Gastrointestinal Pharmacology: Inflammatory Bowel Disease
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Questions and Answers

What is the primary location of mucosal inflammation in ulcerative colitis?

  • Colon (correct)
  • Entire GI tract
  • Stomach
  • Small intestine

    • Which of the following medications is used for active and chronic symptoms of inflammatory bowel disease, but has significant side effects?

  • Methotrexate
  • Cyclosporin (correct)
  • Aminosalicylates
  • Thiopurines

    • What is the mechanism of action of corticosteroids in inflammatory bowel disease?

  • Inhibition of T cell proliferation
  • Stimulation of cytokine synthesis
  • Inhibition of dihydrofolate reductase
  • Inhibition of inflammatory pathways (correct)

    • Which of the following medications is a prodrug of 5-aminosalicylic acid?

    <p>Balsalazide</p> Signup and view all the answers

    What is the primary effect of thiopurines in inflammatory bowel disease?

    <p>Induction of T cell apoptosis</p> Signup and view all the answers

    Which of the following medications is used for relapsing or active Crohn's disease refractory or intolerant to azathioprine or thiopurine?

    <p>Methotrexate</p> Signup and view all the answers

    What is the primary effect of infliximab in inflammatory bowel disease?

    <p>Antibody infusion</p> Signup and view all the answers

    What is the potential long-term benefit of aminosalicylates in inflammatory bowel disease?

    <p>Reduced risk of colorectal cancer</p> Signup and view all the answers

    What is the primary mechanism of action of Infliximab?

    <p>Blocking the activity of TNF-α</p> Signup and view all the answers

    What is the main side effect of bulking agents that can occur if not taken with sufficient water?

    <p>Worsening of constipation</p> Signup and view all the answers

    Which of the following is a major side effect of chronic steroid use?

    <p>Renal impairment</p> Signup and view all the answers

    What is the primary indication for the use of Infliximab in Crohn's disease?

    <p>Fistulizing disease</p> Signup and view all the answers

    What is the primary mechanism of action of osmotic laxatives?

    <p>Inhibiting the absorption of water and electrolytes</p> Signup and view all the answers

    What is the most common cause of constipation in patients who abuse laxatives?

    <p>Laxative abuse</p> Signup and view all the answers

    What is the primary advantage of bulking agents over other types of laxatives?

    <p>Long-term safety</p> Signup and view all the answers

    Which of the following is a common side effect of Infliximab infusion?

    <p>Infusion reactions</p> Signup and view all the answers

    What is the primary mechanism of action of lactulose?

    <p>Breaking down into acetic and lactic acid, causing an osmotic effect</p> Signup and view all the answers

    What is the effect of enteral loss of water and salts on potassium levels?

    <p>It decreases potassium levels by increasing renal excretion of potassium</p> Signup and view all the answers

    What is the primary mechanism of action of docusate sodium?

    <p>Lubricating and softening the consistency of the stool</p> Signup and view all the answers

    What is the effect of laxative abuse on the colon?

    <p>It leads to a vicious cycle of constipation and repeated use</p> Signup and view all the answers

    What is the primary mechanism of action of lubiprostone?

    <p>Stimulating the release of chloride channels in the intestinal mucosa</p> Signup and view all the answers

    What is the effect of aldosterone on potassium levels?

    <p>It decreases potassium levels by stimulating the reabsorption of sodium</p> Signup and view all the answers

    What is the primary mechanism of action of bisacodyl?

    <p>Irritating the GI mucosa and increasing intestinal motility</p> Signup and view all the answers

    What is the effect of osmotic force on the bowel?

    <p>It increases the volume of the bowel and triggers peristalsis</p> Signup and view all the answers

    What is often misinterpreted as constipation?

    <p>Diarrhea</p> Signup and view all the answers

    What is the primary cause of antibiotic-associated diarrhea?

    <p>Clostridium difficile</p> Signup and view all the answers

    Which of the following anti-diarrheal agents reduces peristalsis and increases intestinal transit time?

    <p>Loperamide</p> Signup and view all the answers

    What is the purpose of atropine in combination with diphenoxylate?

    <p>To prevent drug abuse</p> Signup and view all the answers

    What is the consequence of altering the normal fecal flora in the colon?

    <p>Colonic colonization of C. difficile</p> Signup and view all the answers

    What is the role of toxin A and toxin B in C. difficile infection?

    <p>They produce a toxin that causes diarrhea</p> Signup and view all the answers

    What is the indication for treatment in elderly or small children with diarrhea?

