Pharmacology Unit 3: Medications for the Gastrointestinal System and Nutrition

Practice flashcards covering gastrointestinal medications, antiemetics, laxatives, antidiarrheals, vitamins, minerals, and herbal supplements based on pharmacology lecture notes.

Amylase

An enzyme that digests polysaccharides; found in saliva and produced by the pancreas.

Pepsin

An enzyme in the stomach that initiates the digestion of proteins.

$$HCl$$

Hydrochloric acid in the stomach that activates enzymes, breaks up food, and kills germs.

Liver

Organ that breaks down and builds up many biological molecules, stores vitamins and iron, and destroys old blood cells and poisons.

Bile

A substance stored and concentrated in the gallbladder that aids in the digestion of fats.

Trypsin and Chymotrypsin

Pancreatic enzymes responsible for the digestion of proteins.

Lipase

A pancreatic enzyme that digests lipids.

Peptic Ulcer Disease (PUD)

A disease characterized by sores in the stomach lining, often caused by H. Pylori or chronic NSAID use.

Zollinger-Ellison syndrome

A condition of hypersecretion of gastric acid treated by H2-receptor antagonists and proton pump inhibitors.

Histamine2-receptor antagonists

Drug class (ending in -dine) that blocks H2 receptors to suppress gastric acid secretion and lower concentration of $H^+$ ions.

Cimetidine

An H2-receptor antagonist that can block androgen receptors, resulting in decreased libido, gynecomastia, and impotence.

Famotidine

A medication used to prevent/treat gastric and duodenal ulcers and GERD; can be administered IV for acute situations.

Proton pump inhibitors (PPIs)

Drug class (ending in -prazole) that blocks basal and stimulated acid production to reduce gastric acid secretion.

Omeprazole

A proton pump inhibitor used for short-term therapy of ulcers, erosive esophagitis, and GERD.

Pantoprazole

A PPI that can be administered IV; the nurse must monitor the IV site for irritation or thrombophlebitis.

Rebound acid hypersecretion

A complication associated with stopping proton pump inhibitors after long-term therapy.

Hypomagnesemia

A potential complication of long-term PPI use; patients should have baseline levels monitored and report tremors or muscle cramps.

C-diff associated diarrhea

A potential complication of PPIs because elevated gastric pH levels may facilitate the growth of bacterial spores.

Rilpivirine

An antiviral medication used for HIV/AIDS that is contraindicated for use with proton pump inhibitors.

Sucralfate

A mucosal protectant that forms a protective barrier adhering to an ulcer for up to $6$ hours.

Antacids

Medications like aluminum hydroxide and magnesium hydroxide that neutralize or reduce the acidity of gastric acid.

Hypophosphatemia

An electrolyte imbalance that is a specific complication of aluminum-based antacids.

Hypercalcemia

A complication of calcium compounds (antacids) that can cause constipation, anorexia, nausea, and vomiting.

Misoprostol

A prostaglandin E analog used to prevent gastric ulcers in patients taking long-term NSAIDs.

Cervical ripening

An unlabeled use of misoprostol in pregnant patients to induce labor or medical termination of pregnancy.

Antiemetics

A category of medications used to treat or prevent nausea and vomiting.

Dexamethasone

A glucocorticoid used in combination with other antiemetics to treat chemotherapy-induced nausea and vomiting.

Aprepitant

A substance P/neurokinin antagonist used to prevent post-op and chemo-induced nausea and vomiting.

Ondansetron

A serotonin antagonist that prevents emesis by blocking $5\text{-HT}_3$ receptors in the chemoreceptor trigger zone (CTZ).

Torsade's de pointe

A serious dysrhythmia associated with the prolonged QT interval complication of ondansetron.

Dopamine antagonists

Drug class (ending in -azine) including promethazine and prochlorperazine that block dopamine receptors in the CTZ.

