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Pharmacology Test 3
Gastrointestinal
| Question | Answer |
|---|---|
| ____ is the overproduction of hydrochloric acid (HCl) by parietal cells in the stomach | Gastric hyperacidity |
| Large meals, fatty meals, excessive consumption of alchol, and emotional stress can cause ____ overproduction. | gastric hyperacidity |
| Because HCl is secreated by the parietal cell, it is the primary target for many drugs for the treatment of _____ disorders. | acid-related disorders |
| aluminum hydroxide (Amphojel) is classified as a ____? | antacids |
| There are three forms of ____: aluminum based, magnesium based, and calcium based. | antacids |
| ____MOA: neutralize gastric acidity by rasing the pH of the stomach | antacids: aluminum hydroxide (Amphojel) |
| ___ is used to treat hyperacidity related to gastric secretions, gastritis, peptic ulcer, and heart burn. | aluminum hydroxide (Amphojel) |
| ____ antacids can cause diarrhea and should be used with caution in renal patients | magnesium based antiacids |
| ____ & ____ antiacids can cause constipation | Aluminum and calcium based antiacids |
| Adsorption of other drugs with antacids reduces the ability of ? | reduces the ability of the other drug to be absorbed into the body |
| Antacids can have a chemical inactivation of other drugs by chelation, which produces____? | produces insoluble complexes |
| antiacids can increase stomach pH, which increases the ____ of basic drugs and decreases ____ of acidic drugs. | increases the absorption of basic drugs and decreases the absorption of acidic drugs |
| antiacids can increase urinary pH, which increases the ____ of acidic drugs and decreases the ____ of basic drugs. | increases the excretion of acidic drugs and decreases the excretion of basic drugs |
| famotidine (Pepcid) and ranitidine (Zantac) are classified as ____? | H2 Antagonists |
| MOA of ____: compete with histamine for binding sites on the surface of parietal cells. | H2 Antagonists: famotidine (Pepcid), ranitidine (Zantac) |
| Will competing with histamine for binding sites on the surface of parietal cells lead to an increase or decrease in pH? | Incrase in the pH of the stomach and relief of many of the symptoms associated with hyperacidity-related conditions |
| ____ is used to treat GERD, PUD, and erosive esophagitis | H2 Antagonists: famotidine (Pepcid) and ranitidine (Zantac) |
| What does GERD stand for? | Gastroesophageal Reflux Disease |
| What does PUD stnad for? | Peptic Ulcer Disease |
| All ____ can inhibit the absorption of drugs that require an acidic environment for absorption. | All H2 antagonists |
| Omeprazole (Prilosec) is classified as ____? | Proton Pump Inhibitors (PPIs) |
| ____MOA: block gastric acid secretion by preventing the movement of hydrogen ions out of the parietal cell into the stomach. Unlike H2 antagonists (which block 90%), they block all acid secretion. | Proton Pump Inhibitors (PPIs): omeprazole (Prilosec) |
| ____ treats GERD, short-term treatment of active duodenal and benign gastric ulcers, and H. pylori infections. | omeprazole (Prilosec) |
| T/F omeprazole (Prilosec) is not very safe to take? | False omeprazole (Prilosec) is very safe to take |
| ____ is used to reduce gastric ulcers in what type of patients? | Misoprotol (Cytotec) is used to reduce gastric ulcers in NSAIDs patients |
| Patients should not take any other medications within ___ hours after taking an antiacid because they can affect the ____ of the other medications. | within 1-2 hours after taking an antiacid because they can affect the absorption of the other medicaitons. |
| ___ is defined as the abnormal, frequent passage of loose stools. It can be acute (<2 weeks) or chronic (>3 weeks) | Diarrhea |
| What are some (4 listed) of the things that can cause diarrhea? | medications, bacteria, viruses, and diet |
| ____ is defined as abnormal infrequent and difficult passage of feces. | Constipation |
| The usual time form ingestion of food to defecation is ____ hours. | 24-36 hours |
