Drugs Flashcards by Ilana Green

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

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Sucralfate

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

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Bismuth

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

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Misoprostol

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

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Cimetidine

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

Inhibits cytochrome p450, drug interactions

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Ranitidine

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

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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

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Metoclopramide

Prokinetic agent, dopamine antagonist

Increases LES pressure, increases intestinal peristalsis

Can cause hyperprolactemia (breast enlargement etc…)

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Erythromycin

Prokinetic agent, motillin receptor agonist

Has many drug reactions and should not use > 4 weeks

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Domperidone

Prokinetic agent, dopamine antagonist

Does not penetrate CNS, increased risk of cardiac arrhythmias

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Lubiprostone

IBS medication, chloride channel activator to treat constipation

Side effects include nausea and diarrhea

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Alosetron

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

Inhibits motility and decreases pain

Serious side effect is ischemic colitis

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Linaclotide

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

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Refaximin

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

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Methylcellulose

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

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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