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Foundations of Biomedical Science > Gastrointestinal Drugs > Flashcards

Gastrointestinal Drugs Flashcards

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1
Q

What class of drug is Omeprazole (Losec)?

A

Proton pump inhibitor

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2
Q

What class of drug is Esomeprazole (Nexium)?

A

Proton pump inhibitor

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3
Q

What class of drug is Pantoprazole (Somac)?

A

Proton pump inhibitor

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4
Q

What class of drug is Rabeprazole (Pariet)?

A

Proton pump inhibitor

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5
Q

What class of drug is Ranitidine (Zantac)?

A

H2 receptor antagonist

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6
Q

What class of drug is Magnesium hydroxide (Mylanta/Milk of magnesia)?

A

Antacid

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7
Q

What class of drug is Misoprostol (Cytotec)?

A

Prostaglandin analogue

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8
Q

What class of drug is Hyoscine butylbromide (Buscopan)?

A

Anticholinergic (anti-muscarinic)

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9
Q

What class of drug is Mebeverine (Colofac)?

A

Spasmolytic

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10
Q

What class of drug is Bisacodyl (Bisalax)?

A

Stimulant laxative

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11
Q

What class of drug is Hysoscine hydrobromide (Kwells tablets/Travacalm)?

A

Anticholinergic (anti-muscarinic)

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12
Q

What class of drug is Metoclopramide (Maxolon)?

A

Dopamine receptor antagonist/ 5-HT3 receptor antagonist

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13
Q

What class of drug is Ondansetron (Zofran)?

A

5-HT3 receptor antagonist

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14
Q

What class of drug is Docusate (Coloxyl)?

A

Laxative (stool softener)

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15
Q

What class of drug is Loperamide (Imodium)?

A

Opioid antidiarrhoeal

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16
Q

What class of drug is Simethicone (De-Gas)?

A

Anti-foaming agent

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17
Q

What class of drug is Orlistat (Xenical)?

A

Anti-obesity drug

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18
Q

What class of drug is Phentermine (Duromine)?

A

Anti-obesity drug

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19
Q

What is the mechanism of action of Omeprazole (Losec)?

A

Irreversibly inactivates the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated and basal acid secretion

When PPIs are stopped, acid secretion is restored by synthesis of new hydrogen/potassium ATPase

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20
Q

What is the mechanism of action of Esomeprazole (Nexium)?

A

Irreversibly inactivates the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated and basal acid secretion

When PPIs are stopped, acid secretion is restored by synthesis of new hydrogen/potassium ATPase

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21
Q

What is the mechanism of action of Pantoprazole (Somac)?

A

Irreversibly inactivates the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated and basal acid secretion

When PPIs are stopped, acid secretion is restored by synthesis of new hydrogen/potassium ATPase

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22
Q

What is the mechanism of action of Rabeprazole (Pariet)?

A

Irreversibly inactivates the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated and basal acid secretion

When PPIs are stopped, acid secretion is restored by synthesis of new hydrogen/potassium ATPase

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23
Q

What is the mechanism of action of Ranitidine (Zantac)?

A

Competitively blocks H2 receptors on parietal cells, reducing gastric acid secretion

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24
Q

What is the mechanism of action of Magnesium hydroxide (Mylanta/Milk of magnesia)?

A

Neutralises or reduces gastric acidity, resulting in an increase in the pH of the stomach and duodenal bulb and inhibition of the proteolytic activity of pepsin

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25
Q

What is the mechanism of action of Misoprostol (Cytotec)?

A

Prostaglandin E1 analogue that protects GI mucosa by increasing the secretion of mucus in the stomach and stimulating bicarbonate secretion in the duodenum

Inhibits basal and stimulated acid secretion by a direct action on gastric parietal cells

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26
Q

What is the mechanism of action of Hyoscine butylbromide (Buscopan)?

A

Smooth muscle relaxant; reduces GI motility and spasm

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27
Q

What is the mechanism of action of Mebeverine (Colofac)?

A

Direct acting smooth muscle relaxant; reduces GI motility and spasm

No anticholinergic effects

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28
Q

What is the mechanism of action of Bisacodyl (Bisalax)?

