Term
|
Definition
| irreversible blockage of H+K+-ATPase pump in parietal cells |
|
|
Term
| what are the effects of PPIs? |
|
Definition
| long lasting reduction of stimulated and nocturnal acid secretion |
|
|
Term
| How do the half-lives of PPIs compare to DOA? |
|
Definition
|
|
Term
|
Definition
| may reduce absorption of some drugs and increase that of others |
|
|
Term
| What are the effects of H2 receptor blockers like cimetidine? |
|
Definition
| reduction of nocturnal acid, but less effective against stimulated secretion |
|
|
Term
| Cimetidine has which special side effects? |
|
Definition
| weak antiandrogenic agent, potent CYP inhibitor |
|
|
Term
| What does sucralfate do? How many times/day is it given? |
|
Definition
| polymerizes at site of tissue damage and protects against further damage, very insoluble with no systemic effects, must be given 4xday |
|
|
Term
| What is the MOA of metoclopramide? |
|
Definition
| D2 receptor blocker, removes inhibition of Ach neurons in END |
|
|
Term
| What are the effects of metoclopramide? |
|
Definition
| increases gastric emptying and intestinal motility |
|
|
Term
| What is metoclopramide used for? |
|
Definition
| gastric paresis, and as an antiemetic |
|
|
Term
|
Definition
| parkinsonian symptoms due to block of CNS D2 receptors |
|
|
Term
| Domperidone is like which other drug? Is has less effect on what system? |
|
Definition
|
|
Term
| Which cholinomimetic drug is used for colonic pseudo-obstruction in hospitalized pts? |
|
Definition
|
|
Term
| Which antibiotic is useful in diabetic gastroparesis, but tolerance often develops? |
|
Definition
|
|
Term
| How do magnesium hydroxide and other nonabsorbable salts and sugars act as laxatives? |
|
Definition
| osmotic agents increase water content of stool |
|
|
Term
| what are the effects of MgOH and other osmotic laxatives? |
|
Definition
| causes evacuation within 4-6h, sooner in large doses |
|
|
Term
| what are MgOH and other osmotic laxatives used for? |
|
Definition
| simple constipation, bowel prep |
|
|
Term
|
Definition
| may be absorbed and cause toxicity in renal impairment |
|
|
Term
| What do methylcellulose, psyllium, etc do? |
|
Definition
| increase volume of colon (bulk-forming laxative) and stimulate evacuation |
|
|
Term
| How do senna and cascara work? |
|
Definition
| They are stimulants, may cause cramping |
|
|
Term
| Which laxatives are stool surfactants? |
|
Definition
| docusate and mineral oil - lubricate stool and ease passage |
|
|
Term
| How does Lubrprostone work as a laxative? |
|
Definition
| stimulates chloride secretion into intestine, increasing fluid content |
|
|
Term
| Which opioid receptor antagonists are used as laxatives? |
|
Definition
| alvimopan, methylnaltrexone, blocks intestinal m-opioid receptors but does not enter CNS |
|
|
Term
|
Definition
| 5-HT4 agonist, activates enteric 5-HT4 receptors and increases intestinal motility |
|
|
Term
| Loperamide (immodium): MOA? |
|
Definition
| activates m-opioid receptors in ENS |
|
|
Term
|
Definition
| slows motility in gut with negligible CNS effects |
|
|
Term
| Clinical applications for loperamide? |
|
Definition
| nonspecific, noninfectious diarrhea |
|
|
Term
|
Definition
| mild cramping but little or no CNS toxicity |
|
|
Term
| diphenoxylate (lomotil): similar to? |
|
Definition
| loperamide, but high doses can cause CNS opioid effects and toxicity |
|
|
Term
| colloidal bismuth compounds: subsalicylate and citrate salts available - OTC preps are popular and have some value in... |
|
Definition
| traveler's diarrhea, due to absorption of toxins |
|
|
Term
|
Definition
| adsorbent compounds available OTC, anti-diarrheal |
|
|
Term
|
Definition
| 5-HT3 antagonist of high potency and duration of binding |
|
|
Term
|
Definition
| reduces smooth muscle activity in gut |
|
|
Term
| What is alosetron used for? |
|
Definition
| severe diarrhea-predominant IBS in women |
|
|
Term
|
Definition
| rare but serious constipation, ischemic colitis, infarction |
|
|
Term
| Why are anticholinergics used in IBS? |
|
Definition
| nonselective action on gut activity, usually associated with typical antimuscarinic toxicity |
|
|
Term
| What is the chloride channel activator used in IBS? For whom specifically is it used? |
|
Definition
