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Intro to Pharm

respiratory/GI pharmacology

QuestionAnswer
What are the mechanisms of asthma bronchospasm? allergen introduced-->mast cells release bronchoconstrictor substances & inflammatory mediators-->degranulation of mast cells-->histamine release-->inflammatory mediators released (example: prostaglandin, leukotriene)-->cytokine production (interleukins)
What are the two net effects of asthma? bronchoconstriction, inflammation & swelling of airway
What are some characteristics of asthma? effort to force air through= wheezing; exhalation difficult leading to decrease in fresh air; high concentration of CO2 in lungs may lead to blood becoming acidic
What are the ways to treat asthma? bronchodilators (treat primary symptoms of asthma, bronchoconstriction) + anti-inflammatory agents (reduce level of hyper-responsiveness)
What are three types of bronchodilators used to treat asthma? methylxanthines; anticholinergics; beta2-adrenergic agonists
What are the characteristics of methylxanthines? caffeine included here, phosphodiesterase inhibitor, relaxes smooth muscle
What are the characteristics of anticholinergics used to treat asthma? ipatropium bromide (Atrovent); relaxes smooth muscle; sympathetic component dominating, so do not help
What are the characteristics of beta2-adrenergic agonists? Albuterol (Ventolin/Proventil); most widely prescribed & most effective agents for treatment of bronchoconstriction, relaxes smooth muscle
What should not be used to treat asthmatics? beta blockers for cardiovascular disease
What are three anti-inflammatory agents used to treat asthma? Cromolyn Sodium; Prednisone (Deltasone); Montelukast (Singulair)/Zarfirlukast (Accolate)
What are the characteristics of Cromolyn Sodium? prevents mast cell activation, inhibits histamine release; blocks inflammation & constriction
What are the characteristics of Prednisone (Deltasone) related to asthma? glucocorticoid; inhibits production of inflammatory mediators; reduces smooth muscle hyper-reactivity & decreases constriction; inhaled steroids are most effective & prescribed for inflammation; drug of choice in newly diagnosed asthma
What are the characteristics of Montelukast (Singulair) & Zarfirlukast (Accolate)? leukotriene receptor antagonist; decrease inflammation & bronchoconstriction; asprin-induced asthma
What are the characteristics of COPD (chronic obstructive pulmonary disease)? bronchospasm often present (chronic bronchitis, emphysema); use beta2-agonists/anticholinergics; corticosteroids do not show clear therapeutic benefit
What are some characteristics of Cystic fibrosis? thick, viscous secretions in major exocrine glands; mucolytic drugs & corticosteroids often given in combo with respiratory hygeine
What are some respiratory concerns in rehabilitation patients? proper respiratory hygeine; coordinate respiratory therapy with chest PT; exercise may trigger bronchospastic attacks; bronchodilators may cause arrythmias; corticosteroid treatment=weakened musculotendinous structures
What are some characteristics of the alimentary tract? food moves through, secretion of digestive juices & digestion of food, absorption of water & electrolytes, neural & hormonal control
What are some characteristics of the GI smooth muscle layers responsible for motor function, enteric nervous system
What are some characteristics of enteric neural control? myenteric & submucosal plexus: receive sensory input from within gut wall; parasympathetic control enhances GI activity (NT: ACh); sympathetic control decreases GI activity (NT: NE)
What is the responsibility of enteric hormone cholecystokinin? slows emptying of stomach to allow for fat digestion
What is the responsibility of the enteric hormone gastrin? acid secretion
What are the steps in stomach acid secretion? food stimulates gastrin secretion-->gastrin stimulates enterochromaffin like cells (ECL) for histamine release & parasympathetic also increases histamine-->histamine activates acid-producing parietal cells-->gastrin leads to stimulation of the parietal ce
What are three possible consequences of excess acid secretion in the GI tract? Ulcers; GERD; Zollinger-Ellison syndrome (pancreatic tumor that increases gastrin secretion)
What are some factors that increase one's risk for gastric ulcers? caffiene; smoking; asprin-like drugs; Helicobacter pylori
What are two K+/H+ ATPase inhibitors used to treat excess GI acid? used to treat GERD; Omeprazole (Prilosec) & Lansoprazole (Prevacid)
What is an example antibiotic used to treat excess GI acid? Clarithromycin removes H.pylori
What is a bismuth compound + antibiotic that treats excess GI acid? Bismuth subsalicylate (Pepto Bismol): forms protective barrier; removes H.pylori
What are three histamine H2 receptor antagonists used to treat excess GI acid? Cimetidine (Tagament, P450 inhibitor); Ranitidine (Zantac); Famotidine (Pepcid)
What is a prostaglandin agonist that is used to treat excess GI acid? Misoprostol (Cytotec): helpful in preventing ulcers in patients on NSAIDS (side effect: stimulates abortion)
