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I hate DRUGS!! > GI drugs > Flashcards

GI drugs Flashcards

1
Q

A 55 year old woman with T1DM of 40 years duration complains of severe blaoting and abdominal distress especially after meal. Evauluation is consistent with diabetic gastroparesis. Which of the following is a prokinetic drug that could be used in this situation?

A

Metoclopramide

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2
Q

A patient who is taking verapamil for hypertension and angina has become constipated. WHich of the following drugs is an osmotic laxative. That could be used to treat the patient’s constipation?

A

Magnesium hydoxide

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3
Q

Inhibits stomach acid by irreversibly inhibits H+/K+ ATPase in the parietal cell

A

Esomeprazole

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4
Q

A 25 year old college student went to student health care center for severe cramps, diarrhea, fever and weight loss. She was diagnosied with Corhn’s disease. Which dug is most likely to be used in the treatment?

A

Mesalamine

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5
Q

A 34 year old woman has IBD with diarrhea that is not responsive to conventional therapies. Despite the small risk of severe constipation and ischemic colitis. The patinet decides to begin therapy woth alosetron. Alosetron has which receptor actions?

A

5-HT3 anatagonist

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6
Q

On your way to an examiantion, you experience the vulnerable feeling that an attack of diarrhea is imminent. If you stopped ate a drugstore, what drug can be bought OTC at a drugstore despite being an opiod analgesic

A

Loperamide

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7
Q

What antibiotics can be used in eradiacting intestinal H.pylori

A

Clarithromycin

  • Other
    • amoxicillin
    • tetracycline
    • metronidazole
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8
Q

A patient is receiving highly emetogenic chemotherapy for metastatic carcinoma. to prevent chemotherapy-induced nausea and vomiting. She is likely to be treated with which of the following?

A

Ondansetron

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9
Q

Which drug stimulates chloride secretion into the gut lumen and is used for IBD?

A

Linaclotide

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10
Q

This is a small molecule that polymerizes in stomach acid and coats the ulcer bed, resulting in accelerated healing and reduction of symptoms

A

Sucralfate

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11
Q

Proton pump inhibitors

A

irreversible blockade of H+/K+ ATPase in active parietal cells

Used in peptic ulcer, GERD, erosive gastritis

Half-lives much shorter than duration of action

Low toxicity. reduction of stomach acid nay reduce absorption of some drugs and increase that of others

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12
Q

H2-receptor blockers

(cimetidine, famotidine, nizatidine, ranitidine)

A

Reduce noctural acid but less effective than PPIs against stimulatred secretion; very safe, available over the counter.

Cimetidine, but not other H2 blockers, is a weka antiandrogenic agent and a potent P450 enzyme

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13
Q

Polymerzies at the site of tissue and protect agaisnt further damage; very insoluble with no sytemic effects; must be given 4x daily

A

Sucralfate

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14
Q

Popular OTC medication for symptomatic relief of heartburn; not as useful as PPIs and H2 blockers in peptic disease

A

Antacids

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15
Q

Metoclopramide

A

D2 receptor blocker. Icnreases gastric emptying and intestinal motility

Used in gastric paresis. antiemetic

Oral and parenteral formualtions

SE: parkinsonian symptoms due to block of CNS D2 receptors

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16
Q

Like metoclopramide but less CNS effect

A

Domperidone

17
Q

used for colonic pseudo-obstruction in hospitalized patients

A

Cholinomimetics (neostigmine)

18
Q

Useful in diabetic gastroparesis but tolerance develops

A

Eythromycin

19
Q

Laxatives

(Magnesium hydroxide and other nonabsorbable salts and sugars)

A

Osmotic agents increase water content of stool

Simple constipation. Bowel prep for endoscopy (especially PEG solutions)

Oral

SE: magnesium may be absorbed and cause toxicity in renal impairment

20
Q

Bulk forming laxatives

A

Methylcellulose, psyllium

Increase volume, stimulate evacuation

21
Q

Stool surfactants

A

Docusate, mineral oil; lubricate stool, ease passage

22
Q

Stimulants (laxatives)

A

Senna, cascara; stimulate activity; may cause cramping

23
Q

Chloride channel activators

A

Lubiprostone, a prostanoic acid derivative,s timualtes chloride secretion into intestine, increasing fluid content; linaclotide, guanylyl cyclase C-agonist,s timualtes chloride secretion by CFTR

24
Q

Opiod receptor antagonis

A

ALvimopan, methylnatrexone, block intestinal mu opiod receptors but do not enter CNS, so analgesia is maintaine

25
Q

Loperamide

A

Activates mu opiod receptors in enteric nervous system and slows motility with negligible CNS effects

Non specific, non infectious diarrhea

Oral

Mild cramping but little or no CNS toxicity

26
Q

Similar to loepramide but high doses can cause CNS opiod effects and toxicity

A

Diphenoxylate

27
Q

Subsalicylate and citrate salts available as OTC products; adsorption of toxins has some value in travelers’ diarrhea

A

Colloidal bismuth compounds

28
Q

Adsorbent compounds available OTC in some countries

A

Kaolin + pectin

29
Q

Alosetron

A

5-HT3 receptor antagonist of high potency and duration of binding. reduces smooth muscle activity in GI tract

Used in severe diarrhea-predominant IBS in women

Oral

Rare but serious constipation; Ischemic colitis. bowel infarction

30
Q

useful in constipation-predominant IBS in women

A

Lubiprostone

(Chloride channel activator)

31
Q

A neurokinin 1 (NK1), antagonist avaiable for use in chemotherapy-induced nausea and vomiting; associated with fatigue, dizziness, diarrhea, and p450 interactions.

A

Aprepitant

32
Q

Mesalamine

A

Mechanism uncertain, may be inhibition of eicosanoid inflammatory mediators

Mild to to moderately severe Crohn’s disease and ulcerative colitis

Various formualtions designed to deliver drug to distal ielum and colon

Little or notoxicity

33
Q

Antibody that blocks leukocyte integrins; may cause progressive multifocal leukoencephalopathy

A

Natalizumab

34
Q

similat to natalizumab with very low risk if PML

A

Vedolizumab

35
Q

Pancrelipase

A

Repalcement enzymes from animal pancreatic extracts that improve digestion of fat, protein, and carbohydrate

Pancreatic insufficiency due to cystic fibrosis, pancreatitis, pancreatectomy

Taken with every meal

May increase incidence of gout

36
Q

Ursodiol

A

Reduces cholesterol secretion into bile

Gallstone in patients refusing or not eligible for surgery

Oral

Little or no toxicity

37
Q

Octreotide

A

Somatostatin analog

variceal bleeding

IV

Hyper/hypoglycemia

38
Q

Propanolol

A

Reduces variceal pressure

Variceal bleeding

Oral

Bradycardia, bronchoconstriction

I hate DRUGS!! (26 decks)

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