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GI Pharm > Anti-inflammatory Drugs > Flashcards

Anti-inflammatory Drugs Flashcards

1
Q

Imodium: class

A

Antidiarrheal

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2
Q

Imodium: MOA

A

Inhibits preganglion cholinergic nerves in colon submucosa and myenteric plexus, slowing transit time

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3
Q

Imodium: indication

A

Mild to moderate diarrhea without obstruction

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4
Q

Does Imodium cross the blood brain barrier?

A

Nope

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5
Q

Kaopectolin: class

A

Antidiarrheal

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6
Q

Kaopectolin: MOA

A

Clay and pectin combo absorb fluids and bacterial toxins

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7
Q

Kaopectolin: indication

A

Mild diarrhea

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8
Q

Kaopectolin: Dx-Dx

A

Can absorb meds and decrease their concentration

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9
Q

Fiber: class

A

Antidiarrheal

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10
Q

Fiber: MOA

A

Absorbs and binds fluids, provides stool bulk

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11
Q

Fiber: indication

A

mild to moderate diarrhea, constipation

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12
Q

Fiber: Dx-Dx

A

Can bind to meds/vitamins/minerals

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13
Q

Bismuth subsalicylate: class

A

Antidiarrheal

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14
Q

Bismuth subsalicylate: MOA

A 
Salicylate = antisecretory
Bismuth = antimicrobial
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15
Q

Bismuth subsalicylate: indication

A

Mild, unspecific diarrhea, traveler’s diarrhea, part of the H. pylori regimen

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16
Q

Bismuth subsalicylate: side effect

A

Discolored stool

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17
Q

Bismuth subsalicylate: contraindications

A

Pregnancy

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18
Q

Octreotide: class

A

Antidiarrheal

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19
Q

Octreotide: MOA

A

Inhibits bowel secretions; dose-related impact on motility; splanchnic arteriole contraction

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20
Q

Octreotide: indication

A

Diarrhea secondary to bowel dysmotility, carcinoid, VIP-oma, vagotomy, dumping syndrome, short bowel syndrome, HIV diarrhea; GI bleeds

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21
Q

Octreotide: side effect

A

Steatorhea, gallstones (>50% in long term use)

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22
Q

Octreotide: contraindications

A

Bowel obstruction

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23
Q

Octreotide: Dx-Dx

A

Insulin, PO hypoglycemics, BBs, CBs

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24
Q

Senokot: class

A

Antidiarrheal

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25
Q

Senokot: MOA

A

Induces mild inflamation, fluid retention, stimulated bowel motility

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26
Q

Senokot: indication

A

Constipation without obstruction

(then why is it an antidiarrheal???)

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27
Q

Mesalamine: class

A

5ASA anti-inflammatory

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28
Q

Mesalamine: MOA

A

Local colon anti-inflammatory

Systemic prostaglandin inhibition

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29
Q

Mesalamine: indication

A

Ulcerative colitis, proctosigmoiditis

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30
Q

Mesalamine: Dx-Dx

A

Inhibits folate absorption, so you need to supplement it.

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31
Q

Sulfasalazine: class

A

5ASA anti-inflammatory

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32
Q

Sulfasalazine: MOA

A

Local colon anti-inflammation

Systemic prostaglandin inhibition

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33
Q

Sulfasalazine: indication

A

Ulcerative colitis, Crohn’s disease

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34
Q

Sulfasalazine: contraindication

A

G6PD deficiency

35
Q

Sulfasalazine: Dx-Dx

A

Inhibits folate absorption

36
Q

What is so neat baout the pharmycokinetics of sulfasalazine?

I think it’s neat…but I’m a nerd

A

Colonic bacteria cleave away the sulapyridine and release the active 5ASA to do it’s thing in the colon.

(I think that’s clever!)