Extrapyramidal Symptoms (EPS)

Complications of dopamine antagonists including pseudoparkinsonism, acute dystonia, akathisia, and tardive dyskinesia.

Pseudoparkinsonism

An EPS characterized by stooped posture, shuffling gait, rigidity, and tremors at rest.

Acute dystonia

An EPS involving facial grimacing, involuntary upward eye movement, and muscle spasms of the tongue, face, neck, and back.

Akathisia

An EPS where the patient is restless, has trouble standing still, and maintains feet in constant motion.

Tardive dyskinesia

A serious complication of long-term dopamine antagonist or prokinetic agent use involving involuntary movements of the tongue, lips, and face.

Dronabinol

A cannabinoid used to control chemo-induced nausea/vomiting and to increase appetite in patients who have AIDS.

Scopolamine

An anticholinergic medication applied as a transdermal patch behind the ear to prevent or treat motion sickness.

Dimenhydrinate

An antihistamine that blocks muscarinic and histaminergic receptors in nerve pathways connection the inner ear and vomiting center.

Lorazepam

A benzodiazepine used in combination with other medications to cause sedation and anterograde amnesia for chemo-induced nausea.

Metoclopramide

A prokinetic agent that blocks dopamine receptors in the CTZ and augments acetylcholine in the upper GI to increase motility.

Diabetic gastroparesis

A condition of delayed stomach emptying treated with the oral form of metoclopramide.

Psyllium

A bulk-forming laxative that softens fecal mass and increases bulk for the temporary treatment of constipation.

Docusate sodium

A surfactant laxative that lowers surface tension of the stool to allow penetration of water.

Bisacodyl

A stimulant laxative that increases the volume of water and electrolytes in the intestines and stimulates peristalsis.

Proctitis

A burning sensation and inflammation of the rectum that can occur with regular use of bisacodyl suppositories.

Magnesium hydroxide

An osmotic laxative that draws water into the intestine; may cause toxicity in patients with impaired kidney function.

Lactulose

An osmotic laxative used to increase the mass of stool and stretch musculature for peristalsis.

Diphenoxylate plus atropine

An antidiarrheal combination that activates peripheral opioid receptors in the GI tract to decrease motility.

Loperamide

An analog of meperidine used as an antidiarrheal that does not mimic opioids at high doses.

Megacolon

A condition of massive colon dilation that antidiarrheals can increase the risk of in patients with IBS.

Alosetron

A serotonin antagonist approved only for female patients with severe IBS-D lasting longer than $6$ months.

Ischemic colitis

A potentially fatal GI toxicity complication associated with the medication alosetron.

Lubiprostone

A chloride channel activator that increases fluid secretion in the intestine to treat IBS-C in females.

Probiotics

Dietary supplements containing bacteria and yeast that help metabolize foods and promote nutrient absorption.

Water-soluble vitamins

Vitamins that are readily excreted in the urine and not stored in the body, such as Vitamin C and B-complex vitamins.

Fat-soluble vitamins

Vitamins A, D, E, and K, which are found in oils and fats and can be stored in the body.

Vitamin A

A fat-soluble vitamin essential for vision and embryo development; excessive intake during pregnancy can cause birth defects.

Vitamin B1 (thiamine)

Vitamin essential for carbohydrate metabolism; deficiency is common in patients with alcoholism.

Vitamin B2 (riboflavin)

A vitamin essential for protein and fat metabolism; supplements can cause urine to turn a deep yellow color.

Vitamin B3 (niacin)

Vitamin used to treat hyperlipidemia; common adverse effects include skin warmth and flushing.

Vitamin B6 (pyridoxine)

Vitamin essential for protein metabolism; high doses can cause neurotoxicity characterized by ataxia and numb feet.

Vitamin B9 (folic acid)

Vitamin required for DNA synthesis; essential during early pregnancy to prevent neural tube defects.

Vitamin B12 (cyanocobalamin)

Vitamin required for RBC production and myelin for neurons; oral routes are ineffective for patients with pernicious anemia.

