Term
H2 receptor blockers
Names (4)
MOA
Use |
|
Definition
Cimetidine, Ranitidine, Famotidine, Nizatidine
MOA: REVERSIBLE block of H2 rec-> dec H+ secretion by parietal cells
Use: Peptic Ulcer, Gastritis, mild GERD |
|
|
Term
|
Definition
Cimetidine:
Inh p-450
Antiandrogenic effects (prolactin rel, gynecomastia, impotence, dec libido in males).
Crosses BBB (confusion, dizziness, HA) & Placenta.
Cimetidine & Ranitidine:
Dec renal excretion of creatinine.
Other H2 blockers are free of these effects. |
|
|
Term
Proton Pump Inhibitors
Names (2)
MOA
Use |
|
Definition
Omeprazole, Lansoprazole
MOA: Irreversibly inhibit H+/K+ ATPase in stomach parietal cells.
Use: Peptic ulcer, gastritis, GERD, Z-E Syndrome, Errosive esophagitis |
|
|
Term
Bismuth, Sucralfate
MOA
Use
Activation Quirk |
|
Definition
MOA: Bind to ulcer base, providing physical protection & allows HCO3- secretion to reestablish pH gradient in mucous layer.
Use: Inc ulcer healing; traveler's diarrhea
Activation quirk: Sucralfate req acidic env't so it doesn't work if you are on other antacids. |
|
|
Term
|
Definition
MOA: PGE1 analog. Inc production & secretion of gastric mucous barrier, dec acid production.
Use: Prevention of NSAID-induced peptic ulcers; maintenance of a PDA. Also used to induce labor.
|
|
|
Term
Misoprostol
Toxicity
Contraindications |
|
Definition
Tox: Diarrhea
Contra: women of childbearing potential (abortifacient). |
|
|
Term
Muscarinic Antagonists
Names (2)
MOA
Use |
|
Definition
Pirenzepine, Propantheline
MOA: Block M1 rec on ECL cells (dec his secretion) & blocks M3 rec on parietal cells (dec H+ secretion)
Use: Peptic ulcer (rarely used) |
|
|
Term
Muscarinic Antagonist
Toxicity |
|
Definition
| Tox: Tachycardia, Dry Mouth, Difficulty focusing eyes. |
|
|
Term
|
Definition
MOA: Somatostatin analog
(dec gastric acid & pepsinogen secretion, dec pancreatic & sm int fluid secretion, dec gallbladder contraction, dec insulin & glucagon rel)
Use: Acute Variceal bleeds, acromegaly, VIPoma, Carcinoid Tumors |
|
|
Term
|
Definition
| Nausea, Cramps, Steatorrhea |
|
|
Term
Antacid Use
Affects what?
Overuse does what?
AlOH, MgOH, Ca carbonate |
|
Definition
Affects: absorption, bioavailability, or urinary excretion of other drugs by altering gastric & urinary pH or by delaying gastric emptying.
Overuse:
Aluminum Hydroxide- constipation & hypophosphatemia; prox musc weakness; osteodystrophy; seizures; hypokalemia
Magnesium Hydroxide- Osmotic diarrhea, hyporeflexia, hypotension, cardiac arrest; hypokalemia
Calcium carbonate- hypercalcemia, rebound acid inc; hypokalemia (may chelate and dec effectiveness of other drugs like tetracycline) |
|
|
Term
|
Definition
MOA: monoclonal Ab to TNF, proinflamm cytokine.
Use: Crohn's dis, RA
|
|
|
Term
|
Definition
| Tox: Respiratory infection (incl reactivation of latent Tb), fever, hypotension |
|
|
Term
|
Definition
MOA: Cmbo of sylfapyridine (antibacterial) & 5' aminosalicylic acid (anti-inflamm). Activated by colonic bacteria.
Use: Ulcerative colitis, Crohn's dis
|
|
|
Term
|
Definition
| Tox: Malaise, nausea, sulfonamide toxicity, reversible oligospermia |
|
|
Term
|
Definition
MOA: 5-HT3 antagonist. Powerful central-acting antiemetic
Use: Control vomiting postop & in pts underogoing cancer chemo. |
|
|
Term
|
Definition
Toxicity
Headache, Constipation |
|
|
Term
|
Definition
MOA D2 rec antagonist. Inc resting tone, contractility, LES tone, motility.
Does NOT influence colon transport time.
Use: Diabetic & post-surgery gastroparesis |
|
|
Term
Metoclopramide
Toxicity
Drug Interaction
Contraindication |
|
Definition
Tox: Inc parkinsonian effects. Restlessness, drowsiness, fatigue, depression, nausea, diarrhea.
Drug interaction w/digoxin & diabetic agents.
