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🏠9. Gastrointestinal Tract

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Question Bank

1
What are the two main types of inhibitors of gastric acid production?
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Proton pump inhibitors and H2 histamine receptor antagonists

2
Primary function: - Proton pump inhibitors - H2 histamine receptor antagonist
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decrease gastric acid secretion promote mucosal healing

3
What is heartburn?
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a burning sensation, usually from the lower chest area, moves upward towards the neck, within 2 hours after eating or when lying down or bending over

4
What is the most common symptom of GERD
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Frequent and persistent heartburn

5
Antacids function
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neutralize stomach acid, reducing its acidity

6
Antisecretory medication function
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reduce acid secretion in the stomach

7
Treatment strategy for GERD and PUD
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decrease acidity of stomach repair epithelial lining

8
Direct vagal stimulation on gastric secretion
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stimulates H+ secretion via ACh

9
Indirect vagal stimulation on gastric secretion
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stimulates gastrin secretion → stims H+ secretion

10
Gastrin effect on gastric secretion
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↑ H+ secretion via CCK ↑ enterochromaffin-like cells and histamine → H+ secretion

11
Histamine effect on gastric secretion
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stimulates H+ via activation of H2 receptors

12
What factors can inhibit H+ secretion in the stomach?
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Low pH (<3.0) in stomach Somatostatin Prostaglandins

13
Effects of inhibiting H+ secretion?
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Maintain mucosal barrier + stimulate bicarbonate secretion = protecting gastric mucosa

14
Role of Cimetidine in regulation of H+ secretion?
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prevents Histamine signaling by blocking the H2 receptor

15
Which drug blocks stimulatory signal from Vagus nerve mediated by Acetylcholine?
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Atropine blocks signal from Vagus nerve

16
Role of Omeprazole in the regulation of H+ secretion?
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Inhibits the hydrogen/potassium pump

17
What are H2 receptor antagonists/blockers?
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Competitive, reversible antagonists of H2 receptors

18
List the H2 receptor antagonists
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• Cimetidine • Ranitidine • Famotidine • Nizatidine

19
List the oral proton pump inhibitors
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Omeprazole Lansoprazole Dexlansoprazole

20
List the IV proton pump inhibitors?
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Pantoprazole Esomeprazole

21
What are the key members of the PPI class?
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Omeprazole Lansoprazole Dexlansoprazole Pantoprazole Esomeprazole Rabeprazole

22
What is the mechanism of action of PPIs and what do they inhibit?
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irreversibly binds to and inhibits H⁺/K⁺-ATPase in parietal cells → blocks H+ ion secretion

23
What med is used for pre/post op sedative for GI ulcer patients
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diazepam

24
What med is used for sedation of patient treated with cimetidine or omeprazole
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lorazepam or oxazepam

25
What are antacids and how do they work?
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bind to H⁺ → neutralizes existing acid → higher pH → less pepsin activity → less mucosal damage → symptom relief

26
What are the main uses of antacids?
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Symptomatic relief

27
List the antacids
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Aluminum Hydroxide Magnesium hydroxide Calcium carbonate Sodium bicarbonate

28
What is a possible adverse effect of all antacids
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hypokalemia

29
What is the effect of antacids on drug interactions?
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Affect drug interactions by changing gastric and urinary pH

30
How do antacids impact oral absorption of drugs?
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alter the pH of the stomach and urine affecting the absorption of acidic and basic drugs

31
What are sialagogues?
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Enhance salivary secretion through promoting the parasympathetic nervous system

32
List the Sialagogues
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Pilocarpine Cevimeline

33
What is the definition of an anti-sialagogue?
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A drug that decreases salivary flow.

34
List the anti-sialagogues
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Atropine Scopolamine

35
Anti-sialagogue MOA
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Acetylcholine blockade at muscarinic receptor sites

36
What is the brainstem vomiting center and what does it do?
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located in the lateral medullary reticular formation coordinates motor activities associated with nausea and vomiting

37
Types of antiemtics
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antipsychotics metoclopramide H1 antihistamines anticholinergics serotonin 5-HT3 antagonists neurokinin antagonists cannabinoids corticosteroids

38
Classes of Laxatives/Cathartics
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• Bulk forming agents • Stimulant laxatives • Osmotic laxatives • Wetting Agents • Osmotic Cathartics • Chloride Channel Activators

39
What is the difference between laxatives and cathartics?
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Laxatives: ease passage of fully formed fecal matter from rectum Cathartics: cause evacuation of the entire colon

40
List the bulk forming agents
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Psyllium Methylcellulose Polycarbophil

41
Bulk forming agents MOA
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fibrous compounds: absorb water + expanding, ↑ the bulk of intestinal contents ↑ luminal pressure stimulates reflex peristalsis ↑ increased water content softens stool

42
What are the adverse side effects of opioid analgesics on the GI tract?
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Constipation, nausea, and vomiting

43
What are the common adverse effects of antibiotics on the GI system, especially broad-spectrum antibiotics?
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Diarrhea caused by Clostridium difficile overgrowth

44
What is the primary use of Bismuth subsalicylate?
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Antidiarrhea

45
What condition can Bismuth subsalicylate cause?
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Tongue pigmentation