Pharm > Week 7 > Flashcards

Week 7 Flashcards

(57 cards)

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1
Q

Gastric Secretion Phases

A

Cephalic phase - though, smell taste

Gastric Phase - distention of the stomach, presence of partially digested proteins

Intestinal phase - stimulated by histamine and digested protein

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2
Q

Motilin

A

secreted by duodenum when fat or acid enters - increases peristalsis

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3
Q

Secretin

A

in duodenum causes secretion of bicarbonate enzymes to neutralize acidic chyme and inhibit gastrin

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4
Q

Pepsin (previously pepsitogen)

A

secreted by chief cells, turned into pepsin in HCl, proteolytic enzyme to break down protein in stomach

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5
Q

Cholecystokinin (CCK)

A

released from intestines, stimulates pancreatic enzymes like lipase and release bile

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6
Q

Parietal Cells

A

secrete HCl

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7
Q

Chief Cells

A

secrete pepsinogen

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8
Q

D cells

A

secrete somatostatin which inhibits acid and stimulate G cells

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9
Q

G cells

A

secrete gastrin

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10
Q

Antibody secreted by intestine mucosa

A

IgA

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11
Q

Paneth Cells

A

produce defensins and antibiotics and lysosomes

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12
Q

Peyer Patches

A

lymph tissue with phages that protect against infection, produces IgA

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13
Q

Kupffer Cells

A

Innate and adaptive immunity by identifying foreign antigens, macrophages that heal liver injury, bilirubin production, lipid metabolism

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14
Q

Stellate Cells

A

Contractile in liver injury, remove foreign substances from blood, contain retinoids like vitamin A

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15
Q

NK cells

A

produce interferon-y (cytokine) and important in tumor defense

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16
Q

Disse Space

A

drain interstitial fluid into hepatic lymph system

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17
Q

Portal Hypertension Repercussions

A

Varices - distended, torturous, veins, can burst (often esophageal)

Splenomegaly - growth of spleen
- hepato/portopulmonary syndrome (vasodilation that causes fluid in lungs)

Vomiting of blood grom bleeding esophageal varices

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18
Q

Ascites

A

Accumulation of fluid in peritoneal cavity

caused by cirrhosis, portal HT, decreased synthesis of albumin (plasma protein) - which leads to lower oncotic pressure which leads fluid to go into peritoneum

abdominal distention, abdominal girth, weight gain

paracentesis - remove fluid from abdominal cavity

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19
Q

Phases of Hepatits A-E

A

Prodromal - two weeks after exposure with fever, malaise, vomiting

Icteric - jaundice, dark urine, enlarged liver

Recovery - resolution of jaundice

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20
Q

Metabolism of Bilirubin

A

RBCs - Hemoglobin - Heme and globin - iron and biliverdin - unconjugated bilirubin - released in urine and feces

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21
Q

Hepatic Encephalopathy

A

impaired behavioral, cognitive, motor function, rapid during hepatitis, cells in NS are vulnerable to neurotoxins that circulate to brain bc of liver dysfunction, AMMONIA

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22
Q

Jaundice (icterus)

A

Hyperbilirubinemia, dark urine, yellow discoloration, light colored stools

Obstructive jaundice - in or outside of liver (like bile duct)

Hemolytic Jaundice - excessive hemolysis of red blood cells

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23
Q

Nonalcoholic fatty liver disease

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A

infiltration of hepatocytes with fat

progresses into nonalcoholic steatohepatitis - progresses to cirrhosis and end-stage liver disease

24
Q

Cholecytitis

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A

Gall stone causes infection around it (gall stone is hardened bile) after blocking duct

