Drugs used for constipation and diarrhea. Drugs promoting digestion Flashcards

1
Q

List the types of laxatives

A
Bulk laxatives
Osmotic laxatives
Bowel irritants
Stool softeners
Anti-opioid laxatives
Chloride channel activators

Salt/osmotic laxatives:
MgSO4, NA2SO4
Lactulose
Glycerol

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2
Q

Bulk laxatives

A

Bulk laxatives:
Fiber, methylcellulose

Take 1-3 days to work

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3
Q

Osmotic laxatives

A

Rapid onset, 30 mins thru 3 hours

PEG plus ions used prior to colonoscopy

Magnesium hydroxide
Magnesium citrate
Sodium phosphate, bisphosphate

Mannitol
Sorbitol
Lactulose
these 3 cause significant meteorism.

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4
Q

Bowel irritants

A

Take 1-12 hours to work.

Castor oil - the harshest, can ‘cleanse whole bowel’
massive diarrhea then no poop for days

Senna oil, Rhubarb, easier
Biscacodyl

Phenolphythalein - used in hungary, high risk in pregnancy and can cause arrythmia

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5
Q

Stool softeners

A

Paraffin oil - lubricant. can be very pleasant and frequently used, leading to chronic granuloma formation in the GI.

Glycerin
Docusate

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6
Q

Anti-Opioid laxatives

A

Naloxone

Methylnaltrexone

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7
Q

Chloride channel activators

A

Lubiprostone
Lincaclotide

These are indicated for IBS induced constipation.

Enhance Cl secretion into bowel., have minimal absorption.

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8
Q

Antidiarrheal drugs classes

4

A

Opioids

Parasympatholytics

Octreotide

Absorbing Astringint materials

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9
Q

What are the antidiarrheal opioids

A

u agonist opioids
Loperamide
Diphenoxylate

Loperamide pumped out of CNS by P glycoprotein
Diphenoxylate mixed with atropine to prevent abuse and euphoric doses. Atropine also inhibits bowel motility.

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10
Q

What is octreotide used for

A

Diarrhea caused by carcinoid syndrome

its a somatostatin analog

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11
Q

What are the absorbing and astringent antidiarrheals

A

Kaolin Klay Plus Pectin

and

Bismuth subsalicylate- Peptobismol

They absorb bacterial toxins that are stimulating diarrhea, and have weak antibacterial effects.

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12
Q

What substances are used to promote digestion

A

10% HCl solution, drtank through a straw

Pancreatic enzyme replacement therapy.

Pancreatin -
A commercial mix of pancreatic enzymes, lipases, amylases, peptidases, etc. taken orally with meals.

Bitters
Similar to the irritants, promoting gastric/GI secretion and motility.

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13
Q

What are the hepatoprotective drugs

A

N-Acetylcystein – > antidote to NAPQI poisoning from paracetamol. Administered Orally, due to significant risk of anaphylaxis if given i.v.
Regenerates glutathione

Silbinine - Antioxidant that is used with minimal helpfulness in amanita phalloides poisoning. amanatin inhibits RNA pol.

Vitamin B supplements

Antioxidants

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14
Q

What are the sources of hepatotoxicity

A
Halothane
Paracetamol
Alcohol
All the TB drugs
Amiodarone
Methotrexate, Azathioprine
MANY drugs
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15
Q

Biliary tract pharma

A

Bile acid binding resins: Cholestyramine, Cholesevelam, Cholestipol

Can be used for hypercholesterolemia, and also to treat Diarrhea due to Small intestine resection

Ursodiol: Used as bile acid supplement in liver disease, primary biliary sclerosis, or gallstones. Out-dated treatment for gall stone dissolution, now cholecystectomy.

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