GI Pharmacology Midterm

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Questions and Answers

What kind of drugs are useful for the treatment of a peptic ulcer?

  • Histamine (H2) receptor antagonist/blockers (correct)
  • Proton pump inhibitors (correct)
  • Prostaglandin analogs (correct)
  • Antacids (correct)
  • Mucosal protectants (correct)

The ______ in the parietal cell is the H-K ATPase enzyme system on the secretory surface of the gastric parietal cells.

pump

Which of the following are common over-the-counter antacids?

  • Calcium salts (carbonate) (correct)
  • Magaldrate (aluminum and magnesium combination) (correct)
  • Sodium Bicarbonate (correct)
  • Aluminum salts (hydroxide) (correct)
  • Magnesium salts (milk of magnesia) (correct)

Which of the following are considered newer agents for treating peptic ulcers?

<p>Pantoprazole (A), Omeprazole (B), The &quot;prazoles&quot; (C), Esomeprazole (D), Lanisoprazole (E)</p> Signup and view all the answers

Sucralfate is used to protect the eroded ulcer sites in the GIT from further damage by acid and digestive enzymes.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a side effect of Misoprostol?

<p>Constipation (A)</p> Signup and view all the answers

What is the primary target of action for laxatives?

<p>To increase the passage of the colonic contents.</p> Signup and view all the answers

What type of laxative is Lactulose considered?

<p>Bulk-forming (D)</p> Signup and view all the answers

What is the primary action of Bisacodyl (Dulcolax)?

<p>Directly stimulates the GIT nerves (B)</p> Signup and view all the answers

What is the target of action for anti-diarrheal agents?

<p>All of the above (D)</p> Signup and view all the answers

What is the common antidote used for heparin?

<p>Protamine sulfate</p> Signup and view all the answers

Which of the following is NOT a clinical indication for the use of heparin?

<p>Myocardial Infarction (C)</p> Signup and view all the answers

Warfarin is a large protein molecule that cannot pass through the placenta easily.

<p>False (B)</p> Signup and view all the answers

What is the gold standard for monitoring the effectiveness of warfarin therapy?

<p>International Normalized Ratio (INR) (D)</p> Signup and view all the answers

Anti-platelet agents like aspirin work by inhibiting the aggregation of platelets, thus preventing the formation of a platelet plug.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a clinical indication for the use of thrombolytics?

<p>Prevention of blood clots in patients with artificial heart valves (C)</p> Signup and view all the answers

Which of the following agents is a fibrin stabilizer that helps maintain the clot in bleeding vessels?

<p>Aminocaproic acid (D)</p> Signup and view all the answers

Statins work by inhibiting the enzyme HMG CoA reductase, which plays a key role in cholesterol synthesis.

<p>True (A)</p> Signup and view all the answers

What is the primary function of Epoetin Alfa (Epogen)?

<p>Stimulate the production of red blood cells (A)</p> Signup and view all the answers

What is the common antidote used for warfarin toxicity?

<p>Vitamin K</p> Signup and view all the answers

Flashcards

H2 blockers

Drugs that block histamine receptors in the stomach, reducing stomach acid production.

Antacids

Substances that neutralize stomach acid.

Proton pump inhibitors

Drugs that directly suppress stomach acid secretion.

Mucosal protectants

Drugs that coat the stomach lining to protect it from acid.

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Prostaglandin analogs

Drugs that increase stomach mucus production and decrease acid secretions.

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Peptic ulcer

Sores in the lining of the stomach or duodenum caused by acid.

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Gastritis

Inflammation of the stomach lining.

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GI bleeding

Bleeding from the gastrointestinal tract.

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Zollinger-Ellison syndrome

A condition with increased stomach acid secretion.

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Ranitidine

An H2 blocker used for ulcers and GERD.

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Cimetidine

An H2 blocker that can cause gynecomastia and impotence in males.

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Famotidine

An H2 blocker commonly used for ulcers and heartburn.

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Nizatidine

An H2 blocker that is safer in cases of liver dysfunction.

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Aluminum salts (hydroxide)

Antacid that neutralizes stomach acid.

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Calcium salts (carbonate)

Antacid that neutralizes stomach acid.

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Magnesium salts (milk of magnesia)

Antacid that neutralizes stomach acid.

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Sodium bicarbonate

Antacid that neutralizes stomach acid.

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Magaldrate

Combination antacid containing aluminum and magnesium.

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GERD

Gastroesophageal reflux disease

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Heartburn

Burning sensation in the chest caused by acid reflux.