A

Acts by direct stimulation of nerve endings in colonic mucosa to increase intestinal motility

May also cause accumulation of water and electrolytes in the colonic lumen

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29
Q

What is the mechanism of action of Hysoscine hydrobromide (Kwells tablets/Travacalm)?

A

Acts as a competitive antagonist at muscarinic acetylcholine receptors, specifically M1 receptors

30
Q

What is the mechanism of action of Metoclopramide (Maxolon)?

A

The antiemetic action of metoclopramide is due to its antagonist activity at D2 receptors in the CTZ (chemoreceptor trigger zone) — this action prevents nausea and vomiting triggered by most stimuli

At higher doses, 5-HT3 antagonist activity may also contribute to the antiemetic effect

At increased doses, it acts on 5-HT3 and 5-HT4 receptors in the gut as a pro-motility drug to stimulate gastric emptying

However, as it is selective for the upper GIT, it does not cause diarrhoea

31
Q

What is the mechanism of action of Ondansetron (Zofran)?

A

Central and peripheral 5HT3 receptor blockade

Acts on both CTZ (chemoreceptor trigger zone) and in GIT

32
Q

What is the mechanism of action of Docusate (Coloxyl)?

A

Softens stool by assisting mixture of water into faeces

May also increase intestinal fluid secretion

33
Q

What is the mechanism of action of Loperamide (Imodium)?

A

Opioid-receptor agonist which acts on the μ-opioid receptors in the myenteric plexus of the large intestine; by itself it does not affect the CNS

It works similarly to morphine, by decreasing the activity of the myenteric plexus, which in turn decreases the tone of the longitudinal and circular smooth muscles of the intestinal wall. This increases the amount of time substances stay in the intestine, allowing for more water to be absorbed out of the faecal matter

Loperamide also decreases colonic mass movements and suppresses the gastrocolic reflex

34
Q

What is the mechanism of action of Simethicone (De-Gas)?

A

Anti-foaming agent that decreases the surface tension of gas bubbles, causing them to combine into larger bubbles in the stomach that can be passed more easily

Simethicone does not reduce or prevent the formation of gas in the digestive tract, rather, it increases the rate at which it exits the body

However, simethicone can relieve pain caused by gas in the intestines by decreasing foaming, which then allows for easier passing of flatulence

35
Q

What is the mechanism of action of Orlistat (Xenical)?

A

Inhibits GI lipases, preventing absorption of approximately 30% of dietary fat

36
Q

What is the mechanism of action of Phentermine (Duromine)?

A

Sympathomimetic with CNS stimulatory effects, increasing energy expenditure.

Increases NA (mainly), dopamine and 5-HT available to bind to receptors

37
Q

What are the side effects of Omeprazole (Losec)?

A
  • Headache
  • Nausea
  • Vomiting
  • Diarrhoea
  • Abdominal pain
  • Constipation
  • Flatulence
38
Q

What are the side effects of Esomeprazole (Nexium)?

A
  • Headache
  • Nausea
  • Vomiting
  • Diarrhoea
  • Abdominal pain
  • Constipation
  • Flatulence
39
Q

What are the side effects of Pantoprazole (Somac)?

A
  • Headache
  • Nausea
  • Vomiting
  • Diarrhoea
  • Abdominal pain
  • Constipation
  • Flatulence
40
Q

What are the side effects of Rabeprazole (Pariet)?

A
  • Headache
  • Nausea
  • Vomiting
  • Diarrhoea
  • Abdominal pain
  • Constipation
  • Flatulence
  • Rhinitis
  • Pharyngitis
  • Cough
41
Q

What are the side effects of Ranitidine (Zantac)?

A
  • Bradyarrhythmia (following rapid IV administration)
  • Hypotension
  • Headache
  • Tiredness
  • Dizziness
  • Confusion
42
Q

What are the side effects of Magnesium hydroxide (Mylanta/Milk of magnesia)?

A
  • Dizziness
  • Fainting
  • Sweating
  • Diarrhoea
  • Nausea
  • Perianal irritation
  • Hypermagnesia
43
Q

What are the side effects of Misoprostol (Cytotec)?

