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GIT

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gefotusa's version from 2016-11-07 21:36

Section 1

Question Answer
peptide hormone produced by G cells in stomach lining (gastric glands) in response to foodGASTRIN
What cells produce gastrin g cells
What are G cells stimulated by?vagus nerve/ parasympathetic
What is the last step in acid formation?H-K ATPase enzyme/pump
Where is the H-K ATPase enzyme pump located ?present in basolateral membrane of gastric cell
If gastrin stimulates the gastrin receptor in parietal cells, what does this tell the pump to do?tells pump to INCREASE secretion of H+ into lumen of stomach
Block what receptor would BLOCK acid secretion?blocking MUSACARINIC receptor block acid secretion
T/F it is better to block the pump, rather than the individual causes of acid secretion from the pump true
What is the best treatment for treating excess acid secretion?block H-K ATPase pump
What is normally a mediator of pain and inflammation BUT in the stomach will INCREASE mucus secretion and DECREASE acid secretionprostaglandins
T/F prostaglandin is cytoprotective true
Why can NSAIDs cause peptic ulcer?because they decrease prostaglandin levels in the stomach
What is the cause of most peptic ulcer diseases?H. Pylori infection or NSAIDs
What would you use to treat a peptic ulcer that is due to an infection ?Amoxcillion, calrithoromycin and something to decrease acid
What is the final step of gastric acid secretion ?proton pump
memorize

Section 2

Question Answer
What is the drug of choice for treating GIT acid related diseases (GERD, peptic ulcer)?proton pump inhibitor
How do PPI's decrease acid ?Decrease BASAL and STIMULATED acid secretion
What are the 5 examples of PPIs omeprazole , lansoprazole , pantoprazole, esomeprazole, rabeprazole
What do all PPI drugs end with ?-azole
What is the cheapest/OTC PPI?Omeprazole (Prilosec)
What is the longest lasting PPI?Iansoprazole (Prevacid)
What is a negative side effect of PPI?possible bacterial colonization with prolonged use
PPIs decrease absorption of ____________, and INCREASE absorption of _______________ketoconazole; digoxin
What do PPIs inhibit ?inhibits p450 activity interfering with drug metabolism such as diazepam, warfarin and phenytoin
Which PPI would you notice a more pronounced inhibition of p450?OMEPRAZOLE
memorize

Section 3

Question Answer
What is H2 receptor antagonist ?competitive blockers of histamine H2 receptors on PARIETAL cells of stomach
What are the 4 examples of H2 receptor antagonist?cimetidine, ranitidine, famotidine, nizatidine
What do all H2 receptor antagonist end in?-tidine
How do H2 receptor antagonist reduce acid ?decrease BASAL and stimulated gas secretion
How do H2 receptor antagonist increase healing ?by increasing PG synthesis
Which H2 receptor antagonist has more pronounced side effects ?cimdetidine/tagamet
What are the side effects of cimetidine / tagamet?inhibits microsomal enzymes, induces impotency (dec male sex hormones), gynecomastia, impaired renal func in elderly
Which h2 receptor antagonist is used to decrease acid secretion in infants ?RANITIDINE
Which h2 receptor antagonist is used for pregnant women ?FAMOTIDINE
How are h2 receptor antagonist administered ?orally
T/F h2 receptor antagonist are anti-histaminesFALSE-- they just block histamine's effects on H2; they are ANTACIDS
T/F h2 receptor antagonists are anti-acids TRUE
How do you treat a peptic ulcer due to H. pylori infection ?PREVPAC = iasnoprazole + clarithomycin + amox, BID for 2 weeks
What is PREVPAC ?lansoprazole + clarithromycin + amox
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Section 4

Question Answer
What is a gastric antacid?weak base buffering or neutralizing gastric acid
How does an gastric antacid work?DECREASE proteolytic activity of pepsin
What happens if you overuse a gastric agnatic ?overuse induces REBOUND effect, may enhance ulcer healing and mucosal protection
What is the most widely used/ abused gastric antacid ?sodium bicarb
What is an example of chemical antagonism ?bicarbonate is the base that antagonizes effects of acid
what does sodium bicarbonate cause an overload in?na overload and systemic alkalosis
What is the acid that sodium bicarbonate releases ?CARBONIC ACID = ACID rebound
what do you often give sodium bicarbonate with to prevent the acid rebound often given with hydroxides to prevent acid rebound
What are the 6 type of gastric antacids ? 1. sodium bicarbonates 2. magnesium salts 3. aluminum salts 4. calcium carbonate 5. alginic acid 6. sucralfate
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Section 5

Question Answer
What is the antimuscarinic drug ?Pirenzepine --> m1 antagonist
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