When NSAIDS inhibit COX, they also inhibit protective prostaglandins which: inhibit acid secretion; stimulate mucous & bicarb production
What are some characteristics of antacids used to treat excess GI acid? neutralize HCl, immediate relief, short duration of action (examples: Aluminum hydroxide, magnesium hydroxide, calcium carbonate, sodium carbonate, maalox)
What is the best antacid to use for excess GI acid? maalox: combo magnesium & aluminum hydroxide so no side effect
What are some characteristics of inflammatory bowel disease? difficult to treat, ulcerative colitis & Crohn's disease, not same as irritable bowel syndrome which has large psych component
What is the main corticosteroid treatment for IBD (inflammatory bowel disease)? prednisone (Deltasone): drug of choice for acute attacks, inhibits inflammatory mediators, side effect include ulcers
What are some salicylate derivatives (NSAIDS) used to treat IBD (inflammatory bowel disease)? Olsalazine (Dipentum): drug of choice for reoccuring IBD; Mesalamine; Sulfasalzine
What are the characteristics & possible causes of diarrhea? production of watery stool; causes: motility disturbances, drug-induced, psychological, bacterial toxins
What is the best OTC agent for treating diarrhea? Loperamide (Immodium) (Other agents: Bismuth Subsalicylate-Pepto Bismol, Octreotide-Sandostatin which is used to treat carcinoid syndrome)
What are some uses for anti-emetics? chemotherapy, toxic response, infection, motion sickness, anxiety
What are some characteristics of the alimentary tract? food moves through, secretion of digestive juices & digestion of food, absorption of water & electrolytes, neural & hormonal control
What are some characteristics of the GI smooth muscle layers responsible for motor function, enteric nervous system
What are some characteristics of enteric neural control? myenteric & submucosal plexus: receive sensory input from within gut wall; parasympathetic control enhances GI activity (NT: ACh); sympathetic control decreases GI activity (NT: NE)
What is the responsibility of enteric hormone cholecystokinin? slows emptying of stomach to allow for fat digestion
What is the responsibility of the enteric hormone gastrin? acid secretion
What are the steps in stomach acid secretion? food stimulates gastrin secretion-->gastrin stimulates enterochromaffin like cells (ECL) for histamine release & parasympathetic also increases histamine-->histamine activates acid-producing parietal cells-->gastrin leads to stimulation of the parietal ce
What are three possible consequences of excess acid secretion in the GI tract? Ulcers; GERD; Zollinger-Ellison syndrome (pancreatic tumor that increases gastrin secretion)
What are some factors that increase one's risk for gastric ulcers? caffiene; smoking; asprin-like drugs; Helicobacter pylori
What are two K+/H+ ATPase inhibitors used to treat excess GI acid? used to treat GERD; Omeprazole (Prilosec) & Lansoprazole (Prevacid)
What is an example antibiotic used to treat excess GI acid? Clarithromycin removes H.pylori
What is a bismuth compound + antibiotic that treats excess GI acid? Bismuth subsalicylate (Pepto Bismol): forms protective barrier; removes H.pylori
What are three histamine H2 receptor antagonists used to treat excess GI acid? Cimetidine (Tagament, P450 inhibitor); Ranitidine (Zantac); Famotidine (Pepcid)
What is a prostaglandin agonist that is used to treat excess GI acid? Misoprostol (Cytotec): helpful in preventing ulcers in patients on NSAIDS (side effect: stimulates abortion)
When NSAIDS inhibit COX, they also inhibit protective prostaglandins which: inhibit acid secretion; stimulate mucous & bicarb production
What are some characteristics of antacids used to treat excess GI acid? neutralize HCl, immediate relief, short duration of action (examples: Aluminum hydroxide, magnesium hydroxide, calcium carbonate, sodium carbonate, maalox)
What is the best antacid to use for excess GI acid? maalox: combo magnesium & aluminum hydroxide so no side effect
What are some characteristics of inflammatory bowel disease? difficult to treat, ulcerative colitis & Crohn's disease, not same as irritable bowel syndrome which has large psych component
What is the main corticosteroid treatment for IBD (inflammatory bowel disease)? prednisone (Deltasone): drug of choice for acute attacks, inhibits inflammatory mediators, side effect include ulcers
What are some salicylate derivatives (NSAIDS) used to treat IBD (inflammatory bowel disease)? Olsalazine (Dipentum): drug of choice for reoccuring IBD; Mesalamine; Sulfasalzine
What are the characteristics & possible causes of diarrhea? production of watery stool; causes: motility disturbances, drug-induced, psychological, bacterial toxins
What is the best OTC agent for treating diarrhea? Loperamide (Immodium) (Other agents: Bismuth Subsalicylate-Pepto Bismol, Octreotide-Sandostatin which is used to treat carcinoid syndrome)
What are some uses for anti-emetics?