Contra: Pts w/sm bowel obstruction (bc they'd be on prokinetic agents) & epilepsy (bc lowers seizure threshold)
|
|
|
Term
Hormone: Gastrin
Source, Action, Regulation |
|
Definition
Source: G cells (antrum of stomach)
Action: Inc H+ secretion, growth of gastric mucosa, gastric motility
Regulation:
Inc by stomach distention/alkalinization, amino acids, peptides, vagal stimulation
Dec by stomach pH <1.5 |
|
|
Term
High in Zollinger-Ellison Syndrome.
Phenylalanine & tryptophan are potent stimulators.
May cause hypercalcemia.
Hormone???? |
|
Definition
|
|
Term
Horm: Cholecystokinin
Source, Action, Regulation |
|
Definition
Source: I cells (duodenum, jejunum)
Action:
Inc- pancreatic secretion & gallbladder contraction
Dec- Gastric emptying, sphincter of Oddi relaxation
Regulation:
Inc by fatty acids & amino acids |
|
|
Term
| Hormone that acts on neural muscarinic pathways to cause pancreatic secretion? |
|
Definition
|
|
Term
Horm: Secretin
Source, Action, Regulation |
|
Definition
Source: S cells (duodenum)
Action:
Inc- pancreatic HCO3- secretion & bile secretion
Dec- Gastric acid secretion
Regulation:
Inc by acids, fatty acids in lumen of duodenum |
|
|
Term
Horm: Somatostatin
Source, Action, Regulation |
|
Definition
Source: D cells (pancreatic islets, GI mucosa)
Action:
Dec- gastric acid & pepsinogen secretion, pancreatic & sm int fluid secretion, gallbladder contraction, insulin & glucagon rel
Regulation:
Inc by acid
Dec by vagal stimulation |
|
|
Term
| Hormone that has antigrowth hormone effects via digestion and absorption of substances needed for growth? |
|
Definition
|
|
Term
Hormone: Glucose-dependent insulinotropic peptide (AKA gastric inhibitory peptide): GIP
Source, Action, Regulation |
|
Definition
Source: K cells (duodenum, jejunum)
Action: Exocrine- dec gastric H secretion
Endocrine- inc insulin rel
Regulation:
Inc by fatty acids, amino acids, oral glucose |
|
|
Term
Horm: Vasoactive Intestinal Polypeptide (VIP)
Source, Action, Regulation |
|
Definition
Source: Parasympathetic ganglia in sphincters, gallbladder, sm int
Action:
Inc- intestinal water & electrolyte secretion, relaxation of intestinal sm musc & sphincters.
Regulation:
Inc- distention & vagal stimulation
Dec- by adrenergic input |
|
|
Term
Non-alpha, non-beta islet cell pancreatic tumor that secretes VIP.
Name of tumor + major symptom? |
|
Definition
VIPoma
Sx: Copious diarrhea |
|
|
Term
Nitric Oxide
Action as a GI hormone?
Loss is implication in what Gi disease? |
|
Definition
Action: Inc- sm musc relaxation, including LES
Loss: implication in high LES tone of achalasia |
|
|
Term
Horm: Motilin
Source, Action, Regulation |
|
Definition
Source: Small int
Action: Produces migrating motor complexes (MMCs)
Regulation: Inc in fasting state. |
|
|
Term
| What hormones agonists are used to stimulate intestinal peristalsis? |
|
Definition
|
|
Term
Secretory Product: Intrinsic Factor
Source, Action, Consequence of destruction |
|
Definition
Source: Parietal Cells of stomach
Action: Vit B12 binding protein (req for B12 uptake in terminal ileum)
Destruction -> Chronic gastritis & pernicious anemia |
|
|
Term
Secretory Product: Gastric Acid
Source, Action, Regulation |
|
Definition
Source: Parietal cells (stomach)
Action: Dec stomach pH
Regulation:
Inc by histamine, ACh, gastrin
Dec by somatostatin, GIP, prostaglandin, secretin |
|
|
Term
| Name the gastrin secreting tumor that causes continuous high levels of acid secretion & ulcers |
|
Definition
|
|
Term
Secretory Product: Pepsin
Source, Action, Regulation |
|
Definition
Source: Chief cells (stomach)
Action: Protein digestion
Regulation: Inc by vagal stimulation & local acid |
|
|
Term
| What converts pepsinogen to pepsin? |
|
Definition
|
|
Term
Secretory Product: HCO3-
Source, Action, Regulation |
|
Definition
Source: Mucosal cells (stomach, duodenum, salivary glands, pancreas) & Brunner's glands (duodenum)
Action: Neutralizes acids
Regulation: Inc by pancreatic & biliary secretion w/secretin |
|
|
Term
| This secretory product is trapped in mucus that covers the gastric epithelium: |
|
Definition
|
|