37
Q

Azathioprine: class

A

Purine analogue

38
Q

Azathiprine: MOA

A

Inhibits DNA/RNA/Protein synthesis

39
Q

Azathioprine: indication

A

Steroid sparing in steroid dependent CD, UC

Helps maintain remission

40
Q

Azathioprine: Dx-Dx

A

Use with 5ASA increases the risk of myelosuppression

41
Q

MTX:

A

How I’ve missed thee

42
Q

MTX: class

A

Purine analogue

43
Q

MTX: MOA

A

Inhibits protein synthesis and IL-1; increases release of adenosine

44
Q

MTX: indication

A

CD, UC

45
Q

What is important to know about MTX dosing?

A

Use lower doses for CD and for fewer side effects

46
Q

Remicade: class

A

TNFa compound

47
Q

Remicade: MOA

A

Decreased T-helper 1 cell activation & proliferation;
Decrease IL-12 and leukocyte migration;
Increase apoptosis in activated cells

48
Q

Remicade: indication

A

Acute and maintenance Tx for severe CD, UC

49
Q

Remicade: side effects

A

TB activation; HBV reactivation

50
Q

Remicade: CD statistics

A

60% see sxs improvement; 30% see remission

51
Q

Remicade: UC statistics

A

50-70% see sxs improvement; 33% see remission

52
Q

Actigall: class

A

Gallstone dissolution agent

53
Q

Actigall: MOA

A

Reduces hepatic secretion of cholesterol

54
Q

Actigall: indication

A

Gallstones
Gallstone prevention in rapid wt loss
Primary biliary cirrhosis

55
Q

Actigall: side effects

A

H/A, diarrhea

56
Q

Actigall: what’s the down side?

A

Dissolution takes months and the risk of recurrence is ~50%

57
Q

Amitiza: class

A

Ca++ channel activator laxative

58
Q

Amitiza: MOA

A

Activated Ca++ channels increase bowel secretions and motility

59
Q

Amitiza: indication

A

Chronic idiopathic constipation
IBS constipation
Opioid constipation

60
Q

Amitiza: side effect

A

Peripheral edema

***As a side note, you may remember that CCBs also cause peripheral edema. This just proves that pharmacology is black magic.

61
Q

How do you take Amitiza?

A

With food

62
Q

Linzess: class

A

cGMP agonist laxative

63
Q

Linzess: MOA

A

Agonizes cGMP on bowel luminal surface, resulting in increased bowel secretions and motility

64
Q

Linzess: indication

A

IBS-C in adults who did not respond to PEG; chronic idiopathic constipation in adults

65
Q

Linzess: contraindication

A
66
Q

What has to go along with an Rx for Linzess?

A

FDA med guide

67
Q

How do you take Linzess?

A

30 minutes before meals on an empty stomach

68
Q

MiraLax: class

A

Osmotic laxative

69
Q

MiraLax: moa

A

Causes H2O secretion in stool and increases stool frequenct

70
Q

MiraLax: indication

A

Occasional constipation

short term use only

71
Q

MiraLax: side effect

A

Electrolyte imbalance

72
Q

MiraLax: contraindication

A

Bowel obstruction

73
Q

Lactulose: class

A

Osmotic laxative

74
Q

Lactulose: MOA

A

Synthetic saccharide increases osmosis;

enhances secretion on NH3 into gut - then converts it to NH4 which cannot cross back

75
Q

Lactulose: indication

A

Px and Tx of PSE

76
Q

What dietary consideration need to be made on Lactulose?

A

Need a diet low in galactose

77
Q

MgCitrate: class

A

Mg++ laxative

78
Q

MgCitrate: MOA

A

Osmotic retention of bowel fluid distends colon and increases peristalsis

79
Q

MgCitrate: indication

A

Occasional constipation; study prep

80
Q

MgCitrate: contrindication

A

Low salt diet

81
Q

Your Pt is going to call you and complain if you don’t tel them this…

A

Chilling it makes it more palatable

82
Q

Natalizumab: class

A

Anti-integrin

83
Q

Natalizumab: MOA

A

Inhibits intergrins on leukocyte surfaces;

Inhibits their adhesion to vascular endothelium and migration into tissues

84
Q

Natalizumab: indication

A

Severe, refractory CD

GI Pharm (5 decks)

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