| lubiprostone, useful in constipation-predominant IBS in women |
|
|
Term
|
Definition
| 5-HT3 blockage in gut and CNS with shorter duration of binding than alosetron |
|
|
Term
|
Definition
| extremely effective in preventing chemotherapy-induced and postop N/V |
|
|
Term
| What are first-line antiemetic agents in cancer chemotherapy, and also used for post-op emesis? |
|
Definition
| odansetron and other 5-HT3 blockers |
|
|
Term
| How is odansetron given? tox? |
|
Definition
| usually IV but orally active in prophylaxis, very low toxicity but can slow colonic transit |
|
|
Term
|
Definition
| NK1-receptor blocker in CNS |
|
|
Term
| What are the effects of aprepitant? |
|
Definition
| interferes with vomiting reflex, no effect on 5-HT, dopamine, or steroid recepts |
|
|
Term
| aprepitant - clinical applications? |
|
Definition
| effective in reducing both early and delayed emesis in cancer chemotherapy |
|
|
Term
| how is aprepitant given? What is the IV form? tox? |
|
Definition
| orally, fosaprepitant, fatigue, dizziness, diarrhea, CYP interactions |
|
|
Term
| Which drugs are useful in antiemetic IV cocktails through unknown mechanisms? |
|
Definition
|
|
Term
| What is scopolamine? What is it used for? |
|
Definition
| antimuscarinic, effective in emesis due to motion sickness but not other types |
|
|
Term
| What kind of efficacy do antihistaminics have in for anti-emesis action? |
|
Definition
| moderate efficacy in motion sickness and chemotherapy-induced emesis |
|
|
Term
| How do phenothiazines act to help with emesis? |
|
Definition
| act through block of D2 and muscarinic recepts |
|
|
Term
| Which cannabinoid is available for use in chemotherapy-induced nausea and vomiting but is associated with CNS effects? |
|
Definition
|
|
Term
| What is the MOA of 5-aminosalicylates (mesalamine) and sulfasalazine for IBD treatment? |
|
Definition
| uncertain, may be inhibition of eicosanoid inflammatory mediators |
|
|
Term
| What are the effects of 5-aminosalicylates (mesalamine) and sulfasalazine for IBD treatment? |
|
Definition
| topical therapeutic action, systemic absorption may cause toxicity |
|
|
Term
| what are the clinical applications of 5-aminosalicylates (mesalamine) and sulfasalazine? |
|
Definition
|
|
Term
| 5-aminosalicylates (mesalamine) and sulfasalazine for IBD treatment - toxicity? |
|
Definition
| sulfasalazine causes sulfonamide toxicity and may cause GI upset, myalgias, arthralgias, myelosuppression, other aminosalicylates are much less toxic |
|
|
Term
| Purine analogues and antimetabolites, eg 6-mercaptopurine, methotrexate: MOA? |
|
Definition
| uncertain, may promote apoptosis of immune cells, methotrexate blocks dihydrofolate reductase |
|
|
Term
| Purine analogues and antimetabolites, eg 6-mercaptopurine, methotrexate: effects? |
|
Definition
| general suppression of immune processes |
|
|
Term
| Purine analogues and antimetabolites, eg 6-mercaptopurine, methotrexate: clinical applications among GI disorders? |
|
Definition
| mod-severe Crohn's and UC |
|
|
Term
| Purine analogues and antimetabolites, eg 6-mercaptopurine, methotrexate: toxicity? |
|
Definition
| GI upset, mucositis, myelosuppression, purine analogues may cause hepatotoxicity, but rare with methotrexate at dose used |
|
|
Term
| Anti-TNF antibodies (infliximab, others): MOA? |
|
Definition
| bind TNF, prevent it from binding receptors |
|
|
Term
| Anti-TNF antibodies (infliximab, others): effects for GI disorders? |
|
Definition
| suppression of several aspects of immune function, especially Th1 lymphocytes |
|
|
Term
| Anti-TNF antibodies (infliximab, others): clinical applications among GI disorders? |
|
Definition
| infliximab: mod-severe Crohn's and UC, others approves in Crohn's |
|
|
Term
| Anti-TNF antibodies (infliximab, others): toxicity? |
|
Definition
| infusion rxns, reactivation of latent TB, increased risk of dangerous systemic fungal and bacterial infections |
|
|
Term
| Pancrelipase: MOA and effects? |
|
Definition
| replacement enzymes from animal pancreatic extracts, improves digestion of fat, protein and carbs |
|
|
Term
| Pancrelipase: applications? How often do you take it? tox? |
|
Definition
| pancreatic insufficiency, with every meal, may increase incidence of gout |
|
|
Term
| Pancreatin is similar to pancrelipase but... |
|
Definition
