Term
| what does the parietal cell make? |
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Definition
|
|
Term
| what does the Enterochromaffin cell make? |
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Definition
|
|
Term
| What does the antral cell make? |
|
Definition
|
|
Term
| What are the inputs to the parietal cells? |
|
Definition
| neural from vagus, endocrine from antral cells: Histamine, paracrine from ECL cells (Histamine) |
|
|
Term
| How does the parietal cell form acid? |
|
Definition
| H/K ATPase: pumps H into lumen |
|
|
Term
| What is the site of action of PPI's? |
|
Definition
|
|
Term
| What is the critical regulator of acid production? |
|
Definition
| Histamine, through H2 receptors |
|
|
Term
| How does Histamine stimulate acid production? |
|
Definition
| H/K ATPase through the cAMP pathway |
|
|
Term
| How do Muscarinic and gastrin receptor activate acid? |
|
Definition
| through increases in Calcium |
|
|
Term
| What are the Histamine receptor antagonists? |
|
Definition
| Cimetidine, Ranitidine, Famotidine, Nizatidine |
|
|
Term
| What is the structure of Histamine receptor antagonists? |
|
Definition
|
|
Term
| what is the prototype histamine receptor |
|
Definition
|
|
Term
| which Histamine recepotr blocker is the most likely to have side effects? |
|
Definition
| cimetidine; blocks cyt P450 |
|
|
Term
|
Definition
| what else does Cimetidine block?,androgen recepotrs and Estrogen metabolism; lead to Estrogen effects such as gynecomastia |
|
|
Term
| What are side effects of cimetidine? |
|
Definition
| may cause gynecomastia, decreased sperm count, galactorrhea |
|
|
Term
| what drugs does Cimetidine alter the metabolism of? |
|
Definition
| Warfarin, Quinidine, phenytoin, Beta Blockers |
|
|
Term
| Which Histamine antagonist has only 1/10 effect on p450 as Cimetidien? Which 2 are devoid of p450 effects? |
|
Definition
| Ranitidine. Famotidine and Nizatidine |
|
|
Term
| Histamine receptor antagonists not only block stimulated acid secretion |
|
Definition
| but also ____,basal secretion |
|
|
Term
| what suffix is a/w histamine receptor antagonists? |
|
Definition
|
|
Term
| what are the uses of Histamine Receptor antagonists? |
|
Definition
| gastric and duodenal ulcers, suppression of nocturnal acid production, treatment of uncomplicated GERD, prophylaxis of stress ulcers. |
|
|
Term
| What are the Proton Pump Inhibitors? |
|
Definition
| Omeprazole, esomeprazole, Pantoprazole, Lansoprazole, Dexlansoprazole |
|
|
Term
| What is the MOA of PPI"s? |
|
Definition
| covalently interact and form disulfide bridge with H/K ATPase and inhibit the pump; IRREVERSIBLE! |
|
|
Term
| How are PPI's administered? |
|
Definition
| orally active in a delayed releae form so they are protected from stomach acid. |
|
|
Term
| What are adverse reactions of PPI's? |
|
Definition
| very insignificant; alter absorption of other drugs that require acid mileiu of stomach |
|
|
Term
| What drugs' absorption is affected by PPI's? |
|
Definition
| Ketoconazole or Ampicillin esters |
|
|
Term
| what are the uses of PPI's? |
|
Definition
| healing of gastric and duodenal ulcers, Tx of GERD, Zollinger Ellison, erosive esophagitis |
|
|
Term
| What is the MOA of Misoprostol to inhibit acid secretion? |
|
Definition
| PGE1 analog that acts on EP3 receptors of parietal cells to decrease cAMP, decrease acid secretion, increase mucin and bicarbonate |
|
|
Term
| How is Misoprostol administered |
|
Definition
| it is orally active and rapidly absorbed |
|
|
Term
| What is the approved use of Misoprostol that is GI-related? |
|
Definition
| approved for preventing mucosal injury caused by NSAIDs |
|
|
Term
| What is the one adverse effect of Misoprostol? |
|
Definition
| PG's cause smooth muscle contraction, so they cause diarrhea |
|
|
Term
|
Definition
| for treatment of ulcers, contraindicated?,contraindicated in pregnancy |
|
|
Term
| What drug is used for prophylaxis of Stress-induced ulcers? |
|
Definition
|
|
Term
| What are the two components of Sucralfate? |
|
Definition
| sucrose octasulfate and polyaluminum hydroxide |
|
|
Term
| What is the MOA of Sucralfate? |
|
Definition
| at pH 4 and below, undergoes cross-linking and adheres to form a protective coat on ulcers |
|
|
Term
| What is the adverse effect of Sucralfate? |
|
Definition
| constipation due to the Aluminum component |
|
|
Term
| Antacids are either ___ or ___ |
|
Definition
|
|
Term
| What is the MOA of Antacids? |
|
Definition
| They are weak bases that neutralize acid |
|
|
Term
| Which 2 antacids are rapid acting? |
|
Definition
| Calcium carbonate and Magnesium Hydroxide |
|
|
Term
| What is the slow acting antacid? |
|
Definition
|
|
Term
| What are side effects of Aluminum? |
|
Definition
| constipation, can bind drugs, toxic in individuals with reanl insufficiency: osteoporosis, encephalopathy, myopathy |
|
|
Term
| What are the effects of Magnesium? |
|
Definition
|
|
Term
| Whcih antacid can lead to hypercalcemia? |
|
Definition
|
|
Term
| What class of drugs is used in Europe for peptic ulcer disease by blocking acetylcholine activity of EC cells? |
|
Definition
| Anticholinergics: Pirenzipine and Telenzipine |
|
|
Term
| When are antibiotics used as acid regulators? |
|
Definition
| in treatment of H.pylori. used in combo with PPI's |
|
|
Term
| How are Prostaglandins 'bifunctional'? |
|
Definition
| 1. inhibit acid secretion by decreasing cAMP. 2. increase mucus production |
|
|
Term
| What is the overall theme of prokinetic drugs? |
|
Definition
| ACH and activation of M3 receptor |
|
|
Term
| What is the effect of Dopamine on Gut motility? |
|
Definition
| inhibitory; inhibits the release of ACH through D2 receptors |
|
|
Term
| What is the effect of blocking Dopamine on Gut motility? |
|
Definition
| Dopamine inhibits gut motility, so inhibiting Dopamine activates gut smooth muscle. |
|
|
Term
| What is the bimodal effect of Serotonin on gut motility? |
|
Definition
| 5HT3 and 4 increase motility, 5HT1 inhibits ACH release. |
|
|
Term
| what is a naturally occuring peptide taht stimulates the upper GI tract? |
|
Definition
|
|
Term
| What is a Dopamine inhibitor that blocks D2 receptors |
|
Definition
| blocking the inhibitory effect of Dopamine on Gut Motility?,Metoclopramide |
|
|
Term
| What are the uses of Dopamine inhibitors? |
|
Definition
|
|
Term
| What are adverse effects of Dopamine inhibitors? |
|
Definition
| crosses BBB causing Extrapyramidal side effects. also increases prolactin |
|
|
Term
| What are the 2 5HT4 agonists? |
|
Definition
|
|
Term
| What are the adverse effects of 5HT4 agonists? |
|
Definition
| myocardial and CNS iscehmia/stroke |
|
|
Term
| What are 2 Motilin agonsits? |
|
Definition
| Erythromycin, Clarithromycin |
|
|
Term
| When is a Motilin agonist used? |
|
Definition
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