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GI Pharm I-short and sweet
Terms in this set (31)
ACh acts on what 4 cells?
1. chief (pepsinogen)
2. parietal (HCl)
3. ECL (Histamine)
4. G cells *as GRP (gastrin)
which receptors does ACh act on at parietal and ECL cells?
gastrin, ACh act via what signalling pathway? Histamine?
gastrin, ACh:Gq (IP3/DAG)
what is the most important gastric secretagogue? what else can stimulate parietal cells?
-also, ACh directly and gastrin
4 inhibitors of gastric acid secretion
1. acidic pH (<3)
3. prostaglandins, esp. PGE2
4. enterogastrones (secretin, GIP, neurotensin, PYV)
why is smoking bad for GI mucosa (other than cancer)?
nicotine reduces pancreatic bicarb secretion
what does H. pylori do to the stomach?
1. decreases mucus/bicarb release
2. increases gastrin release
3. decreases somatostatin release
name the 4 antacids and their AE:
1. Sodium bicarbonate (CI'd in HTN)
2. Calcium carbonate (CI'd in renal impairment)
3. Magnesium Hydroxide (diarrhea)
4. Aluminum Hydroxide (constipation, depetion of phosphate)
which antimuscarinic do we actually use for gastric acid inhibition? MOA?
-selective antagonist of M1 receptor (inhibits histamine release)
how do H2 receptor antagonists work? what' s the most commonly used one?
-block histamine stimulation of parietal cells (so no H+ secretion
Of the 4 H2RAs, which ones have anti-androgen effects?
Of the 4 H2RAs, which ones have p450 inhibitor effects?
ranitidine has some
what are the PPIs?
IRREVERSIBLY block K+ transport site of H,K ATPase of parietal cells
1. increased GI/resp infectin (C. diff)
2. CI'd in patients taking clopidogrel
3. osteoporosis (Ca malabsorption)
4. may cause stomach carcinoid tumors
1. blocks histamine stimulation of AC
2. stimulates secretion of mucus, bicarb
3. increases mucosal blood flow
diarrhea and UTERINE CONTRACTIONS
-acts like bandaid for ulcer crater
2. suppresses H. pylori
3. increases mucus production
-stimulates mucus secretion and scavenges free radicals
stimulates mucus secretion
1. mucus secretion
DOC for treating H. pylori
can sub metronidazole for amoxicillin allergies
How does our intestine contract?
1. ENS releases ACh
2. ACh binds to M2 and
which causes stimulation
Name 1 stimulant and 1 depressant of the cholinergic motor neuron:
-not used because of SLUDS
Metoclopramide MOA and actions
-DA antagonist (disinhibition mechanism)
1. increases lower esophageal sphincter tone
2. increase esophageal clearance
3. stimulates gastric emptying
4. stimulates peristalsis
Parkinson like effect
-taken off market because of ventricular arrhythmias
-binds to motilin receptor
-inhibits HMG-CoA reductase and reduces cholesterol secretions
-but INCREASES bile acid secretion
-decreases cholesterol and lipid secretion in bile
(no effect on CYP7A1)
other gallstone dissolvers
1. methyl tert-butyl ether
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