Vitamin C (ascorbic acid)

Vitamin essential for collagen in connective tissue and bone matrix; also promotes resistance to infection.

Vitamin D

Vitamin that promotes calcium and phosphorus absorption; used to treat rickets in children and osteomalacia in adults.

Vitamin E

An antioxidant with anti-inflammatory properties that may increase clotting times in patients taking anticoagulants.

Vitamin K

The reversal agent for warfarin; essential for the liver formation of clotting factors II, VII, IX, and X.

Calcium

Major mineral essential for muscular, neurological, and cardiac function.

Trousseau's sign

A sign of hypocalcemia where hands and fingers go into spasm after inflating a blood pressure cuff for $1-4$ minutes.

Chvostek's sign

A sign of hypocalcemia involving facial twitching after tapping the face in front of the ear.

Calcium carbonate

An OTC antacid and calcium supplement that is considered the most elemental and best-absorbed form of calcium.

Iron

A mineral essential for the production of myoglobin and hemoglobin.

Ferrous sulfate

An oral iron preparation used to treat iron deficiency anemia.

Z-track method

The specific technique required for IM iron injections to prevent staining of the skin.

Chelating agent

A type of agent, such as deferoxamine, given to bind to iron and remove it during an overdose.

Magnesium sulfate

A parenteral mineral used to treat deficiency, stop preterm labor, and as an anticonvulsant during labor.

Calcium gluconate

The reversal agent that should be available during IV magnesium sulfate administration.

Potassium

Mineral essential for conducting nerve impulses and maintaining electrical excitability of muscle.

Peaked T-waves

A specific EKG change that is a manifestation of severe hyperkalemia.

Dietary supplement

A product containing vitamins, herbals, botanicals, or amino acids, labeled as a supplement and not intended to cure disease.

Aloe

An herbal used topically for anti-inflammatory effects and orally for its laxative effects.

Black Cohosh

An herbal supplement that acts as an estrogen substitute to treat manifestations of menopause.

Echinacea

An herbal that stimulates the immune system and can decrease inflammation; used to treat viruses like the common cold.

Feverfew

An herbal used to decrease the frequency and severity of migraine headaches by blocking platelet aggregation.

Post feverfew syndrome

A condition caused by abrupt discontinuation of feverfew resulting in agitation, fatigue, and headache.

Garlic

An herbal that forms allicin; used to lower triglycerides and LDL cholesterol while acting as a vasodilator.

Ginger Root

An herbal used to relieve vertigo and nausea, increase intestinal motility, and decrease GI spasms.

Ginkgo Biloba

An herbal that promotes vasodilation and is claimed to improve memory; can interact with medications that lower the seizure threshold.

Glucosamine

An herbal that stimulates cartilage and synovial fluid production; should be avoided by patients with shellfish allergies.

Kava

An herbal that promotes sleep and muscle relaxation; chronic large doses can cause severe liver failure.

St. John's Wort

An herbal used for mild depression that can cause serotonin syndrome when combined with other antidepressants.

Saw Palmetto

An herbal supplement used to decrease the manifestations of prostate hyperplasia.

Valerian

An herbal that increases GABA to prevent insomnia; its drowsiness effect increases over time.

Gastric reflux (GERD)

A GI disorder where stomach acid flows back into the esophagus, for which a nurse might administer H2 blockers or PPIs.

Antihypertensives interaction

Interaction where dopamine antagonists like promethazine increase the hypotensive effect of blood pressure medications.

Methotrexate and Sulfonamides

Medications that decrease the effectiveness of folic acid when taken concurrently.

NSAIDs

Nonsteroidal anti-inflammatory drugs that can cause PUD and should be limited in patients with gastric ulcers.

$$90-240\,mL$$

The amount of cold water or juice required to mix powder formulations of potassium.

$$10\,mg$$

The dosage threshold for metoclopramide; if below this, it can be given undiluted IVP over $2$ minutes.