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Gastrointestinal System > Drugs > Flashcards

Drugs Flashcards

1
Q

Al(OH)3 & Mg(OH)2

A

Antacids, act in lumen to increase pH

Excess Al can lead to constipation

CaCO3 becoming more popular because fewer side effects

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2
Q

Sucralfate

A

Protective agent, acts on mucosal surface by polymerizing and covering up ulcer

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3
Q

Bismuth

A

Protective agent, retards H+ diffusion to mucosa, “pepto-bismol”

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4
Q

Misoprostol

A

Protective agent, antagonizes adenylyl cyclase, stimulates uterine contractions (contraindicated for pregnancy)

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5
Q

Cimetidine

A

H2 antagonist, acts at receptors on basolateral surface of parietal cells

Inhibits cytochrome p450, drug interactions

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6
Q

Ranitidine

A

H2 antagonist, acts at receptors on basolateral surface of parietal cells

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7
Q

Omeprazole

A

Proton pump inhibitor (prilosec)
Irreversible binds to H/K ATPase via disulfide bond

Consumed as pro-drug that is metabolized and delivered to parietal cells via bloodstream

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8
Q

Metoclopramide

A

Prokinetic agent, dopamine antagonist

Increases LES pressure, increases intestinal peristalsis

Can cause hyperprolactemia (breast enlargement etc…)

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9
Q

Erythromycin

A

Prokinetic agent, motillin receptor agonist

Has many drug reactions and should not use > 4 weeks

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10
Q

Domperidone

A

Prokinetic agent, dopamine antagonist

Does not penetrate CNS, increased risk of cardiac arrhythmias

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11
Q

Lubiprostone

A

IBS medication, chloride channel activator to treat constipation

Side effects include nausea and diarrhea

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12
Q

Alosetron

A

IBS medication, 5HT3 selective antagonist (anti-diarrhea)

Inhibits motility and decreases pain

Serious side effect is ischemic colitis

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13
Q

Linaclotide

A

IBS medication, guanylate cyclase agonist (increase cGMP, more ions into lumen) to treat constipation

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14
Q

Refaximin

A

IBS medication, poorly absorbed antibiotic that helps reduce diarrhea and pain

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15
Q

Methylcellulose

A

Laxative (stool softener), undigested fibers that add mass and absorbed water to soften stool

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16
Q

Psyllium

A

Laxative (stool softener), undigested fibers/polymers that add mass and absorbed water to soften stool

17
Q

Polyethylene glycol

A

Laxative (miralax), poorly absorbed so water flows out of human due to osmotic gradient

Osmotic laxative

18
Q

MgSO4 and MgCitrate

A

Laxative, poorly absorbed so water flows out of human due to osmotic gradient

Osmotic laxative

19
Q

Bisacodyl

A

Laxative, promotes accumulation of fluid and electrolytes in lumen and reduces tone of circular muscle

Stimulant laxative

20
Q

Senna

A

Laxative, promotes accumulation of fluid and electrolytes in lumen and reduces tone of circular muscle

Stimulant laxative

21
Q

Castor oil

A

Laxative, promotes accumulation of fluid and electrolytes in lumen and reduces tone of circular muscle

Stimulant laxative

22
Q

Loperamide

A

Anti-diarrheal, increases tone of smooth muscle and segmenting contractions

23
Q

Diphenoxylate/Atropine

A

Anti-diarrheal, opioid that reduces peristalsis and intestinal contractions

Too much could induce CNS effects so paired with atropine

24
Q

Alvimopan

A

Mu opioid receptor antagonist, prokinetic effect to treat post-op ileus

25
Q

Methylnaltrexone

A

Mu opioid receptor antagonist, prokinetic effect to treat opioid-induced constipation

26
Q

Mesalamine

A

Aminosalicylate (5-ASA), first line therapy for IBD treatment to prevent relapse

Anti-inflammatory but mechanism unknown, safe in pregnancy, some concern about nephrotoxicity

27
Q

Sulfasalazine

A

Aminosalicylate (5-ASA), first line therapy for IBD treatment to prevent relapse

Anti-inflammatory but mechanism unknown, sulfur portion responsible for some drug allergies (SJS would be bad)

28
Q

Olsalazine

A

Aminosalicylate (5-ASA), first line therapy for IBD treatment to prevent relapse

Anti-inflammatory but mechanism unknown, diarrhea can be side effect

29
Q

Budesonide

A

Immunosuppressive agent less potent than prednisone. Does not work as well as prednisone. Effective in acute plains of IBD.

30
Q

Azathioprine

A

Immunomodulator. Pro-drug for purine analog, block T-cell growth

Works for long-term management of IBD but takes 3-4 weeks to kick in. 15% of people cannot tolerate this drug.

31
Q

Mercaptopurine

A

Immunomodulator. Pro-drug for purine analog, block T-cell growth

Works for long-term management of IBD but takes 3-4 weeks to kick in. 15% of people cannot tolerate this drug.

32
Q

Methotrexate

A

Immunomodulator. Inhibits dihydrofolate reductase. Reserved for steroid resistant/dependent IBS (works better with Crohn’s than UC)

Side effects: myelosuppression, lung/liver fibrosis, teratogenic

33
Q

Infliximab

A

Chimeric monoclonal anti-TNF antibody. Neutralizes TNF alpha by binding membrane TNF alpha and lysing cells

Side effects: TB and hep B reactivation potential, infusion reactions, opportunistic infections etc…

34
Q

Adalimumab

A

Human monoclonal anti-TNF antibody. Less immunogenic than infliximab (less likely to create antibodies against it)

Side effects: TB and hep B reactivation potential, infusion reactions, opportunistic infections etc…

35
Q

Certolizumab pegol

A

Humanized Fab fragment more specific to GI tract, mostly used for Crohn’s, minimal placental transfer

Side effects: TB and hep B reactivation potential, infusion reactions, opportunistic infections etc…

36
Q

Natalizumab

A

Anti-integrin (alpha 4) antibody, blocks leukocyte migration out of blood vessels

Risk of PML via activation of JC virus (so not longer used)

37
Q

Vedolizumab

A

Anti-integrin (alpha4B7) antibody, blocks leukocyte migration into GI sites

38
Q

Ustekinumab

A

Anti-IL12/23 antibody, only approved for Crohn’s so far, very recently approved

Gastrointestinal System (5 decks)

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