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Study Notes

GI Pharmacology Midterm

  • Lecture Outline:
    • Review GI anatomy and physiology
    • Review GI drug categories:
      • Drugs affecting GI secretions
      • Laxatives
      • Anti-diarrheals
      • Emetics and anti-emetics

GI Drug Categories

  • Drugs affecting GI secretions:

    • Histamine (H2) receptor antagonists/blockers (e.g., cimetidine)
    • Antacids (e.g., aluminum hydroxide, magnesium hydroxide)
    • Proton pump inhibitors (e.g., omeprazole)
    • Mucosal protectants (e.g., sucralfate)
    • Prostaglandin analogs (e.g., misoprostol)
    • Indications: peptic ulcer, gastritis, stress ulcers -Administration times: varies depending on the specific medication
  • Laxatives:

    • Chemical stimulants (irritants): bisacodyl, castor oil, senna
    • Mechanical stimulants (hyperosmotic agents): lactulose, magnesium salts
    • Lubricants/stool softeners: docusate
    • Clinical indications: short-term relief of constipation, bowel preparation, removal of toxins
    • Side effects: diarrhea, abdominal cramping, nausea
  • Anti-diarrheals:

    • Local anti-motility agents: loperamide, diphenoxylate
    • Opioid-derived agents: codeine
    • Other anti-diarrheal agents: bismuth subsalicylate, other medications
    • Indications: symptomatic relief of acute and chronic diarrhea
    • Side effects: constipation, nausea, vomiting, abdominal distention
  • Emetics and anti-emetics:

    • Emetics — Syrup of ipecac: induces vomiting
    • Anti-emetics:
      • Phenothiazines: prochlorperazine
      • Non-phenothiazines: metoclopramide
      • Anticholinergics/Antihistamines: meclizine
      • Serotonin receptor blockers (e.g., ondansetron): for chemotherapy-induced nausea and vomiting.
      • Miscellaneous: dronabinol, hydroxyzine.
      • Indications: prevent or manage nausea and vomiting
      • Side effects: vary widely

H2 Blockers

  • Mechanism: Block histamine receptors in parietal cells, decreasing gastric acid secretion.
    • Side effects: CNS effects (dizziness, headache), GI effects (diarrhea, constipation) ,Cardiovascular abnormalities (hypotension), gynecomastia and impotence.
    • Nursing considerations: Administer with meals or at bedtime to ensure therapeutic levels, Monitor for cardiovascular status, warn against taking with other medications that could increase concentration.

Proton Pump Inhibitors

  • Mechanism: Inhibit the proton pump (H+/K+ ATPase) in parietal cells, suppressing gastric acid secretion.
    • Side effects: usually mild and transient, but can include CNS effects (dizziness, headache), and GI effects (diarrhea, nausea) and abdominal pain
    • Nursing considerations: Administer before meals (to maximize effectiveness) ,Assess for allergies, Monitor for side effects, especially severe or prolonged effects

Mucosal Protectants (e.g., sucralfate)

  • Mechanism: Forms a protective barrier over the gastric mucosa, thus protecting it.
    • Side effects :can be mild or severe: constipation, nausea, indigestion, gastric discomfort and dry mouth.
    • Nursing considerations:Administer on an empty stomach or 1 hour before meals or 2 hours after meals, and at bedtime, Monitor for side effects (constipation, GI upset), Encourage fluid and fiber intake

Prostaglandin Analogs (e.g., misoprostol)

  • Mechanism:Stimulates prostaglandin receptors, increasing mucus secretion and protecting the gastric mucosa.
    • Side effects: mainly GI (nausea, diarrhea, abdominal pain), potentially also menstrual irregularities. -Nursing considerations: Contraindicated in pregnancy due to abortifacient effects, Patients should use reliable contraception methods, Monitor for side effects, especially any serious or prolonged effects

Antacids

  • Mechanism: Neutralize gastric acid.
    • Side effects: constipation (aluminum-containing antacids), diarrhea (magnesium containing antacids); metabolic alkalosis (sodium bicarbonate).
    • Nursing considerations: Administer antacids separately from other medications; teach patients to chew tablets thoroughly and to take with a full glass of water. Monitor for acid-base and electrolyte imbalances.

Diuretics

  • Definition: Drugs that increase urine production.
  • Mechanism: Act on various parts of the nephron, inhibit reabsorption of sodium and other electrolytes, causing water excretion.
  • Types: Thiazide, loop, potassium-sparing, osmotic, and carbonic anhydrase inhibitors.

Anticoagulants

  • Mechanism: Inhibit blood clotting process.
  • Types: Heparin, Warfarin, low-molecular-weight heparin (LMWH).
  • Mechanism of action: Interfere with different stages of coagulation cascade; thus, either prevent clots from forming or help to dissolve them.

Antiplatelets

  • Mechanism: Prevent platelets from sticking together.
  • Types: Aspirin, clopidogrel, dipyridamole.
  • Mechanism of action: Inhibit platelet aggregation/adhesion, reducing the formation and size of blood clots

Thrombolytics

  • Mechanism: Dissolve pre-existing blood clots.
  • Types: Streptokinase, urokinase, tissue plasminogen activators (t-PAs).
  • Mechanism of action: Convert plasminogen to plasmin, which breaks down the fibrin components of blood clots

Other Important Drug Categories (from the notes)

  • Anti-emetics (treating nausea and vomiting)
  • Anti-anemics/hematinics (treating anemia)
  • Anti-hyperlipidemics (treating high cholesterol)

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