respiratory/GI pharmacology
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| 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)
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| What are the two net effects of asthma? | bronchoconstriction, inflammation & swelling of airway
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| 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
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| What are the ways to treat asthma? | bronchodilators (treat primary symptoms of asthma, bronchoconstriction) + anti-inflammatory agents (reduce level of hyper-responsiveness)
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| What are three types of bronchodilators used to treat asthma? | methylxanthines; anticholinergics; beta2-adrenergic agonists
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| What are the characteristics of methylxanthines? | caffeine included here, phosphodiesterase inhibitor, relaxes smooth muscle
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| What are the characteristics of anticholinergics used to treat asthma? | ipatropium bromide (Atrovent); relaxes smooth muscle; sympathetic component dominating, so do not help
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| What are the characteristics of beta2-adrenergic agonists? | Albuterol (Ventolin/Proventil); most widely prescribed & most effective agents for treatment of bronchoconstriction, relaxes smooth muscle
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| What should not be used to treat asthmatics? | beta blockers for cardiovascular disease
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| What are three anti-inflammatory agents used to treat asthma? | Cromolyn Sodium; Prednisone (Deltasone); Montelukast (Singulair)/Zarfirlukast (Accolate)
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| What are the characteristics of Cromolyn Sodium? | prevents mast cell activation, inhibits histamine release; blocks inflammation & constriction
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| 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
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| What are the characteristics of Montelukast (Singulair) & Zarfirlukast (Accolate)? | leukotriene receptor antagonist; decrease inflammation & bronchoconstriction; asprin-induced asthma
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| 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
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| What are some characteristics of Cystic fibrosis? | thick, viscous secretions in major exocrine glands; mucolytic drugs & corticosteroids often given in combo with respiratory hygeine
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| 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
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| 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
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| What are some characteristics of the GI | smooth muscle layers responsible for motor function, enteric nervous system
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| 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)
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| What is the responsibility of enteric hormone cholecystokinin? | slows emptying of stomach to allow for fat digestion
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| What is the responsibility of the enteric hormone gastrin? | acid secretion
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| 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
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| What are three possible consequences of excess acid secretion in the GI tract? | Ulcers; GERD; Zollinger-Ellison syndrome (pancreatic tumor that increases gastrin secretion)
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| What are some factors that increase one's risk for gastric ulcers? | caffiene; smoking; asprin-like drugs; Helicobacter pylori
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| What are two K+/H+ ATPase inhibitors used to treat excess GI acid? | used to treat GERD; Omeprazole (Prilosec) & Lansoprazole (Prevacid)
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| What is an example antibiotic used to treat excess GI acid? | Clarithromycin removes H.pylori
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| What is a bismuth compound + antibiotic that treats excess GI acid? | Bismuth subsalicylate (Pepto Bismol): forms protective barrier; removes H.pylori
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| What are three histamine H2 receptor antagonists used to treat excess GI acid? | Cimetidine (Tagament, P450 inhibitor); Ranitidine (Zantac); Famotidine (Pepcid)
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| 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)
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| When NSAIDS inhibit COX, they also inhibit protective prostaglandins which: | inhibit acid secretion; stimulate mucous & bicarb production
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| 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)
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| What is the best antacid to use for excess GI acid? | maalox: combo magnesium & aluminum hydroxide so no side effect
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| 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
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| 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
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| What are some salicylate derivatives (NSAIDS) used to treat IBD (inflammatory bowel disease)? | Olsalazine (Dipentum): drug of choice for reoccuring IBD; Mesalamine; Sulfasalzine
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| What are the characteristics & possible causes of diarrhea? | production of watery stool; causes: motility disturbances, drug-induced, psychological, bacterial toxins
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| 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)
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| What are some uses for anti-emetics? | chemotherapy, toxic response, infection, motion sickness, anxiety
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| 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
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| What are some characteristics of the GI | smooth muscle layers responsible for motor function, enteric nervous system
🗑
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| 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)
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| What is the responsibility of enteric hormone cholecystokinin? | slows emptying of stomach to allow for fat digestion
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| What is the responsibility of the enteric hormone gastrin? | acid secretion
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| 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
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| What are three possible consequences of excess acid secretion in the GI tract? | Ulcers; GERD; Zollinger-Ellison syndrome (pancreatic tumor that increases gastrin secretion)
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| What are some factors that increase one's risk for gastric ulcers? | caffiene; smoking; asprin-like drugs; Helicobacter pylori
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| What are two K+/H+ ATPase inhibitors used to treat excess GI acid? | used to treat GERD; Omeprazole (Prilosec) & Lansoprazole (Prevacid)
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| What is an example antibiotic used to treat excess GI acid? | Clarithromycin removes H.pylori
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| What is a bismuth compound + antibiotic that treats excess GI acid? | Bismuth subsalicylate (Pepto Bismol): forms protective barrier; removes H.pylori
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| What are three histamine H2 receptor antagonists used to treat excess GI acid? | Cimetidine (Tagament, P450 inhibitor); Ranitidine (Zantac); Famotidine (Pepcid)
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| 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)
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| When NSAIDS inhibit COX, they also inhibit protective prostaglandins which: | inhibit acid secretion; stimulate mucous & bicarb production
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| 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)
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| What is the best antacid to use for excess GI acid? | maalox: combo magnesium & aluminum hydroxide so no side effect
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| 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
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| 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
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| What are some salicylate derivatives (NSAIDS) used to treat IBD (inflammatory bowel disease)? | Olsalazine (Dipentum): drug of choice for reoccuring IBD; Mesalamine; Sulfasalzine
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| What are the characteristics & possible causes of diarrhea? | production of watery stool; causes: motility disturbances, drug-induced, psychological, bacterial toxins
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| 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)
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| What are some uses for anti-emetics? |
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| What are the control centers for vomiting? | chemoreceptor trigger zone, vomiting center in brainstem
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| What are the anti-emetics used for motion sickness? | Dimenhydrinate (dramamine) + Scopolamine (Hyoscine)
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| What are the anti-emetics used for chemo side effects? | Ondansetron (Zofran) & Dronabinol (Marinol, uses THC)
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| What is the anti-emetic used for blocking the CTZ for nausea & vomiting? | Metoclopromide (Reglan)
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| What is the anti-emetic used for stage fright induced or anticipatory vomiting? | Lorazepam (Ativan)
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| What are some causes for constipation? | inhibition of reflexes, drug-induced (morphine), obstruction, or stress, diet & exercise
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| What are the examples of Cathartics (laxatives)? | Magnesium hydroxide (milk of magnesia: water & electrolyte retaining cathartic, may dehydrate); Disacodyl (correctal); Lactulose (cephulac)
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| 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
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| 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
🗑
|
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| 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? |
🗑
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