Drugs Employed in GI Disease 2

Question 1

lifestyle measures to prevent GERD

Answer 1

elevation of the hrad of the bed, avoidance of food/drink 2-3 hours before bedtime. avoidance of fatty or spicy foods. avoidance of cigs/booze. weight loss. liquid antacid. pregnancy.

Question 2

what do you give if there are persistent GERD symptoms?

Answer 2

alginic acid antacids, promotility drugs, H2 receptor blockers

Question 3

what do you give if non-response or relapse or Barrett’s esophagus?

Answer 3

H2 receptor blockers regular or double dose, or H2 blocker + promotility agent, or Proton pump inhibitors, or antireflux surgery

Question 4

metochlopramide

Answer 4

promotility drug. peripheral dopamine antagonist. increases peristalsis. tightens lower esophogeal sphincter. can cause tremor

Question 5

cisapride

Answer 5

cant be prescribed due to sudden cardiac death. increases peristalsis. tightens lower esophogeal sphincter.

Question 6

treatment goals for vomiting

Answer 6

reverse underlying local problems causing gastric irritation, treat or eliminate the problems causing CNS stimulation, treat pain

Question 7

prochlorperazine

Answer 7

phenothiazine antiemetic. CNS interaction with dopaminergic receptor. antagonist. can cause torticollis.

Question 8

promethazine

Answer 8

phenothiazine antiemetic. antihistaminic, anticholinergic, causes somnolence in old people

Question 9

trimethobenzamide

Answer 9

benzamide antiemetic. unknown effect on CRTZ. used in kids.

Question 10

metochlopramide

Answer 10

benzamide antiemetic. used in cancer chemo patients. CNS and peripheral dopaminergic receptor antagonism.

Question 11

THC

Answer 11

suppresses CRTZ by probable anticholinergic mechanism

Question 12

ondansetron

Answer 12

serotonin receptor antagonist.

Question 13

what 2 serotonin receptor antagonists are used in anesthesia related vomiting?

Answer 13

granesitron, dolasetron.

Question 14

treatment of gastroparesis

Answer 14

promotility drugs. can also put a pacemaker in to stimulate paristalsis

Question 15

treatment goals of diarrhea

Answer 15

prolong GI transit time. reduce cramps. try to minimize systemic side effects.

Question 16

anticholinergics used to stop diarrhea

Answer 16

atropine sulfate. relaxes all bowel smooth muscle

Question 17

opioid agonists to stop diarrhea

Answer 17

interact with mu or sigma receptors in GI tract. loperamide, diphenoxylate. dont give diphenox to kids. loperamide is super safe. these drugs contract the gut.

Question 18

colloids and pectins for diarrhea

Answer 18

metamucil (colloid)
kaopectate (pectin)
absorb water.

Question 19

irritants or stimulants for constipation

Answer 19

irritate colon and cause peristalsis

castor oil, cascara sagrada, senna extract, bisacodyl, phenolphthalein.

Question 20

osmotic cathartics for constipation

Answer 20

magnesium citrate, magnesium sulfate, sodium sulfate, milk of magnesia, sodium phosphate, lactulose

Question 21

bulk forming hydrophilic colloids for constipation

Answer 21

psyllium seed. methycellulose. sodium carboxymthyl cellulose

Question 22

lubricant and fecal softeners for constipation

Answer 22

mineral oil. dioctyl sodium sulfo-succinate. poloxalkol.

Question 23

amitizia

Answer 23

for constipation. chloride channel activator

Question 24

linzess

Answer 24

for constipation. stimulates cGMP and results in chloride and bicarb secretion

Question 25

naloxegol

Answer 25

for constipation. mu opioid receptor antagonist. used in opioid constipation

Question 26

anti-inflammatories for IBD

Answer 26

mesalamine, sulfasalazine, olsalazine.

Question 27

immunosuppressive agents for IBD

Answer 27

azathioprine. corticosteroids. methotrexate. biologics. cyclosporine

Question 28

IBS-C vs IBS D treatments

Answer 28

bulk forming agents, opioids (IBS-D), cathartics (osmotic IBS-C), anticholinergics, antidepresents, serotonergic antagonists, serotonergic agonists.