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Pharmacology > EXAM #1: GI PHARMACOLOGY III > Flashcards

EXAM #1: GI PHARMACOLOGY III Flashcards

1
Q

What is IBS?

A

Idiopathic relapsing disorder w/

  • Abdominal pain (pain, bloating, distension)
  • Constipation
  • Diarrhea
  • BOTH constipation and diarrhea
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2
Q

What is IBD?

A

Inflammatory Bowel Disease

  • Crohn’s Disease= any part of the GI tract
  • Ulcerative Colitis= limited to the distal GI tract
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3
Q

What is the difference between IBS and IBD?

A

IBS= Irritable Bowel Disease

IBD= Inflammatory Bowel Disease

  • Crohn’s Disease
  • Ulcerative Colitis
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4
Q

What is the common drug of choice to treat diarrhea in IBS?

A

Loperamide

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5
Q

What is the common drug of choice to treat constipation in IBS?

A

Osmotic laxatives

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6
Q

What is the role of tricyclic antidepressants and antispasmodics/antimuscarinics in IBS?

A

Pain relief

  • Tricyclic antidepressants= increase 5-HT, which causes a decrease in receptor density, limiting pain
  • Antispasmodics inhibit GI smooth muscle contraction and limit pain
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7
Q

What is the difference in pharmacological approach in IBS to targeting 5-HT4 and 5-HT3 receptors?

A

5-HT4= AGONIST
- Promotes NT release to result in MOTILITY w/ constipation

5-HT3= ANTAGONIST

  • Block visceral pain
  • Block motility
  • Block secretions
  • Used for DIARRHEA*
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8
Q

Why has Tegaserod been generally pulled off the market?

A

Cardiovasuclar adverse effects:

  • MI
  • CVA
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9
Q

What drug is commonly used for 5-HT3 receptor antagonism in IBS? What symptom of IBS is this used for?

A

Alosetron

DIARRHEA

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10
Q

What patient population is Alosetron used in?

A

Women ONLY

This drug does not work in men*

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11
Q

What is the serious adverse effect induced by Alosetron?

A

Ischemic colitis (fatal)

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12
Q

What are the four general categories of drugs used to treat IBD?

A

ASA
Glucocorticoids
Antimetabolites
Anti-TNF-a therapy

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13
Q

What is the mechanism of action of ASA drugs to treat IBD?

A

1) Inhibit COX and prostaglandins
2) Interfere with inflammatory cytokine production
3) Inhibit NF-KB signaling

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14
Q

What is the important feature of ASA-type drugs to remember about their efficacy?

A

If the drug is absorbed via a lesion in the GI tract, it will NOT work

There must be TOPICAL application i.e. it must STAY in the GI tract

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15
Q

What are the three strategies to keep ASA drugs in the GI tract?

A
  • Proprietary release formula
  • Chemical binding
  • High concentration delivered rectally
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16
Q

What are the examples of ASA drugs?

A

Sulfasalazine

Mesalamine

17
Q

What is the mechanism of action of glucocorticoids in the treatment of IBD?

A

Suppression of inflammatory factors

18
Q

What are the examples of steroids used for IBD?

A

Prednisone

19
Q

What is the mechanism of action of anti-metabolites for IBD?

A
  • Inhibit proliferation of immune cells

- Immune suppression

20
Q

What are the examples of anti-metabolites used to treat IBD?

A

Methotrexate

Azathropine

21
Q

What is the mechanism of Anti-TNF-a drugs in the treatment of IBD?

A
  • TNF-a is a cytokine that mediates the inflammatory response in IBD
  • Monocolonal antibodies are administered to bind and prevent the action of TNF-a
22
Q

What is the example of an anti-TNFa monoclonal antibody to treat IBD?

A

Infliximab

23
Q

What are the first line agents for mild-moderate IBD?

A

Sulfasalazine

Mesalamine

24
Q

What are the adverse effects of Sulfasalazine? What is important to remember about these side effects?

A
  • Nausea
  • GI upset
  • Headache
  • Artralgia
  • Myalgia
  • Bone marrow suppression
  • Malaise

A sizable number of patients CANNOT tolerate these effects and will STOP using the drug

25
Q

What is the indication for Prednisone?

A

Moderate to severe active IBD

26
Q

What is the indication for Azathropine?

A

To maintain remission of IBD

27
Q

What is the indication for Methotrexate?

A

To maintain remission of Chron’s Disease

28
Q

What is the indication for Infliximab?

A

Moderate to severe IBD

Pharmacology (64 decks)

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