What are the control centers for vomiting? chemoreceptor trigger zone, vomiting center in brainstem
What are the anti-emetics used for motion sickness? Dimenhydrinate (dramamine) + Scopolamine (Hyoscine)
What are the anti-emetics used for chemo side effects? Ondansetron (Zofran) & Dronabinol (Marinol, uses THC)
What is the anti-emetic used for blocking the CTZ for nausea & vomiting? Metoclopromide (Reglan)
What is the anti-emetic used for stage fright induced or anticipatory vomiting? Lorazepam (Ativan)
What are some causes for constipation? inhibition of reflexes, drug-induced (morphine), obstruction, or stress, diet & exercise
What are the examples of Cathartics (laxatives)? Magnesium hydroxide (milk of magnesia: water & electrolyte retaining cathartic, may dehydrate); Disacodyl (correctal); Lactulose (cephulac)
What are some concerns in rehab patients? 60-100% critically ill patients will suffer damage to stomach mucosa, many patients are inactive & suffer from effects of bed rest including constipation, most cancer patients benefit from anti-emetic drugs, most GI drugs do not produce significant side e
What are some characteristics of the alimentary tract? food moves through, secretion of digestive juices & digestion of food, absorption of water & electrolytes, neural & hormonal control
What are some characteristics of the GI smooth muscle layers responsible for motor function, enteric nervous system
What are some characteristics of enteric neural control? myenteric & submucosal plexus: receive sensory input from within gut wall; parasympathetic control enhances GI activity (NT: ACh); sympathetic control decreases GI activity (NT: NE)
What is the responsibility of enteric hormone cholecystokinin? slows emptying of stomach to allow for fat digestion
What is the responsibility of the enteric hormone gastrin? acid secretion
What are the steps in stomach acid secretion? food stimulates gastrin secretion-->gastrin stimulates enterochromaffin like cells (ECL) for histamine release & parasympathetic also increases histamine-->histamine activates acid-producing parietal cells-->gastrin leads to stimulation of the parietal ce
What are three possible consequences of excess acid secretion in the GI tract? Ulcers; GERD; Zollinger-Ellison syndrome (pancreatic tumor that increases gastrin secretion)
What are some factors that increase one's risk for gastric ulcers? caffiene; smoking; asprin-like drugs; Helicobacter pylori
What are two K+/H+ ATPase inhibitors used to treat excess GI acid? used to treat GERD; Omeprazole (Prilosec) & Lansoprazole (Prevacid)
What is an example antibiotic used to treat excess GI acid? Clarithromycin removes H.pylori
What is a bismuth compound + antibiotic that treats excess GI acid? Bismuth subsalicylate (Pepto Bismol): forms protective barrier; removes H.pylori
What are three histamine H2 receptor antagonists used to treat excess GI acid? Cimetidine (Tagament, P450 inhibitor); Ranitidine (Zantac); Famotidine (Pepcid)
What is a prostaglandin agonist that is used to treat excess GI acid? Misoprostol (Cytotec): helpful in preventing ulcers in patients on NSAIDS (side effect: stimulates abortion)
When NSAIDS inhibit COX, they also inhibit protective prostaglandins which: inhibit acid secretion; stimulate mucous & bicarb production
What are some characteristics of antacids used to treat excess GI acid? neutralize HCl, immediate relief, short duration of action (examples: Aluminum hydroxide, magnesium hydroxide, calcium carbonate, sodium carbonate, maalox)
What is the best antacid to use for excess GI acid? maalox: combo magnesium & aluminum hydroxide so no side effect
What are some characteristics of inflammatory bowel disease? difficult to treat, ulcerative colitis & Crohn's disease, not same as irritable bowel syndrome which has large psych component
What is the main corticosteroid treatment for IBD (inflammatory bowel disease)? prednisone (Deltasone): drug of choice for acute attacks, inhibits inflammatory mediators, side effect include ulcers
What are some salicylate derivatives (NSAIDS) used to treat IBD (inflammatory bowel disease)? Olsalazine (Dipentum): drug of choice for reoccuring IBD; Mesalamine; Sulfasalzine
What are the characteristics & possible causes of diarrhea? production of watery stool; causes: motility disturbances, drug-induced, psychological, bacterial toxins
What is the best OTC agent for treating diarrhea? Loperamide (Immodium) (Other agents: Bismuth Subsalicylate-Pepto Bismol, Octreotide-Sandostatin which is used to treat carcinoid syndrome)
What are some uses for anti-emetics?
Created by: mpost51 on 2008-09-16



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