Upper and Lower GI Disorders

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  1. Name the causes of peptic ulcers
    • Smoking, stress, genetics
    • Helibacter pylori
    • NSAIDS
  2. Discuss treatment of Peptic ulcers
    • Triple therapy (2 anti biotics, 1 PPI)
    • Amoxicillin
    • Clarithomicin
    • Omeprazole
  3. Describe the actions and administration and side effects of Omeprazole
    • Irreversibly blocks H/K ATPase
    • Single dose/daily
    • Side effects: Diarrhea, farts, nausea
  4. Name 4 kinds of Acid suppressants
    • Antacids
    • Cytoprotective agents
    • H2 receptor antagonists
    • PPI
  5. Discuss 3 antacids used in acidsuppression
    • Aluminum hydroxide -> s/e constipation
    • Magnesium hydroxide -> s/e diarrohea
    • Sodium bicarbonate -> s/e alkalosis
  6. Discuss 3 cytoprotective agents used in acid suppression
    • Bismuth & Sucralfate: stimulate PG and HCO3; bind to ulcer base; preotect mucosa
    • Misoprostol -> PGE analog
  7. Discuss 2 H2 receptor antagonists used inacid suppression
    • Cinitidine and renitidine
    • They competitively block histamine H2 receptor induced acid secretion
  8. State five ways to treat GORD (gastrooesophageal reflux disease)
    • PPI; H2 antagonist; antacids; lifestyle changes and…modify GI motility
    • Metoclopramide; Cisapride; Domperidone
  9. Describe mechanism of action of Metoclopramide
    • Inhibits dopamine BUT increases prolactin
    • Ach release
    • Increases GI motility
  10. Describe mechanism of action of Domeperidone
    • Inhibits dopamine BUT increases prolactin
    • Increases Lower Esophageal Sphincter tone
  11. State 5 kinds of anti-emetics
    • Anti cholinergic drugs
    • Anti-histamine
    • Anti-dopamines
    • Anti-serotonins
    • Cannabinoid analogs
  12. Discuss anti-cholinergic drugs listed under Anti-emetics. Side effects?
    • Hyosine
    • Muscurinic antagonist
    • Works in vestibular nuclei
    • Treats motion sickness
    • Anticholinergic side effects
  13. Discuss use of anti-histamines listed underanti-emetics. Side effect?
    • Cyclizine
    • H1 receptor antagonist
    • In vestibular nuclei
    • Treats motion sickness
    • S/e sedation
  14. Discuss use of anti-dopamines listed underanti-emetics
    • Domeperidone and Metaclopramide
    • Haloperidole
    • Phenothiazines
    • Is a H1 antagonist
    • In the Chemoreceptor trigger zone
    • Used in chemotherapy
  15. Discuss use of anti-serotonins listed underanti-emetics. Side effect?
    • Ondansetron
    • Depresses visceral afferent nerve fibers
    • In Chemorecptor trigger zone
    • Used in chemotherapy
    • S/e constipation and hedach
  16. Discuss use of cannabinoid analogs listedunder anti-emetics. Side effect?
    • Nabilone
    • Mimics canabis
    • Depresses Chemoreceptor trigger zone
    • Used in chemotherapy
    • S/e drowsiness and psycotic rxn
  17. Name 7 treatments for Inflammatory bowel disease
    • Anti-diarrhoeas
    • Laxatives
    • Immunosuppresants
    • Corticosteroids
    • Aminosalisylates
    • TNF-a inhibitors
    • Anti-microbials
  18. Discuss anti-diarrhoea treatment in IBD
    • Fluid/electrolyte balance:
    • -- Oral rehydration
    • Constipating agents:
    • -- Kaolin
    • Opiates:
    • -- Diphenoxylate
    • -- Loperamide (immodium)
  19. discuss laxative treatment in IBD
    Laxatives: decrease H20 and electrolyte absorption, increase motility, increase transit

    • Bulk forming laxatives:
    • -- Bran
    • Osmotic laxatives:
    • -- Mg Sulphate, MgOH, NaPO4: avoid in renal problems; takes 1-3 hours
    • -- Lactulose: takes days
    • Direct stimulants of mucosa:
    • -- Senna: takes 6-8 hours
    • -- Biscodyl supository: takes 30 minutes buddy
  20. State three immunosuppressants used in IBDtreatment
    • Azathioprine
    • Mercaptopurine (side effect = myelosuppression)
    • Cyclosporine
  21. State 3 corticosteroids used in IBD treatment and side effects associated:
    • Prednisone
    • Hydrocortisone
    • Budisanide
    • S/e: metabolic effects, growth retardation in kids, osteoperosis
  22. Briefly describe the use of aminosalisilates in treatment of IBD
    Inhibit leukotriene and PGs
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57354
Card Set
Upper and Lower GI Disorders
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