Term
| What would be a relative contraindication for NaCO3 and CaCl2? |
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Definition
| Hypertension. They have been known to exacerbate fluid retention. |
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Term
| MgOH and AlOH are both used as antacids but they share an "opposite" adverse effect. What is it? |
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Definition
Excess Mg can cause osmotic diarrhea
Excess Al can cause constipation |
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Term
Physio Review Card
Gastrin
Where is it made?
What does it do?
When is it super increased? (pathology) |
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Definition
Gastrin is made by the G cells in the antrum of the stomach
It increases H+ secretion and gastric motility
It is super increased in Zollinger-Ellison syndrome |
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Term
| What GPCR does Ach and Gastrin work through? |
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Definition
Gq which increases IP3/DAG which increases Ca++
Recall that Ach responds via an M3 receptor
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Term
| What receptor does histamine work through? |
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Definition
| H2 which is Gs which increases cAMP |
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Term
| What receptor do prostaglandins work through? What is an example prostaglandin that does this? |
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Definition
Misoprostol works through a Gi receptor which decreases cAMP.
This will counter the effects of histamine. |
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Term
What is the end-MOA of histamine (H2) antagonists?
Name a cool fact about:
Cimetidine
Famotidine
Nizatidine |
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Definition
H2 increases cAMP so H2 antagonists will decrease cAMP
Cimetidine blocks p450
Famotidine is the most potent
Nizatidine has 100% bioavailability |
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Term
| What is the MOA of proton pump inhibitors? |
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Definition
Irreversible binding of H/K ATPase.
These drugs are usually used to treat pts with Zollinger-Ellison or high-risk peptic ulcer disease. |
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Term
As we all know the Antacid cartel has kept the secret from the public that their upset stomach is due to a bacterial infection and not just food that actually tastes good.
What are the first line triple therapy, second line triple therapy and qudruple therapy options? |
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Definition
1. PPI (omeprazole), amoxicillin, clarithromycin for 7 days
2. PPI (omeprazole), amoxicillin, metronidazole for longer
3. Bismuth subsalicylate, metronidazole, tetracycline and PPI/H2 antagonist |
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Term
| What is the scariest thing I could show you right now? |
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Definition
| http://www.youtube.com/watch?v=Jl1VIhdpl4c |
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Term
| What is an absolute contraindication of Misoprostol? |
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Definition
| Misoprostol is catagory X in pregnancy. |
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Term
| What are the two classes of drugs that are DOC for CIN/V (chemo-induced nausea/vomiting)? |
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Definition
5-HT2 antagonists -good for pregnancy
Ondansetron
Ramosetron
Granisetron
Palonosetron
Dolasetron
Neurokinin antagonist
Aprepitant |
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Term
| These two drugs block the D2 receptors in the CTZ. |
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Definition
Metoclopramide and Prochlorperazine
Recall that usually if you block D receptors you could get extra-pyramidal effects. |
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Term
| What are the two "most effective" drugs against cisplatin chemotherapy according to Azim? |
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Definition
| Dexamethasone and Ondestron |
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Term
| Name two H1 receptor antagonists. |
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Definition
| Dimenhydrinate and Dronabinol (cannabinoid) |
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Term
| What drug can directly activate the motilin receptors in the GIT? |
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Definition
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Term
| When you eat food what 4 hormones are released and what is the overall effect? |
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Definition
Secretin (increase pancreatic bicarb secretion and bile)
CCK (increase pancreatic and gall bladder secretion)
GIP (decrease H+ increase insulin)
Gastrin (increase H+ and motility)
They all inhibit pyloric relaxation (generally) |
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Term
| You've been plugged up realy good for a while now. What are two drugs you could take and their MOA? |
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Definition
Metoclopramide and Domperidone
Block D2 receptors which allows more Ach release thus increasing motility. |
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Term
| What do Diphenoxylate, Loperamide and Diphenoxin do? |
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Definition
They are antimotility agents which activate presynaptic opioid receptors to limit Ach release which increases s.muscle tone and decreases peristalsis.
Do not use with inflammatory bowel disease! |
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Term
| A lot of people have a tendency to overdose on antimotility agents to get high. Yeah, they are so dumb you can't even make fun of them. What is a product you could give them? |
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Definition
Lomotil = diphenoxylate + atropine
The atropine give you bad side effects so you dont overdose. |
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Term
| How do Kaolin-pectin, activated charcoal, chalk, and Al(OH) work? |
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Definition
They bind water avidly and also potential enterotoxins.
It's important to note that they are much less effective than opioids. |
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Term
| This drug is frequently used for many types of diarrhea because it is antisecretory, antiinflammatory, and antimicrobial. |
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Definition
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Term
| These two drugs are polysaccharide polymers which expand in the intestine to stretch and stimulate peristaltic activity. |
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Definition
Psyllium
Methylcellulose
Remember not to use these drugs if whatever is stuck in there can't be moved like a fecal impaction or other obstruction. |
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Term
You've been hired to work a case with Jack Bauer and it's the 23rd hour! The suspect has swallowed the codes which disable a nuclear warhead hidden in one of the Wendy's in the greator Scranton area. If he deficates too early though...um something else bad will happen!!!! (just roll with me here)
What laxitive would be best to use?!? |
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Definition
MgSO4/NaSO4 (osmotic laxitives) act mainly in the small intestine and can work within an hour if used in cathartic doses.
FYI: Cathartic means "emotionally purging" so you can imagine how strong this stuff is. You literally shit your feelings out! |
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Term
| You're a pretty mellow person and want a slow end laxative with a mile effect. What are two good choices? |
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Definition
Carbohydrate laxatives such as Sorbitol and lactulose.
They are non-absorbable and also act as osmotic laxatives. They need 1-2 days to work. |
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Term
| Name a stimulate laxative which is a triglyceride that is hydrolized in the duodenum by lipase to ricinoleic acid? |
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Definition
Castor oil
It can lead to colic pain but is good in cases of poisoning or parasitic elimination. |
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Term
| These two drugs are plan extracts which are hydrolized by bacteria to anthraquinone which inhbits absorption and simulates motility. |
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Definition
Cascara and senna.
The effect takes place 6-12 hours after you eat it since it needs to reach the colon. |
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Term
| This laxative works in 15-30 minutes and is usually administed by suppository. |
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Definition
Bisacodyl
It's a favorite of drug mules. |
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Term
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Definition
Docusate and Mineral oil
Docustae is a surfactant which has minimal laxative effect
Mineral oil can lead to a deficiency in ADEK vitamins |
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Term
| This drug class can be used in inflammatory bowel disease both systemically and topically but will show toleracnce over time. |
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Definition
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Term
| What is one positive and one negative aspect of azanthioprine and mercaptopurine compared to glucocorticoids? |
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Definition
| Cytotoxic agents such as azathioprine and mercaptopurine can maintain remisssion longer but take a longer time to take effect. |
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Term
| A drug you give in Crohn's that doesn't work for ulcerative colitis. |
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Definition
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Term
| This monoclonal antibody reacts to TNF-alpha which could reduce the symptoms of crohns. |
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Definition
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Term
| This drug is useful in ulcerative colitis and not in Crohn's |
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Definition
5-ASA
It inhibits PG and leukotriene synthesis
Binds ROS metabolites
Decreases macrophage activity
Inhibits cytokines
This is a SULFA and SALICYLATE so watch out for allergies to sulphur and acne wash. |
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