A
  • Diarrhoea
  • Abdominal pain
  • Nausea
  • Flatulence
  • Dyspepsia
  • Vomiting
  • Rash
  • Headache
  • Dizziness
  • Constipation
  • Uterine cramps
  • Heavy uterine bleeding
  • Intermenstrual bleeding
44
Q

What are the side effects of Hyoscine butylbromide (Buscopan)?

A
  • Dry mouth
  • Tachycardia
  • Reduced sweating
  • Rash
  • Itching
  • Redness of skin
  • Dysuria
45
Q

What are the side effects of Mebeverine (Colofac)?

A
  • Dyspepsia
  • Anorexia
  • Constipation
  • Dizziness
  • Insomnia
  • Headache
  • Bradycardia
  • Malaise
  • Allergic reactions
46
Q

What are the side effects of Bisacodyl (Bisalax)?

A
  • Rectal irritation
  • Proctitis
  • Diarrhoea
  • Fluid and electrolyte imbalance
  • Abdominal discomfort
  • Cramps
  • Nausea
47
Q

What are the side effects of Hysoscine hydrobromide (Kwells tablets/Travacalm)?

A
  • Dry mouth
  • Dyshidrosis (inability to sweat)
  • Tachycardia
  • Bradycardia (at higher doses)
  • Urticaria
  • Pruritis
  • Constipation
48
Q

What are the side effects of Metoclopramide (Maxolon)?

A
  • Akathisia (feeling of restlessness)
  • Drowsiness
  • Dizziness
  • Headache
  • Tardive dyskinesia
49
Q

What are the side effects of Ondansetron (Zofran)?

A
  • Constipation
  • Headache
  • Dizziness
  • Transient rise in hepatic aminotransferases
  • Transient visual disturbances
50
Q

What are the side effects of Docusate (Coloxyl)?

A
  • Abdominal cramps
  • Diarrhoea
  • Nausea
  • Rash
51
Q

What are the side effects of Loperamide (Imodium)?

A
  • Abdominal pain and bloating
  • Nausea
  • Vomiting
  • Constipation
  • Paralytic ileus (bowel obstruction)
  • Dizziness
  • Rash
52
Q

What are the side effects of Simethicone (De-Gas)?

A
  • Mild diarrhoea
  • Nausea
  • Regurgitation
  • Vomiting
53
Q

What are the side effects of Orlistat (Xenical)?

A
  • Flatus
  • Steatorrhoea
  • Faecal urgency/incontinence
  • Headache
  • Fatigue
  • Hepatitis
  • Pancreatitis
54
Q

What are the side effects of Phentermine (Duromine)?

A
  • Insomnia
  • Restlessness
  • Nervousness
  • Euphoria
  • Agitation
  • Arrhythmia
  • Tachycardia
  • Hypertension
  • Diarrhoea
  • Vomiting
  • Headache
  • Rash
  • Urinary frequency
  • Facial oedema
  • Unpleasant taste
  • Urticaria
  • Impotence
55
Q

What are the indications for use of Omeprazole (Losec)?

A

Administration: oral tablet, capsule, injection (IV)

  • PUD
  • GORD
  • Zollinger-Ellison syndrome
  • H. pylori eradication
  • Treatment and prevention of peptic ulcer and erosion associated with NSAIDs

Contraindications: Gastric carcinoma

56
Q

What are the indications for use of Esomeprazole (Nexium)?

A

Administration: oral tablet, capsule, injection (IV)

  • GORD
  • Zollinger-Ellison syndrome
  • H. pylori eradication
  • Treatment and prevention of peptic ulcer and erosion associated with NSAIDs
  • Prevention of peptic ulcer rebleeding
  • Combination treatment with high-dose NSAID (e.g. rheumatoid arthritis)

Contraindications: Gastric carcinoma

57
Q

What are the indications for use of Pantoprazole (Somac)?

A

Administration: oral tablet, granule, injection (IV)

  • PUD
  • GORD
  • Zollinger-Ellison syndrome
  • H. pylori eradication
  • Prevention of dyspepsia, peptic ulcer and erosions associated with NSAIDs in people at increased risk who need continuous nonselective NSAID treatment

Contraindications:

Gastric carcinoma

58
Q

What are the indications for use of Rabeprazole (Pariet)?

