15a Lower GI pharm

Question 0

Diphenoxylate (lomotil)

Answer 0

Mu receptor agonist- can penetrate CNS in large doses

Administered with atropine to prevent abuse

Question 1

Loperamide (immodium)

Answer 1

Mu receptor agonist - poor CNS penetration

Question 2

Octreotide

Answer 2

Used for carcinoid diarrhea

Question 3

FiberMOA

Answer 3

Creates SCFA- prokinetic and trophic for endothelium

Question 4

Mg(OH)2

Answer 4

Milk of magnesia- inorganic salt not absorbed- osmotic retention

Question 5

Lactulose

Answer 5

unabsorbed carbohydrate- acidifies gut lumen- can trap ammonia
osmotic

Question 6

Polyethelene glycol (miralax)

Answer 6

Osmotic

Question 7

Biscodyl

Answer 7

Prodrug broken down by bowel esterases

Makes a anionic surfactant- minor irritation causes motility and secretion

Question 8

Senna

Answer 8

Prodrug transformed by colonic bacteria

Slight inflammation causing losening of stools

Question 9

Ducosate salts

Answer 9

Anionic surfactants

Question 10

Lubiprostone

Answer 10

Prostinoid ^ CFTR

treats constipation in IBS

Question 11

Linaclotide

Answer 11

^cGMP- opens CFTR, decreases pain fibers

Question 12

Methylnaltrexone

Answer 12

Opioid antagonist to block opioid constipation

Question 13

Budesonide

Answer 13

Enteric released steroid used for crohns

Question 14

Mesalamine, osalazine, sulfasalazine

Answer 14

5-ASAs
INHIBIT IL1 and TNF NOT COX I

Sulfa and osalazine have azides broken down in gut to yield mesalamine

Question 15

Inflixamab

Answer 15

ANTI TNF alpha