robbypowell's version from 2016-11-08 04:45

GIT (yeah you know me)

Question Answer
_____ is a peptide hormone produced by G cells in stomach lining (gastric glands) in response to foodGastrin
What cells produce Gastrin?G cells (in stomach lining)
Gastrin release stimulates _____-like cells... which release ______... acting on ___ receptors on ____ cells leading to an increase in gastric acid secretionEnterochromaffin-like cells; Histamine; H2 receptor on Parietal cells
what membrane bound enzyme is the last step in acid formation, present in basolateral membrane of parietal cellsH-K ATPase enzyme/pump
Blocking muscarinic receptors had what effect on gastric acid secretion?Decrease ("block"?)
H2 stimulation has what effect on gastric acid secretionIncrease (histamine is messenger, parietal cells is location)
Prostaglandin is usually a mediator of pain and inflammation... but not in the stomach... there it does what?increases mucous secretion and dec acid secretion; here it is cytoprotective
NSAID's can cause peptic ulcer because they decrease _____ levels in the stomachProstaglandin (acts differently in stomach)
Best treatment to knock out Hypersecretion of Gastric AcidPPI (target the H-K ATPase pump) (these drugs end in -azole)
this drug class ends in -azoleProton Pump Inhibitors (PPI)
PPI's (such as omeprazole or lansoprazole) Decrease absorption of ______, and inc absorption of ______ketoconazole (anti fungal); digoxin (CHF tx)
T/F: Ketoconazole is a Proton Pump inhibitorFalse (antifungal) (trick question, doesn't follow the -azole's are PPI's rule on this test) (anti-fungals are AZOLES too)... so if Moz is being a big time AZOLE he'll try to trick you with this
T/F: Omeprazole is a Proton Pump InhibitorTrue (azoles are either PPI's or Antifungals.. don't be tricked)
T/F: Omeprazole Inhibits P450 activity interfering with drug metabolism such as diazepam, warfarin, and phenytoinTrue (PPI's but especially Omeprazole)
T/F: Ketoconazole Inhibits P450 activity interfering with drug metabolism such as diazepam, warfarin, and phenytoinFalse (this is associated with PPI's, esp Omeprazole) (Ketoconazole is an anti fungal)
If Moz is being a big-time -Azole, he'll try to get you to confuse the two drug types with the suffix -azole.. what are they.. list an example of eachPPI (proton pump inhibitor) (e.g. Omeprazole) & Anti-fungals (e.g. Ketoconazole)
this class of drugs ends in -tidineH2 receptor antagonists (Cimetidine)
this drug, sometimes used for GIT problems, induces impotency (due to dec male sex hormones), gynecomastia, & impaired renal func in elderlyCimetidine*** (H2-receptor antagonist) (inhibits microsomal enzymes in liver)
H2 receptor antagonist used to dec gastric acid secretion in infantsRanitidine
H2 receptor antagonist used for pregnant women to dec gastric acid secretionFamotidine
T/F: H2 receptor antagonist, Cimetidine, is an antihistamineFalse (ant-acid, only blocks Histamine effects on H2)
T/F: Histidine is an H2 receptor antagonistFalse
T/F: Cimetidine is an H2 receptor antagonistTrue
T/F: Ranitidine is an H2 receptor antagonistTrue
T/F: Cimetidine is an H2 receptor agonistFalse (ANTAGONIST)
combination of drugs given for ulcer patients with H. Pylori infections goes by trade name _____; what are the constituent drugs?i. Prevpac = lansoprazole (PPI) + clarithromycin + amox, BID for 2 wks (**TEST**)
side effects of Sodium bicarb...Na overload, systemic alkalosis, releases another acid (carbonic acid = ACID REBOUND) (**TEST**)
Sodium bicarb is often given with _____ to prevent Acid ReboundHydroxides
T/F: Prostaglandins always mediate pain and inflammation, regardless of localeFalse (in stomach are actually CYTOPROTECTIVE by inc mucous secretion and dec acid secretion)