A

Administration: oral tablet

  • PUD
  • GORD
  • H. pylori eradication

Contraindications: Gastric carcinoma

59
Q

What are the indications for use of Ranitidine (Zantac)?

A

Administration: oral tablet, liquid, injection (IV)

  • PUD
  • GORD
  • Dyspepsia

Contraindications:

Sodium-restricted diets

Phenylketonuria (PKU)

60
Q

What are the indications for use of Magnesium hydroxide (Mylanta/Milk of magnesia)?

A

Administration: oral tablet, powder

  • Indigestion
  • GORD
  • Constipation
61
Q

What are the indications for use of Misoprostol (Cytotec)?

A

Administration: oral tablet

  • PUD
  • Prevention of NSAID-induced ulcers
  • Termination of second trimester pregnancy

Contraindications:

Cerebrovascular or coronary artery disease
Predisposition to diarrhoea or dehydration

Pregnancy

62
Q

What are the indications for use of Hyoscine butylbromide (Buscopan)?

A

Administration: oral tablet, IV, IM

  • GI spasm
  • Renal and biliary spasm
  • Aid in GI radiology or endoscopy
  • Irritable bowel syndrome

Contraindications:

Children < 6 years old
Glaucoma
Achalasia

Prostatic hypertrophy

63
Q

What are the indications for use of Mebeverine (Colofac)?

A

Administration: oral tablet

  • Irritable bowel syndrome (IBS)

Contraindications:

Angina
Lactose intolerance

64
Q

What are the indications for use of Bisacodyl (Bisalax)?

A

Administration: oral tablet, suppository

  • Constipation
  • Bowel preparation

Contraindications:

Intestinal obstruction
Acute abdominal conditions (e.g. appendicitis)
Inflammatory bowel condition
Dehydration, hypokalaemia

65
Q

What are the indications for use of Hysoscine hydrobromide (Kwells tablets/Travacalm)?

A

Administration: oral tablet, injection

  • Motion sickness
  • Premedication to dry excess respiratory tract secretion (injection)
  • Diarrhoea
66
Q

What are the indications for use of Metoclopramide (Maxolon)?

A

Administration: oral tablet, IV, IM

  • Nausea and vomiting
  • Gastric stasis
  • Difficult small intestinal intubation
  • Migraine with nausea and vomiting (with paracetamol)

Contraindications:

Phaeochromocytoma
Parkinson’s disease
Depression

Children

67
Q

What are the indications for use of Ondansetron (Zofran)?

A

Administration: oral tablet, IV, IM

  • Nausea and vomiting

Contraindications:

Phenylketonuria

68
Q

What are the indications for use of Docusate (Coloxyl)?

A

Administration: oral tablet

  • Constipation
  • Prevent straining following rectal surgery and acute perianal disease

Take tablets with plenty of fluid.

69
Q

What are the indications for use of Loperamide (Imodium)?

A

Administration: oral tablet, capsule

  • Diarrhoea
  • Intestinal stoma (to reduce frequency and fluidity of motions)

Contraindications:

Phenylketonuria (PKU)
Children (unless for chronic diarrhoea)
Dysentery
Hepatic impairment

70
Q

What are the indications for use of Simethicone (De-Gas)?

A

Administration: oral capsule

  • Flatulence
  • Functional gastric bloating
  • Post-operative gas pain
71
Q

What are the indications for use of Orlistat (Xenical)?

A

Administration: oral capsule

  • Adjunct to lifestyle modification in obese adults

Contraindications:

Vitamin deficiency
Pancreatic enzyme deficiency states
Major GI surgery
Malabsorption syndrome
Cholestasis
Pregnancy

Must be combined with low-fat diet. Fat-soluble vitamin supplementation (D and E) is recommended due to lack of absorption.

72
Q

What are the indications for use of Phentermine (Duromine)?

A

Administration: oral capsule

  • Adjunct to lifestyle modification in obese adults

Contraindications:

Hyperthyroidism
Peptic ulcer
History of drug misuse
Prostatic hypertrophy
Epilepsy
Cardiac disease
Elderly patients
Pregnancy

Can only be used for 3 weeks due to development of tolerance. Cannot be combined with other weight loss drugs or antidepressants (MAO inhibitors) due to excessive catecholamine release.

Foundations of Biomedical Science (9 decks)

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