    <p>Severe diarrhea lasting more than 2-3 days</p> Signup and view all the answers

    What is the contraindication for Loperamide use?

    <p>Toxic colitis/megacolon</p> Signup and view all the answers

    Which antibiotic is contraindicated in patients with liver or renal impairment, and is used to treat infection that can lead to colitis and toxic megacolon?

    <p>Metronidazole</p> Signup and view all the answers

    What is the mechanism of action of Simethicone in relieving painful symptoms associated with gas?

    <p>Alters elasticity of mucus-coated bubbles</p> Signup and view all the answers

    Which area of the brain is responsible for stimulating emesis, and is also known as the chemoreceptor trigger zone?

    <p>Area postrema</p> Signup and view all the answers

    What is the mechanism of action of Scopolamine as an antiemetic?

    <p>Muscarinic M1 receptor antagonist</p> Signup and view all the answers

    What is the primary side effect of Phenothiazines as antiemetics?

    <p>Extrapyramidal effects</p> Signup and view all the answers

    Which antiemetic is used to treat chemotherapy-induced nausea and vomiting, and has a mechanism of action that involves antagonism of serotonin 5-HT3 receptors?

    <p>Ondansetron</p> Signup and view all the answers

    What is the primary contraindication for the use of Metoclopramide as an antiemetic?

    <p>Parkinson's disease</p> Signup and view all the answers

    Which antiemetic has central anticholinergic actions, and is used to treat benign paroxysmal positional vertigo (BPPV)?

    <p>Meclizine</p> Signup and view all the answers

    Study Notes

    Ulcerative Colitis and Inflammatory Bowel Disease (IBD)

    • Mucosal inflammation primarily occurs in the colon in ulcerative colitis.
    • Thiopurines are used to manage active and chronic symptoms of inflammatory bowel disease but have significant side effects.

    Medications and Mechanisms

    • Corticosteroids work through immunosuppressive action, reducing inflammation and immune response in IBD.
    • Mesalamine is a prodrug of 5-aminosalicylic acid, aiding in the treatment of IBD.
    • Thiopurines mainly act as immunosuppressants in inflammatory bowel disease, reducing the immune system's activity.

    Specific Medications

    • Infliximab is used for relapsing or active Crohn's disease that is refractory to azathioprine or thiopurine.
    • The primary effect of infliximab is to block tumor necrosis factor (TNF), reducing inflammation.

    Long-Term Benefits and Side Effects

    • Aminosalicylates may provide long-term benefits by maintaining remission and preventing relapses in IBD.
    • The long-term use of corticosteroids is associated with significant side effects, including osteoporosis and adrenal insufficiency.

    Mechanisms of Laxatives and Anti-Diarrheals

    • Osmotic laxatives work by drawing water into the bowel, facilitating stool passage.
    • Laxative abuse often leads to colonic dysfunction or dependence.
    • Bulking agents offer an advantage over other laxatives by improving stool consistency without causing irritation.

    Loperamide and Constipation

    • Loperamide is contraindicated in cases of suspected infectious diarrhea, as it may worsen the condition.
    • The most common cause of constipation related to laxative misuse is colonic atony or decreased motility.

    Antibiotic-Associated Diarrhea

    • The primary cause of antibiotic-associated diarrhea is the alteration of normal gut flora, often leading to overgrowth of pathogenic organisms.

    Toxin A and B in C. difficile Infection

    • Toxins A and B are responsible for the pathogenic effects in C. difficile infection, leading to diarrhea and colitis.

    Nausea and Vomiting Medications

    • The chemoreceptor trigger zone (CTZ) in the brain is critical for inducing emesis.
    • Scopolamine, an antiemetic, works by blocking acetylcholine, reducing nausea.
    • Phenothiazines have notable side effects, including sedation and dystonic reactions.
    • Serotonin 5-HT3 receptor antagonists are effective against chemotherapy-induced nausea and vomiting.

    Special Considerations

    • Metoclopramide is contraindicated in patients with Parkinson's disease due to its dopamine antagonism.
    • Anticholinergic antiemetics are effective for treating benign paroxysmal positional vertigo (BPPV).

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    GI Pharmacology Part 2 PDF

    Description

    Test your knowledge of gastrointestinal pharmacology, focusing on inflammatory bowel disease, including ulcerative colitis and Crohn's disease, their symptoms, and treatment options. Learn about the therapeutics used to resolve acute episodes and prolong remission.

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