| What are some of the things that can cause constipation? | medication, lifestyle habits, metabolic/endocrine disorders, neurogenic disorders, and not getting enough fiber |
| diphenoxylate (Lomotil), loperamide (Imodium A-D) are classified as what drug class? | Antidiarrheals |
| What are the 4 categories of antidiarrheals? | adsorbents, anticholinergics, opiates, and intestinal flora modifers |
| ____ is a synthetic opiate agonist that is structurally related to meperidine. It acts on smooth muscle of the intestinal tract, inhibiting GI motility and excessive GI propulsion. It has little or no analgesic activity. | diphenoxylate (Lomotil) |
| _____ is combined with subtherapeutic quantities of atropine to discourage recreational opiate drug use. | diphenoxylate (Lomotil) |
| ___ is a synthetic antidiarrheal that is similar to diphenoxylate. It inhibits both peristalsis in the intestinal wall and intestinal secretion, thereby decreasing the number of stools and their water content. | Loperamide (Imodium A-D) |
| Diphenoxylate (Lomotil) and Loperamide (Imodium A-D) are used to treat? | diarrhea |
| What happens with adsorbents and digoxin and hypoglycemic agents? | Decrease absorption |
| T/F Antidiarrheals have the potential to either increase or decrease the absorption of many drugs. | True |
| What about adsorbents and anticoagulants? | Increase bleeding time or bruising |
| What is the interactions of opiate antidiarrheals and other CNS depressants? | Increased anti-cholinergic effects |
| There are 5 categories of laxatives. What are they? | Bulk forming, emollient, hyperosmotic, saline, and stimulant |
| Milk of magnesia is also used as a(n) ____? | laxative |
| docusate sodium (Colace), psyllium (Metamucil), magnesium hydroxide (milk of Magnesia) are all classified as _____? | Laxatives |
| T/F The MOA of all laxatives is to decrease bowel movements? | False MOA of laxatives is to promote bowel movements. |
| Some common indications of _____ include constipation and preparation for diagnostic procedures (colonoscopy) or surgery. | laxatives |
| T/F Laxatives are used to treat bulk forming: acute and chronic constipation, irritable bowel syndrome, diverticulosis. | True |
| T/F laxatives treat emollient: acute and chronic constipation, sofetening of fecal impaction, facilitation of bowel movements in anorectal conditions | True |
| T/F laxatives treat hyperosmotics: Chronic constipation, bowel preparation for diagnostic and surgical procedures | True |
| T/F Laxatives dont treat saline: Constipation, removal of helminths and parasites, bowel preparation for diagnostic and surgical procedures | False they do |
| T/F Laxatives are stimulants; acute constipation, bowel preparation for diagnostic and surgical procedures | true |
| T/F overuse and misuse of laxatives do not lead to many problems? | False they do lead to many problems |
| T/F Laxatives alter intestinal function? | True |
| T/F there are not many interactions with other drugs and laxatives. | False there are many because laxatives alter intestinal function-remember that the GI tract is where many medications are absorrbed |
| What are the two different things we as nurses teach patients about laxatives/stool softeners? | 1. Stool softeners & bulk-forming agents are preferred over laxatives because they are not as problematic w/ fluid and electrolyte imbalances. 2. Long-term laxative use may lead to dependence-a healthy, high-fiber diet w/ increased fluid intake-encouraged |
| ____ is an unpleasant feeling that can lead to vomiting, or emesis | Nausea |
| _____ in the brain stimulate the vomiting center (VC) and chemoreceptor trigger zone (CTZ) which initiate the vomiting reflex. | Neurotransmitters |
| Dimenhydrinate (Dramamine), Prochlorperazine (Compazine), ondansetron (Zofran), dronabinol (Marinol) are all classified as_____? | Antiemetic and Antinausea Agents |
| There are 6 categories of antiemetic and antinausea agents. What are they? | 1. anticholinergics 2. antihistamines 3. neuroleptics 4. Prokinetics 5. Serotonic Blockers 6. Tetrahydrocannabinoids |