rebounding tenderness

25
GERD
reflux of acid and pepsin from stomach to the esophagus resting tone lower esophageal sphincter is low conditions that increase abdominal pressure can contribute (older age, obesity)
26
Gastric Ulcers
lower antral region of the stomach due to increased mucosal permeability to hydrogen ions, normal gastric secretion pain caused by eating
27
Peptic Ulcers
duodenal most common primarily caused by H pylori, hypersecretion of stomach acid and pepsin, use of NSAIDs (inhibit prostaglandins which build up mucosal lining) pain in epigastric region, relief from eating
28
Crohn's Disease
Granulomatous colitis colon is inflamed with granulomas giving cobblestone appearance idiopathic, affecting any part of digestive tract weight loss, abdominal pain, malabsorption
29
Ulcerative Colitis
Inflammatory Bowel Disease inflammation of rectum and sigmoid colon diarrhea, bloody stool, no malabsorption
30
Irritable Bowel Syndrome
from a brain-gut interaction recurrent abdominal pain with altered bowel habits more common in females, associated with anxiety, depression, and reduced quality of life
31
Diverticular disease of the colon
Diverticula (outpoutchings of the colon wall) Diverticulosis - have diverticula but asymptomatic Diverticulitis - inflammatory when infected or something gets stuck (seeds, kernels)
32
Celiac's Disease
Autoimmune with genetic disposition multi-organ T cell mediated injury to small intestine villi triggered by gluten causing malabsorption, abdominal distension, diarrhea, anorexia
33
Proton Pump Inhibitors
omeprazole (Prilosec), lansoprazole, pantoprazole, PRAZOLE reduce acid secretion by binding to ATPase short term 4-8 weeks for peptic ulcer and GERD nausea, diarrhea, rash, abdominal pain, headache empty stomach bc susceptible of acid, can be given with antacids, LFTs
34
H2 Receptor Blockers
rantidine (Zantac), famotidine (Pepcid), nizatidine (cimetidine) block histamine (H2 receptor) in stomach to decrease acid production of parietal cells mild headache, possible reduction of RBCs, WBCs, platelets, impotence or loss of libido after meals, LFTs, avoid in elderly because inhibits CYP 450 which raises drug levels
35
Antacids
aluminum hydroxide, magnesium hydroxide neutralize stomach acid by raising pH in combination with other antiulcer agents constipation can affect absorption of other drugs so administer 2 hours before or after, no suspected bowel obstruction, monitor phosphate levels
36
sucralfate (Carafate)
GI protectant - bind with pos charged proteins to form protective coating on gastric lining constipation caution in renal, drug-drug interaction with warfarin
37
misoprostol (Cytotec)
prostaglandin - replace prostaglandins inhibited by NSAIDs also causes uterine contractions diarrhea, abdominal pain, fetal harm in pre-term use do not use in preganant individuals except those at term, not first line therapy
38
metoclopramide (Reglan)
Antiemetic - block dopamine and serotonin receptors to increase GI motility prevent backup of chyme and vomiting prevention no elderly, monitor for tardive dyskinesia (involuntary dyskinesia), administer 30 mins prior to meals
39
H pylori drug regimend
Proton pump compounds bismuth compounds (peptobismol) inhibit bacterial growth and prevent H pylori from adhering
40
Triple vs Quadruple Therapy
PPI once or twice daily 2 antibiotics PPI twice daily bismuth subsalicylates (peptobismol) (prevents adherence of H pylori) 2 antibiotics
41
bismuth subsalicylate (Pepto-bismol)
Antidiarrheal: antimicrobial by preventing adhering of bacteria to mucosa and antisecretory effect constipation discolors feces and tongue to black, drug-drug interactions with aspirin and NSAIDs
42
Constipation
Primary: caused by disease process secondary: caused by medication or side effect causes: lack of exercise, insufficient fiber or fluid, slow motility
43
pysllium mucilloid (Metamucil)
(dietary fiber, first-line treatment) bulk-type laxative: increase size of fecal mass rare adverse effects assess bowel sounds, mix with sufficient water because expands, ensure ability to swallow 8 oz
44
magnesium citrate (Citroma)
saline laxative: cause osmotic retention of fluid to distend colon and increase peristalsis abdominal pain, diarrhea, flatulence, nausea, vomiting monitor electrolytes and stool output, assess bowel sounds, contraindicated with bowel obstruction
45
docusate sodium (Colace)
surfactant laxative: reduce surface tension of oil-water in stool for stool softening abdominal pain, diarrhea monitor stool output, assess bowel sounds
46
bisacodyl (Dulcolax)
stimulant laxative: irritate smooth muscle, alter water and and electrolyte secretion abdominal cramping, electrolyte disturbances monitor electrolytes and diarrhea, caution with geriatrics
47
diphenoxylate with atropine (Lomotil)
Opioid: inhibit GI motility, atropine to make less addictive dizziness and drowsiness assess electrolyte, blood presence in stool, ambulation concerns bc of dizziness, schedule V
48
prochlorperazine
Phenothiazine (antiemetic): block dopamine 1 and 2 receptors to inhibit vomiting sensor, anticholinergic dry mouth, sedation, constipation, orthostatic hypotension, tachycardia, extrapyramidal symptoms monitor for drowsiness, Beers Criteria, no delirium or dementia
49
ondansetron (Zofran)
selective 5-HT3 receptor antagonist: block serotonin headaches, malaise, constipation monitor for QT prolongation, decrease dose in hepatic impairment, commonly used in pregnancy
50
metaclopramide (Reglan)
dopamine antagonist and serotonin 5-HT4 receptor antagonist tardive dyskinesia, CNS depression caution w elderly, monitor TD
51
dronabinol (Marinol)
cannabinoid: activate CB1 receptor, increase appetite dizziness, lethargy monitor CNS, monitor falls, caution with geritatric
52
dexamethasone (Decadron), prednisone
glucocorticoid: reduce gut serotonin increased blood sugar, adrenal suppression, abdominal distention, emotional liability, insomnia monitor labs, cardiac monitoring, monitor wound healing, strong caution with pregnancy bc readily crosses placenta
53
promethazine (Phenergan)
Antihistamine, phenothiazine derivative: block H1, musacrinic, dopamine 2 receptors sedation, dry mouth, blurred eyesight, extrapyramidal symptoms warning for resp depression in peds, deep IM preferred or diluted IV, monitor for anticholinergic effects, short term only for severe nausea
54
anticholinergic effects
blurry vision, dry mouth, tachycardia, constipation, confusion, urinary retention, flushed skin
55
dimenhydrinate (Dramamine), meclizine (Anti-Vert)
antihistamine: block H1 and muscarinic receptors for motion sickness and radiation sickness dry mouth, blurred vision, drowsiness Beer criteria, monitor for sedation
56
scopolamine (Transderm-Scop)
anticholinergic: block action of acetylcholine motion sickness drug dry mouth, blurred vision, drowsiness 72 hour patch, no use in glaucoma bc increases intraocular pressure, caution with obstructive disease processes
57
A 70-year-old male with a history of alcoholism presents with accumulation of fluid in the peritoneal cavity. Of the following, which is NOT associated with the development of ascites? a. Decreased synthesis of albumin b. Increased serum creatinine lab value c. Portal hypertension d. Splanchnic Vasodilation
B
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