| has lower potency, is rarely used |
|
|
Term
|
Definition
| reduces cholesterol secretion into bile |
|
|
Term
|
Definition
|
|
Term
| ursodiol: clinical applications? |
|
Definition
| gall stones in pts refusing or not eligible for Sx |
|
|
Term
|
Definition
|
|
Term
|
Definition
| somatostatin analogue, mechanism not certain |
|
|
Term
|
Definition
| may alter portal blood flow and variceal pressures |
|
|
Term
| octreotide: clinical applications? |
|
Definition
| pts with bleeding varices or at high risk of repeat bleeding |
|
|
Term
|
Definition
| reduced endocrine and exocrine pancreatic activity, other endocrine abnormalities, GI upset |
|
|
Term
| What effect do beta-blockers have for treatment of varices? |
|
Definition
| reduce CO and splanchnic vascular resistance |
|
|
Term
| Which H2 blockers cause less CNS and sexual disturbance than cimetidine? |
|
Definition
| ranitidine (zantac), famotidine (pepsid), nizatadine (axid) |
|
|
Term
| Which H2 blockers are only PO? |
|
Definition
| famotidine (pepsid), nizatidine |
|
|
Term
| Which H2 blockers have less P450 inhibition? no P450 inhibition? |
|
Definition
| ranitidine (zantac), famotidine (pepsid) and nizatidine (axid) |
|
|
Term
| Which H2 blockers have increased first pass metabolism? |
|
Definition
|
|
Term
| Aluminum salts given for antacid effect will cause... |
|
Definition
|
|
Term
| Which antacids cause constipation? |
|
Definition
| aluminum salts, Ca carbonate |
|
|
Term
| Which antacids cause diarrhea? |
|
Definition
|
|
Term
| Which antacids are contraindicated in renal failure? |
|
Definition
|
|
Term
| which antacids are preferred pre-op due to lower risk of aspiration pneumonitis? |
|
Definition
|
|
Term
| Metabolic alkalosis, hemorrhoids and fissures, and milk-alkali syndrome can be caused by which antacids? |
|
Definition
|
|
Term
| Sucralfate contains aluminum which can cause... |
|
Definition
|
|
Term
| Metoclopramide can cause HTN when coadministered with... |
|
Definition
|
|
Term
| Cisapride increases ___ and rate of ____ |
|
Definition
|
|
Term
| Omeprazole has what effect on P450? constipation or diarrhea? What kind of tumor is associated with it? |
|
Definition
| inhibition, constipation, carcinoid tumor |
|
|
Term
| Misoprostole is a ____ analogue, and causes ____ |
|
Definition
|
|
Term
| Misoprostole increases... |
|
Definition
|
|
Term
| Of the opioid anti-diarrheal drugs, which has no drug interactions? |
|
Definition
|
|
Term
| Of the opioid anti-diarrheal drugs, which overdose is treated with naloxone? |
|
Definition
|
|
Term
| Of the opioid anti-diarrheal drugs, which is dosed in drops? |
|
Definition
|
|
Term
| Of the opioid anti-diarrheal drugs, which is used in convulsive states? |
|
Definition
|
|
Term
| Of the opioid anti-diarrheal drugs, which has a greater risk of hypotension with anesthetics or phenothiazine? |
|
Definition
|
|
Term
| Of the opioid anti-diarrheal drugs, which is also available IM? |
|
Definition
|
|
Term
| Of the adsorbent anti-diarrheal drugs, which is used for traveler's diarrhea prophylaxis? |
|
Definition
|
|
Term
| Of the adsorbent anti-diarrheal drugs, which is contraindicated in ASA sensitivity? |
|
Definition
|
|
Term
| Of the adsorbent anti-diarrheal drugs, which increases the concentration of oral anticoagulants and hypoglycemics? |
|
Definition
|
|
Term
| Of the adsorbent anti-diarrheal drugs, which decreases the effects of uricosuric drugs? |
|
Definition
|
|
Term
| Of the adsorbent anti-diarrheal drugs, which decreases the absorption of many drugs? |
|
Definition
| kaopectate, cholestyramine |
|
|
Term
| Of the adsorbent anti-diarrheal drugs, which may increase K+ loss? |
|
Definition
|
|
Term
| Of the adsorbent anti-diarrheal drugs, which is given for diarrhea caused by C Diff or bile? |
|
Definition
|
|
Term
| Of the laxatives, which may damage nerves? |
|
Definition
|
|
Term
| Of the laxatives, which are like psyllium? |
|
Definition
| methylcellulose, Ca polycarbophil |
|
|
Term
| Of the laxatives, which are stimulants and carthartics? |
|
Definition
| bisacodyl, phenolphthalein, danthron, senna, castor oil |
|
|
Term
| Of the laxatives, which is metabolized in the intestine to ricinoleate, a surfactant? |
|
Definition
|
|
Term
| Of the laxatives, which improves penetration of water and fat into feces? |
|
Definition
|
|