| Dimenhydrinate (Dramamine) is a ______? | Antihistamine (H1 receptor blockers) |
| Prochlorperazine (Compazine) is a ______? | Neuroleptics |
| Ondansetron (Zofran) is a ______? | Serotonin blocker |
| Dronabinol (Marinol) is a _____? | Tetrahydrocannabinoid |
| The MOA of ______: In general, each works at some site in the vomiting pathway to block a particular receptor. | Antiemetic and Antinausea Agents |
| The MOA of ______ (Antihistamine): Block H1 receptors, thereby preventing ACh from binding to receptors in the vestibular nuclei | Dimenhydrinate (Dramamine) |
| The MOA of ____(neuroleptics): Block dopamine in the CTZ and may also block ACh | prochlorperazine (Compazine) |
| THe MOA of ____(Serontonin Blockers): Block serotonin receptors in the GI tract, CTZ, and VC | ondansetron (Zofran) |
| The MOA of _____(Tetrahydrocannabinoid): Have inhibitory effects on the reticular formation, thalamus, and cerebral cortex | dronabinol (Marinol) |
| The Indications of what drug class is: Nausea and vomiting - prevent motion sickness, reduce secretions before surgery, treat postoperative N&V, prevent N associated w/ chemotherapy | Antiemetic or Antinausea Agents |
| The Side/Adverse Effects of ____: Unfortunately, there are many because of the nonselective blockade of receptors. For instance, when an antihistamine is used for emesis it can also cause a dry mouth and urinary retention. | Antemetic and Antinausea Agents |
| T/F Most antiemetics cause drowsiness and hypotension? | True |
| Where does the GI tract begin and end? | Begins in the mouth with salivary glands and ends in the rectum |
| The GI drugs effect the ____, ____, and _____? | esophagus, stomach, and intestines |
| _____ Cells produce and secrete HCl, aids in digestion and is a barrier to infection | Parietal cells |
| The 3 most important cell types in the gastric glands are the ___,___, & _____. | parietal, chief, and mucous cells |
| When the balance of the 3 different cell types in the gastric glands and their secretions are impaired what disease occurs? | acid-related diseases |
| T/F Because the parietal cell is the source of HCl production, it is the primary target for many drugs for the treatment of acid-related disorders. | True |
| MOA of Antiacids: Antacids neutralize gastric acid in the stomach by raising or decreasing the pH? | Increasing the pH. (Stomach pH 1-4) |
| What is aluminum hydroxide (Amphojel) used for? | Heart burn |
| Are there a lot of drug interaction of aluminum hydroxide (Amphojel)? Why? | Lots because they change the pH of the stomach |
| The 4 MOA of _____ are: Absorption, chemical inactivation, increase pH, decrease pH | aluminum hydroxide (Amphojel) |
| Patients should not take any other medications within 1-2 hours after taking an ____? | antacid |
| ____-MOA: Compete with histamine for binding sites on surface of parietal cells; Blocks 90% of acid secretion | H2 Antagonists-famotidine (Pepcid) and Ranitidine (Zantac) |
| ____ is used for dyspepsia, heartburn, ulcers, GERD | famotidine (Pepcid) |
| What does Pepcid AC mean? | Means give famotidine (Pepcid) before meals |
| ____ is used for ulcers, GERD, Heartburn, dyspepsia and EROSIVE ESOPHAGITIS. | Ranitidine (Zantac) |
| Proton Pump Inhibitors such as ______ MOA: binds irreversibly to the proton pump; blocks all gastric acid secretion | omeprazole (Prilosec) |
| ___ is used to treat erosive esophagitis, GERD. | omeprazole (Prilosec) |
| ____ is used in the treatment of active stress ulcers - it coats the ulcer. | sucralfate (Carafate) |
| ____ reduces the incidence of gastric ulcers in patients taking NSAIDs. It is a prostaglandin E analogue. | misoprotol (Cytotec) |
| Are there any concerns regarding the use of antacids in patients with decreased renal function? Why? | Yes, Patients with decreased renal function should be careful taking antacids as their kidneys may not be able to process the additional calcium or magnesium, and can throw off the electrolyte balance (hyper). Kidneys filter Ca and Mg (pee them out). |
