Pharmacology - Week 13 - Gi Drugs

Front 1

What are the protective effects of the stomach? What hormone produces it?

Back 1

increase blood supply, increase mucus and bicarbonate-----Prostaglandins

Front 2

Gastric acid increase is caused by

Back 2

endogenously - histamine, gastrin, acetylcholine --------------- others - infection, NSAIDs, smoking

Front 3

What antibiotics are used to treat ulcer disease

Back 3

amoxicillin, clarithromycin, tetracycline, metronidiazole

Front 4

What are the types of antiulcer drugs?

Back 4

H2 receptor (histamine) inhibitor ------------- Proton pump inhibitor ------------- Mucosal protectants ------------- Prostaglandin replacement therapy

Front 5

What is the mechanism of Cimetidine?

Back 5

(H2 inhibitor) - H2 receptor stimulates acid production. Cimetidine blocks this receptor. Ranitidine also.

Front 6

What is the action of Omeprazole?

Back 6

(proton pump inhibitor) - irreversible inhibition of enzyme that secretes gastric acid. Also Esomeprazole, Lansomeprazole.

Front 7

What is mechanism of Sucralfate?

Back 7

(Mucosal protectant) - creates protective barrier around ulcer

Front 8

What is Mechanism of Misoprostal?

Back 8

(prostaglindin replacement) - analog for endogenous Prostaglandin E - stomach protective effects

Front 9

Mechansims of antacids?

Back 9

alkaline substances that neutralize stomach acid

Front 10

Compare Cimetidine and Ranitidine adverse effects.

Back 10

Ranitidine produces similar, but less adverse effects. ------- Cimetidine has anti-androgenic effects ( gynocomastia, reduced libido, impotence) ------ hallucinations in the elderly --------- hypotension and dysrhythmias from IV Bolus

Front 11

What effect does concurrent food have with Cimetidine?

Back 11

prolongs the effect of Cimetidine

Front 12

What reduces absorption of Cimetidine?

Back 12

antacids

Front 13

How long does Omeprazole have an effect?

Back 13

irreverible binding to proton pump enzymes. replaced after 2 hours.

Front 14

Omeprazole reduces the absorption of what?

Back 14

Ataznavir (HIV) and ketoconazole (antifungal)

Front 15

What medications are contraindicated with sucralfate?

Back 15

antacids, proton pump inhibitor, H2 receptor antagonist b/c sucralfates require and acid pH for proper activation

Front 16

What is the most common adverse effect of sucralfate? What can be done to avoidit?

Back 16

constipation. drink at least 1500 ml/day and high fiber diet

Front 17

What antiulcer drugs are contraindicated for pregnancy?

Back 17

misoprostal (prostaglandin replacement) and cemitidine (H2 antagonist)

Front 18

What are adverse effects for Misoprostal?

Back 18

abdominal pain, diarrhea, cramping and vaginal bleeding in women

Front 19

What antacid may cause acid rebound?

Back 19

Calcium carbonate

Front 20

What antacid can cause hypertenntion and HF

Back 20

sodium bicarb - not used often

Front 21

What are different kinds of antacids?

Back 21

Mg(OH)2, Al(OH)2 -------- Calc Carb, Sodium Bicarb

Front 22

How does methylcellulose and psyllium work?

Back 22

bulk formaing lax - retains water as it moves down tract

Front 23

How does docusate sodium work?

Back 23

surfactant lax - decrease surface tension on stool allowing water to be absorbed

Front 24

How does Bisacodyl work?

Back 24

Stimulant lax - stimulate intestinal motility

Front 25

How does lactulose work?

Back 25

osmotic lax - disaccharide not absorbed, water pulled into intestines

Front 26

What does Mg(OH)2 do?

Back 26

both antacid and laxative. as laxative, salts are not absorbed through GI wall. Water pulled in through osmotic effect.

Front 27

What does sodium phosphate do?

Back 27

osmotic laxative - as laxative, salts are not absorbed through GI wall. Water pulled in through osmotic effect.

Front 28

How does a glycerin suppository work?

Back 28

lubricant - like mineral oil, it softens stool

Front 29

What is a precaution for osmotic laxatives?

Back 29

since evacuates large amt of watery stool, keep hydrated

Front 30

What laxative causes a burning sensation??

Back 30

bisacodyl (due to intestinal motility?)

Front 31

While on laxatives it is important to

Back 31

take fluids

Front 32

What are the kinds of antidiarrheal meds?

Back 32

opiates (paregoric) and opiodios (lomotil, loperamide = immodium, bismuth subsalicylate = pepto bismol)

Front 33

What is the action of odensatrion

Back 33

serotonin receptor antagonist (seratonin associated with emesis)

Front 34

Action of Metclopramide?

Back 34

1. block dopamine and serotonin receptors 2. inc upper GI motility and tone

Front 35

Action of scopolamide?

Back 35

for motion sickness - muscarinic antagonist, suppressing neuarl activity in pathway to middle ear

Front 36

Action of chlorpromazine?

Back 36

block dopamine

Front 37

Action of Dramamine?

Back 37

blocks acetylcholine and histamine, blocking neuronal receptors in path from inner ear to vomit center

Front 38

Action of antivert?

Back 38

blocks acetylcholine and histamine, blocking neuronal receptors in path from inner ear to vomit center