Clinical 6.1 Drugs for the bowel Flashcards
What drugs can you use to decrease gastric secretions and give an example of each
PPI: omeprazole
H2 receptor antagonists: ranitadine
Antacids: Magnesium and aluminium salts, NaHCO3, Calcium salts, Alginate
What do you have to be careful with when giving H2 receptor antagonists?
drug interactions with cimetidine
What are the side effects of PPIs and what do you have to be careful of?
Generally well tolerated but can ave nausea, vomiting, diarrhoea and constipation
May increase the risk of C.difficile
How do PPIs have a long lasting effect with a short t1/2?
They are a suicide inhibitor - consume and destroy so the duration of effect relates to the ability of regeneration of the enzymes
What is the treatment for H.pylori infection
triple therapy of PPI and two antibiotics (clarithromycin and amoxicillin)
What are the drugs that protect the mucosa and how do they work?
Sucralfate (forms a protective barrier at ulcer site)
Misoprostol (prostaglandin E1 analogue which stimulates secretion of gastric mucus and HCO3 in the duodenum)
What type and give an example of drugs for motion sickness and gastric irritants
H1 antagonists: promethazine (morning sickness too)
M antagonist: scopolamine
What type and give an example of drugs for post operative vomiting
D2 antagonists: Phenothiazines and metoclopramide
What type and give an example of drugs for chemotherapy and radiotherapy vomiting
5-HT3 antagonists: ondansatron
NK-1 antagonists: Aprepitant
How can you minimise constipation with opioid use and give an example?
Use an opioid receptor antagonist for example oxycodone with naloxone
What is an example of an anti diarrhoeal drug and how does it work?
Loperamide (immodium) and codeine which are opioid receptor antagonists
What drug classes can be used to UC and Chron’s and give examples
5-aminosalicylic acid derivatives: sulfasalazine
Immunosuppressants: Azathioprine
Glucocorticoids: Prednisolone
TNF-a antagonists: Ifliximab
How does sulfasalazine work?
activates PPAR-gamma which decreases inflammation in local bowel mucosa
What kind of drug is infliximab?
Monoclonal IgG