What is the major disadvantage associated with Magnesium Salts (gastric antacid)Laxative (--> when your sliding into first and you feel your bowels burst... DIARRHEA)
Magnesium Salts are contraindicated when there is impairment of what organ?Kidney (Mg overload can cause a problem in renal impairment)
Which Magnesium Salt can produce kidney stones?Mg trisilicate (forms silicon dioxide in stomach → may produce silicate kidney stone)
_____ salts (gastric antacid) can cause PO4 depletion, is poorly absorbed forms a gel (also causes constipation)Aluminum salts (e.g. Al(OH)3)
Sucralfate/Ulcar/Carafate is a combination of ____ and _____; for long-term duodenal ulcers... it is a cytoprotective, viscous suspension that directly inhibits pepsin and bile saltsAl(OH)3 and sulfated sucrose (TEST)
e.g. of Antimuscarinic drug that is used for GIT to target M1 (as an antagonist)... (a. Not selective, not frequently used in the US; dec digestion and secretion)Pirenzepine
Prostaglandin drug that is PGE-1 derivative, inhibits acid secretion (via inhibition of adenyl cyclase-derived cAMP production), increases mucous secretion and bicarb production, is good for gastric ulceration associated with NSAID use... and CAN CAUSE AN ABORTION FROM JUST ONE PILLMisoprotosol/cytotec**** (probably the example of prostaglandin that inducers labor too)
What drug is "Good for gastric ulceration associated with NSAID use?"Misoprotosol (cytotec) (a prostaglandin drug)
T/F: Inhibition of gastric acidity alters GI absorption of some drugs such as ketoconazole and digoxinTrue (dec absorption ketoconazole, inc absorption digoxin)
T/F: Cimetidine and omeprazole have inhibitory effect on hepatic P450True!
____ and ____ are examples of anti-cholinergics that can act as antisialogougues, but aren't appropriate b/c they also act on the CNS; ______ is a better choice in this class because it is more selective (peripheral selectivity, less CNS effects)atropine & scopolamine (have CNS effects, atropine especially is overkill here); Propantheline ((methantheline, cyclopyrrolate) (more peripheral selective)
Syrup of _____ has emetine alkaloid → acts centrally on chemoreceptor trigger zone (CTZ) and locally on GIT to cause irritationIpecac
Non-OTC Emetic that acts as a dopamine agonist derived from morphine, ... stimulates CTZ (chemoreceptor trigger zone)Apomorphine
Anti-emetic drugs mainly affect what 3 receptors?affect H1 (antagonist), D2 (agonist), 5HT3 receptor (antagonist)**
T/F: Anti-histamines can be given as anti-emetics or for motion sicknessTrue (E.g. benadryl)
The best anti-emetic drug would act solely on what receptor?by blocking 5HT3 receptor (serotonin)
anti-emetic drug good for pregnancy and narcotic induced nauseapromethazine (Phenergan) (a Phenothiazine drug)
natural anti-emetic, anti muscarinic drug used for motion sickness and sometimes cancer ptsScopolamine
most common tx for cytotoxic/cancer drug-induced emesisOndansetron/Zofran (5HT3 receptor antagonist)
This laxative is used prior to endoscopy and is also gentle enough to use with babiesDolcolax + polyethylene glycol
what is the active ingredient in the laxative Caster oil?ricinoleic acid
This GI stimulant releases Ach peripherally, useful for diabetic gastroparesis (delayed gastric emptying)Metoclopramide (**TEST**)
is it safe to give a child Pepto-bismol?No, has aspirin products and can cause Reye’s syndrome --> liver and brain damage

adverse rxns associated with dental-related drugs

Question Answer
Opioid analgesics→ cause constipation
Aspirin and other NSAIDs→ gastric distress
Chloral hydrate (hypnotic)→ GI irritation
Antibiotics→ GI distress

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