GASTROINTESTINAL PHARMACOLOGY Flashcards
Neutralize stomach acid
Antacids
Magnesium hydroxide
Aluminum hydroxide
Calcium carbonate
Sodium bicarbonate
Competitve pharmacologic block of H2 receptors
H2-receptor antagonists
Cimetidine
Ranitine
Famotidine
Nizatine
H2 antagonist that causes gynecomastia
Cimetidine
H2 receptor antagonist that is a potent CYP450 inhibitor
Cimetidine
Irreversible blockade of H+/K+ATPase in active gastric parietal cells
Proton-pump inhibitor
Omeprazole
Lansoprazole
Rabeprazole
Pantoprazole
Esomeprazole
DOC for PUD
PPIs
PPI with the least drug-drug interaction
Pantoprazole
Binds to injured tissue and forms a protective covering over ulcer beds. Accelerate healing of peptic ulcers and reduces recurrence rate
Sucralfate
Activates EP receptors causing increased HCO3 and mucus secretion in stomach. Causes uterine contraction > miscarriage (abortifacient)
Misoprostol
Forms protective coating on ulcerated tissue
Stimulates mucosal protective mechanisms
Direct antimicrobial effect
Sequestrations of enterotoxin
BISMUTH SALICYLATE
Dual effect: mucosal protection and bactericidal effect on H. pylori
S/E: Black tarry stools and darkening of the tongue
Reduces stool frequency and liquidity in infectious diarrhea
Prokinetic agent that blocks the D2 receptors
Metoclopramide
Domperidone
Prokinetic agent that stimulates motilin receptors hence used in bowel prep during surgery to to increase gastric emptying and intestinal motility
Erythromycin
DOC for diabetic gastroparesis
Prokinetic agents
Metoclopramide
Domperidone
Erythromycin
Benign disorder of colonic pigmentation due to accumulation of brown lipofuscin pigments in macrophages.
Melanosis coli
D/t intake of Anthraquinone-containing laxatives (e.g., Senna)
Ingestible, hydrophilic colloids that absorb water, forming a bulky, emollient gel that distend colon and promotes peristalsis
Bulk-forming laxative
Psyllium
Methylcellulose
Polycarbophil
Maltodextrin
Soften stool material permitting water and lipids to penetrate
Stool softener
Docusate
Glycerine suppository
Mineral oil
*usually given in patients post-MI to avoid Valsalva
Soluble but non-absorbable compounds that result in increased stool liquidity due to an obligate increase in fecal fluid
Osmotic laxative
Lactulose — hepatic encephalopathy
Magnesium oxide
Sorbitol
Magnesium citrate
Sodium phosphate
Polyethylene glycol — endoscopy preparation
Directly stimulate enteric nervous system and colonic electrolyte and fluid secretion
Stimulant laxative
Bisacodyl
Aloe
Senna
Cascara
Castor oil
*Melanosis coli
Opioid anti-diarrheal agents
Diphenoxylate
Loperamide
Non-opioid anti-diarrheal agents
Kaolin + Pectin
Colloidal bismuth
Difenoxin
Used for reversal of paralytic ileus
Bethanechol
Anti-emetics that blocks chemoreceptor trigger zone and enteric nervous system 5-HT3 receptors
Ondansetron
Granisetron
Dolasetron
Palonosetron
Alosetron
Tropisetron
Used in IBD that inhibits production of eicosanoid inflammatory mediators
Mesalamine (5-asa)
Balsalazide
Olsalazine
Sulfasalazine
Mesalazine
Decreases the cholesterol content of bile by reducing cholesterol secretion
Used for dissolution of small cholesterol gallstones
Ursodiol (Ursodeoxycholic acid)
Therapy used for kidney stones to metabolize them to bicarbonate which alkalinizes urine and raises urinary citrate.
Used in calcium oxalate nephrolithiasis and uric acid lithiasis.
Potassium citrate
S/e: Hyperkalemia > MI
An amino acid derivative of quinolone used for mucosal protection, healing of gastroduodenal ulcers and treatment of gastritis. Works by enhancing mucosal defense scavenging free radicals and temporarily activating genes encoding for COX-2
Rebamipide
Gastrokinetic benzamide derivative
Inhibit dopamine and Ach esterase
For functional dyspepsia and gastroparesis
Itopride
Changes surface tension of gas bubbles and causes collapse of foam bubbles
Simethicone
Gastroprokinetic agents
Selective 5HT4 agonist (M1)
Also acts as 5HT3 antagonist — accelerates gastric emptying
Treatment of gastritis, GERD, functional dyspepsia, and IBS
Mosapride
Increases the availability if endogenous opioid by inhibiting membrane-bound enkephalinase
Has an antisecretory effect — it reduces the secretion of water and electrolyte into the intestine
Reduces both the frequency and duration of acute diarrhea
Racecadotril
Probiotic, has been found to produce antimicrobial substances
Bacillus clausii
Hepatoprotectant, an antioxidant, scavenger and regulator of intracellular content of glutathione as cell membrane stabilizers and permeability regulators
Stimulating liver regeneration and inhibitor of transformation of stellate hepatocyes into myofibroblasts
Silymarin
Increases biliary secretion, relieves spasms of the bile ducts, enhances metabolic liver function and reduces biliary stasis
Rowachol
Potent venotropic drug, treatment of venous insufficiency, increases venous tone, improves lymph drainage, and protects microcirculation
Daflon
Arrest bleeding by coagulating blood protein and inducing the muscle fibers of small blood vessels to contract
FAKTU
