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Gastrointestinal
FA complete review part 4 Pharmacology
| Question | Answer |
|---|---|
| What are common Histamine-2 blockers? | Cimetidine, Ranitidine, Famotidine, and Nizatidine |
| What does the blockage of H-2 receptor by histamine-2 blockers cause? | Decrease H+ secretion by parietal cells |
| What are the most common uses of Histamine-2 receptor blockers? | Peptic ulcer disease and mild esophageal reflux |
| What is an important adverse effect of Cimetidine? | Potent inhibitor of cytochrome P-450 |
| What are the common antiandrogenic effects of Cimetidine? | Prolactin release, gynecomastia, impotence, and decreased libido |
| Which histamine-2 receptor blocker is the one with the most adverse effects? | Cimetidine |
| What is a common adverse effect of Cimetidine and Ranitidine? | Decrease renal excretion of creatine |
| List of common Proton pump inhibitors: | Omeprazole, Lansoprazole, Esomeprazole, pantoprazole, and dexlansoprazole. |
| Irreversibly inhibit H+/K+ ATP in stomach parietal cells. | Mechanism of action of PPIs |
| What is the mechanism of action so Histamine-2 receptor blockers? | Reversible block of H-2 receptor |
| Common pathologies treated with PPIs? | PUD, gastritis, esophageal reflux, Zollinger-Ellison syndrome, component of therapy for H. pylori, and stress ulcer prophylaxis |
| What are common infections seen with use of PPIs? | C. difficile infection, pneumonia, and acute interstitial nephritis |
| What cation (electrolyte) is severely decreased by chronic use of PPIs? | Serum Mg2+ |
| Why is an elder person at increase risk of bone fracture in case of long term treatment with PPIs? | Due to decreased Mg2+ and decreased Calcium absorption. |
| In the parietal cell of stomach, which drug inhibits Ach action to the M3 receptor? | Atropine |
| What electrolyte imbalance is seen with all antacids? | Hypokalemia |
| What adverdse effets with Aluminum hydroxide? | -Constipation and hypophosphatemia - Proximal muscle weakness, osteodystrophy, and seizures |
| What is the featured adverse effect of Calcium carbonate? | Milk-alkali syndrome (hypercalcemia), and rebound acid. |
| Antiacid able to chelate and decreased effectiveness of drugs? | Calcium carbonate |
| What are the associated adversse effects of Magnesium hydroxide? | Diarrhea, hyperreflexia, hypotension, cardiac arrest |
| MOA of Bismuth and/or sucralfate: | Bind to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer. |
| What kind of enviroment is required in Bismuth? | Acidic |
| What medications are not given with Bismuth? | PPIs and H2 blockers |
| Common PGE2 analog | Misoprostol |
| Misoprostol is a __________________. | PGE1 analog |
| What is the mode of action of misoprostol? | Increase production and secretion of gastric mucous barreir, and decresa acid prodiction |
| Abortifacient PGE1 analog | Misoprostol |
| What is the main use for Misoprostol? | Prevention of NSAID-induced pepti ulcers |
| What is the off-label use of Misoprostol? | Induction of labor (abortive) |
| Why is Misoprostol used to induce abortion? | Ripens the cervix |
| Long-acting somatostatin analog | Octreotide |
| MOA of Octreotide: | Inhibits secretion of various splanchnic vasodilatory hormones |
| What are common uses for Octreotide? | Acute variceal bleeds, acromegaly, VIPoma, and carcinoid tumors |
| Why is the use of Octreotide associated with development of Cholelithiasis? | Due to CCK inhibition |
| What is the mechanism of action of Sulfasalazine? | Combination of Sulfapyridine and 5-aminosalicylic acid; activated by colonic bacteria |
| What are the most common uses for Sulfasalazine? | Ulcerative colitis, and Crohn disease |
| Severe adverse effects of Sulfasalazine? | Sulfonamide toxicity and reversible oligospermia |
| Agonist a u-opioid receptors. | Loperamide |
| What GI medication is known to slow gut motility? | Loperamide |
| What is the most common condition for using Loperamide? | Diarrhea |
| Ondansetron is an _________ antagonist. | 5-HT3 |
| Powerful central-acting antiemetic. | Ondansetron |
| Which antiemetic is known to decrease vagal stimulation? | Ondansetron |
| What is the clinical use for Ondansetron? | Control vomiting postoperatively and in patients undergoing cancer chemotherapy |
| What are the most serious adverse effects seen with Ondansetron? | 1. QT interval prolongation 2. Serotonin syndrome |
| Metoclopramide is an: | D2 receptor antagonist |
| MOA of Metoclopramide | Increase resting tone, contractility, LES tone, motily, promotes gastric emptying. |
| What is the effect of Metoclopramide on colon transport time? | None |
| Which are the MC uses for Metoclopramide? | 1. Diabetic and postsurgery gastroparesis 2. Antiemetic 3. Persistent GERD |
| Which GI drug is seen with development of parkinsonian effects? | Metoclopramide |
| Metoclopramide may have an drug interaction with what other drugs? | Digoxin and diabetic agents |
| Which patients should not be treated with Metoclopramide? | - Small bowel obstruction patiens - Parkison disease patients |
| Why are Parkinson patient patients not treated with Metoclopramide? | Due to D2-receptor blockade. |
| A patient just after a surgery is seen with tardive dyskinesia. Which is the most likely drug causing such adverse effect? | Metoclopramide |
| What is the mode of action of Orlistat? | Inhibits gastric and pancreatic lipase leading to the breakdown and absorption of dietary fats |
| What are the main types (categories) of laxatives? | 1. Bulk-forming laxatives 2. Osmotic laxatives 3. Stimulants 4. Emollients |
| Examples of Bulk-forming laxatives: | Psyllium, and methylcellulose |
| What are some Osmotic laxatives? | Magnesium hydroxide, magnesium citrate, polyethylene glycol, and lactulose. |
| Most common stimulant laxative | Senna |
| Emollient example? | Docusate |
| Soluble fibers draw water into gut lumen, forming a viscous liquid that promotes peristalsis | Mechanism of action Bulk-forming laxatives |
| What category or type of laxatives may be abused by bulimics? | Osmotic laxatives |
| What is a rare and unique side effect of Stimulant laxatives? | Melanosis coli |
| What is melanosis coli? | Harmless condition in which the lining of the colon turns a shade of black or brown |
| What is the mode of action of Senna? | Enteric nerve stimulation leading to colonic contraction |
| Promotes incorporation of water and fat into stool. | Mode of action of Emollients |
| What kind of laxatives work by providing osmotic load to draw water into GI lumen? | Osmotic laxatives |
| Substance P antagonist | Aprepitant |
| What medication or GI drug opposes the actions of Substance P? | Aprepitant |
| Which receptors are blocked by Aprepitant? | NK1 receptors in the brain |
| Which medication is used to block the actions by neurokinin-1 receptors in the brain? | Aprepitant |
| What is the use of Aprepitant? | Antiemetic for chemotherapy-induced nausea and vomiting |
Created by:
rakomi
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