Drugs Flashcards
Al(OH)3 & Mg(OH)2
Antacids, act in lumen to increase pH
Excess Al can lead to constipation
CaCO3 becoming more popular because fewer side effects
Sucralfate
Protective agent, acts on mucosal surface by polymerizing and covering up ulcer
Bismuth
Protective agent, retards H+ diffusion to mucosa, “pepto-bismol”
Misoprostol
Protective agent, antagonizes adenylyl cyclase, stimulates uterine contractions (contraindicated for pregnancy)
Cimetidine
H2 antagonist, acts at receptors on basolateral surface of parietal cells
Inhibits cytochrome p450, drug interactions
Ranitidine
H2 antagonist, acts at receptors on basolateral surface of parietal cells
Omeprazole
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
Metoclopramide
Prokinetic agent, dopamine antagonist
Increases LES pressure, increases intestinal peristalsis
Can cause hyperprolactemia (breast enlargement etc…)
Erythromycin
Prokinetic agent, motillin receptor agonist
Has many drug reactions and should not use > 4 weeks
Domperidone
Prokinetic agent, dopamine antagonist
Does not penetrate CNS, increased risk of cardiac arrhythmias
Lubiprostone
IBS medication, chloride channel activator to treat constipation
Side effects include nausea and diarrhea
Alosetron
IBS medication, 5HT3 selective antagonist (anti-diarrhea)
Inhibits motility and decreases pain
Serious side effect is ischemic colitis
Linaclotide
IBS medication, guanylate cyclase agonist (increase cGMP, more ions into lumen) to treat constipation
Refaximin
IBS medication, poorly absorbed antibiotic that helps reduce diarrhea and pain
Methylcellulose
Laxative (stool softener), undigested fibers that add mass and absorbed water to soften stool
Psyllium
Laxative (stool softener), undigested fibers/polymers that add mass and absorbed water to soften stool
Polyethylene glycol
Laxative (miralax), poorly absorbed so water flows out of human due to osmotic gradient
Osmotic laxative
MgSO4 and MgCitrate
Laxative, poorly absorbed so water flows out of human due to osmotic gradient
Osmotic laxative
Bisacodyl
Laxative, promotes accumulation of fluid and electrolytes in lumen and reduces tone of circular muscle
Stimulant laxative
Senna
Laxative, promotes accumulation of fluid and electrolytes in lumen and reduces tone of circular muscle
Stimulant laxative
Castor oil
Laxative, promotes accumulation of fluid and electrolytes in lumen and reduces tone of circular muscle
Stimulant laxative
Loperamide
Anti-diarrheal, increases tone of smooth muscle and segmenting contractions
Diphenoxylate/Atropine
Anti-diarrheal, opioid that reduces peristalsis and intestinal contractions
Too much could induce CNS effects so paired with atropine
Alvimopan
Mu opioid receptor antagonist, prokinetic effect to treat post-op ileus
Methylnaltrexone
Mu opioid receptor antagonist, prokinetic effect to treat opioid-induced constipation
Mesalamine
Aminosalicylate (5-ASA), first line therapy for IBD treatment to prevent relapse
Anti-inflammatory but mechanism unknown, safe in pregnancy, some concern about nephrotoxicity
Sulfasalazine
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)
Olsalazine
Aminosalicylate (5-ASA), first line therapy for IBD treatment to prevent relapse
Anti-inflammatory but mechanism unknown, diarrhea can be side effect
Budesonide
Immunosuppressive agent less potent than prednisone. Does not work as well as prednisone. Effective in acute plains of IBD.
Azathioprine
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.
Mercaptopurine
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.
Methotrexate
Immunomodulator. Inhibits dihydrofolate reductase. Reserved for steroid resistant/dependent IBS (works better with Crohn’s than UC)
Side effects: myelosuppression, lung/liver fibrosis, teratogenic
Infliximab
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…
Adalimumab
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…
Certolizumab pegol
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…
Natalizumab
Anti-integrin (alpha 4) antibody, blocks leukocyte migration out of blood vessels
Risk of PML via activation of JC virus (so not longer used)
Vedolizumab
Anti-integrin (alpha4B7) antibody, blocks leukocyte migration into GI sites
Ustekinumab
Anti-IL12/23 antibody, only approved for Crohn’s so far, very recently approved
