5 GIT Drugs Flashcards by Rea Ferrer

Drug receptor interaction:

Beltanechol

Muscarinic receptor

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Drug receptor interaction

Metrochlopramide

Serotonin

5HT4 receptor antagonist and Vargas and central 5HT3 antagonism

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Drug receptor interaction

Domperidone

Dopamine D2 receptor antagonist

** elevate prolactin level

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Drug receptor interaction

Neostigmine

muscarinic receptor antagonist or ach esterase inhibitor

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Therapeutic approach to inflammatory bowel disease

aminosalicylates, glucocorticoids, purine analogs, antitumor necosis factor therapy, anti integrin therapy and methotrexate

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Budesonide

inflam bowel dis

glucocorticoids

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azathioprine and 6 mercaptopurine

purine analogs inflam bowel disease

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infliximab, adalimumab, certolizumab

antitumor necrosis factor therapy inflammatory bowel disease

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natalizumab

anti integrin therapy inflammatory bowel disease

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dumping syndrome
octreotide
adverse effects?

sludge or gallstone formation

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somTostatin

octreotide
anti diarrheal
slow motility and inhibit gallbladder contraction thefore AD steatorrhea

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melanosis coli

it is a brown pigmentation of colon due to chronic use of anthraquinone derivatives such as aloe, senna, and cascara

anthraquinone derivatives are stimulant laxatives

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dependence

due to prolonged use of diphenoxylate aka lomotil an opiod agonists that is used as anti diarrheal agents

Diphenoxylate can cross BBB compared to loperamide that cant cross BBB

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visual disturbance

can be caused by HIGH dose of antispasmodics or anticholinergics such as dicyclomine and hyoscyamine

use for irritable bowel syndrome

by inhibiting muscarinic receptors in the enteric plexus and on smooth muscle

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diarrhea predominant IBS

recommended drugs

alosetron
a serotonin 5HT3 receptor antagonists

long duration of action

AD can cause ischemic colitis and constipation

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constipation predominant IBS

recommended drug

tegaserod
serotonin 5HT4 receptor antagonist

AD increase number of cardiovascular death therefore it wAs removed from the market

lubiprostone

chloride channel activator
stimulate type 2 Cl channel in SI

women with IBS with predominant constipation
Category C for pregnancy

for chronic constipation== 25mcg bid

mild inflammatorry bowel disease therapy

budesonide (ileitis)
topical corticosteroids (proctitis)
antibiotics
5 aminosalicylates

moderate inflam bowel disease therapy

TNF antagonists
oral corticosteroids
methotrexate
azathioprine/ 6 mercaptopurine

severe inflam bowel disease therapy

surgery
natalizumab
cyclosporine
TNF antagonists
IV corticosteroids

motion sickness

Meclizine
aka Bonamine

H1 Antihistaminic agent
prevention of motion sickeness and treatment of vertigo due to labyrinth dysfunction

antiemetic agent

naturally occuring hydrated magnesium aluminum silicate

used as antidiarrheal agent

Kaolin
attapulgite

colloidal bismuth compounds anti diarrheal
kaolin and pectin

acts as absorbent bacterial toxins thus decrease stool liquidity and number of nonselective absorption

bulk forming laxatives (4)

psyllium
bran
methylcellulose
polycarbophil

absord water bulky emollient gel
promotes peristalsis

AD increased bloating and flatus

osmotic laxatives(3 class)

non absobable sugar or salts ( saline laxatives, magnesium hydroxide, magnesium sulfate, sorbitol)

nondigestible sugars and alcohol
(magnesium citrate, sodium phosphate, lactulose)

balanced polyethylene glycol PEG LAVAGE

stool surfactant or softeners (3)

docusate glycerinsuppository mineral oil

T OR F PPIs inhibit both fasting and meal stimulatd acid secretion

True because they block the common pathway of acid section, proto pump

T OR F histamin receptor antagonist provide prolonged 24hours suppressiom of acid secretion

H2 receptor antagonist used for peptic ulcer disease cimetidine, ranitidine, famotidine and nizatidine undergo first pass hepatic metab suppress basal and meal stimulated acid secretion in linear dose dependent manner 6-10 hours

T OR F antacids neutralize gastic acid up to 10 hours

antacids acts rapidly only 1-2 hours

T OR F PPIs provide rapid 1-2nours of neutralizationod gastric acid

short serum half life 1.5 hours but acid inhibition lasts up to 24hours owing to irreversible inactivation of proton pump

mucosal protective agents

sucralfate prostaglandin analogs ( misoprisol) bismuth (bismuth subsalicylate and bismuth subcitrate)

this drug forms a viscous tenacious paste that binds selectively to ulcers

sucralfate mucosal protctive agents agaist PUD less than 3% of intact drug and aluminum absorbed from intestinal tract AD constipation

long term us of cimetidine may cause

mental status change gynecomastia galactorrhea an h2 receptor antagonist has effects on the adrenals and endocrine system

advantage of loperamide over diphenoxylate

no potential for addiction | doesnt cross BBB

5 ASA delivered to rectum and sigmoid by enema

Rowasa

5 ASA delivered to rectum and sigmoid by suppository

Canasa

pregnant patient | cramping abdominal pain

Misoprostol

almunium hydroxide containing antacid

constipation