| What is the type of Antidiarrheal that has a MOA of: binding of bacterial toxins? | Adsorbents |
| What is the type/group of antidiarrheals that has a MOA: slow peristalsis? | Anticholinergics |
| What is the type/group of antidiarrheals that has the MOA: reduce bowel motility? | Opiates |
| What is the type/group of antidiarrheals that has a MOA of: Replenish normal bacterial flora | Intestinal Flora Modifiers |
| T/F Diphenoxylate (Lomotil) and Ioperamide (Imodium A-D) are opiates, so they increase bowel motility. | False They are opiates, so the REDUCE bowel motility |
| T/F Diphenoxylate (Lomotil) is combined with atropine (very little) to discourage recreational use--there has not been any reports of physical dependence on Loperamide (Imodium A-D)....you can get it OTC. | True |
| Laxatives are used to treat _____? | constipation |
| What is the usual time span between ingestion and defacation with a laxative? | 24-36 hours |
| Laxatives have 4 different MOAs: Bulk-forming; Emollient; Hyperosmotic Saline; and ______? | Stimulant |
| Bulk-forming laxative means? | Increases bulk |
| Emollient Laxative means? | stool softeners |
| Hyperosmotic Saline Laxatives means? | Increases fecal water content |
| Stimulant Laxatives means? | Increases peristalsis |
| T/F Docusate sodium (Colace) is a stool softner --emollient. It is used to treat constipation, fecal impactions, & facilitate BMs for pt with hemorrhoids. | True |
| What type of laxative is psyllium (Metamucil)? | bulk-forming laxative |
| T/F Action of psyllium (Metamucil) is limited to respiratory tract, so few, if any, systemic SE. | False Action of psyllium (Metamucil) is limited to the GI tract, so few, if any, systemic SE. |
| _____ is a laxative and an antacid. | magnesium hydroxide (MOM) |
| Magnesium based antacids can cause _____ whereas aluminum and calcium based can cause _____? | magnesium based=diarrhea; aluminum and calcium based=constipation |
| T/F Chronic & inappropriate use of laxatives may result in laxative dependence, damage the bowel, or lead to instestinal problems. | True |
| With the exception of _____ laxatives should not be used for long periods of time. | With the exception of the bulk-forming type of laxatives... |
| T/F Of the OTC medications, laxatives are some of the most misused. | True |
| The following are the 6 categories of ____ based on MOA: Anticholinergics; Antihistamines; Neuroleptics; Prokinetics; Serotonin Blockers; Tetrahydrocannabinol. | Antiemetics |
| Anticholinergics block _____? | acetylcholine |
| Antihistamines block _____? | Antihistamines block histamine (histamine 1 not 2 which are used for gastric acid control). |
| Neuroleptics block _____? | dopamine |
| Prokinetic block ____ and are actually used to ____? | Prokinetic - block dopamine....actually used to stimulate peristalsis |
| Serotonin blocker, blocks _____? | serotonin |
| Tetrahydrocannabinol (THC) - is a _____ substance in marijuana - patients with cancer and AIDs use this drug. | psychoactive substance in marijuana |
| T/F The numerous drugs used to prevent or treat nausea work by blocking one of the vomiting pathways & in doing so block the stimulus that induces vomiting. | True |
| What drug is an antihistamine - used for motion sickness? | dimenhydrinate (Dramamine) |
| What drug is a neuroleptic and is used in the hospital setting? | prochlorperazine (Compazine) |
| What drug is a serotonin blocker with few adverse effects. Used for prevention of N/V with chemotherapy & also post-op. | ondansetron (Zofran) |
| What drug is a tetrahydrocannabinoid (THC)....marijuana. Used for N/V with chemotherapy & to stimulate appetite & weight gain with AIDs patients | dronabinol (Marinol) |
| When reviewing the various types of antinausea medications, the nurse recognizes that prokinetic drugs are also used for ______? | Delayed gastric emptying |
Created by:
cgwayland
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