBB

Front 18

Domperidone:
class?
acts on?
speical becuase?

Back 18

-D2 antagonists
- most D2(metoclopromide) act centrally, chronic use ends up with serious sx of extrainflammatory? D2 doesn't need to cross BBB, acts on chemoreceptor trigger zone

Front 19

5ht3 acts on ?

Back 19

serotonin receptors

Front 20

Laxatives
class?
stimulant?
when not to use?

Back 20

Stimulants
Saline catharctics
Bulk-forming agents

Castor Oil-rapid onset do not amin during bedtime

Bethanecol, metoclopromide, domperiodne-stimulate peristalsis