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PHARM 233 > GI 3 (Motility and Chronic Bowel Disease) > Flashcards

GI 3 (Motility and Chronic Bowel Disease) Flashcards

1
Q

How to treat Constipation

A

Enhance Motility
- Enhance Peristalsis

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2
Q

How to treat Diarrhea

A

Reduce Motility
- Restore fluid electrolyte balance
- Get rid of infection
- Opioid-based Drugs

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3
Q

Bisacodyl

A

Stimulant Laxatives

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4
Q

Sodium Picosulfate

A

Stimulant Laxatives

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5
Q

Senna

A

Stimulant Laxatives

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6
Q

Dantron

A

Stimulant Laxatives

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7
Q

Stimulant Laxatives
- MOA

A

Increases electrolyte secretion (thus increasing water secretion) by the mucosa
–> More Water Content, easier for stools to flow

  • Increases Peristalsis
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8
Q

Stimulant Laxatives
- Adverse Effects

A

Abdominal Cramps

Do not use if there is an obstruction in the bowel
–> Causes Atonic Colon

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9
Q

Methylcellulose

A

Bulk Laxatives

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10
Q

Sterculia

A

Bulk Laxatives

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11
Q

Agar Bran

A

Bulk Laxatives

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12
Q

Ispaghula Husk

A

Bulk Laxatives

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13
Q

Bulk Laxatives
- MOA

A

Polysaccharide Polymers that are not digested in the upper GI tract
- Gives mass to stools and allows them to be pushed out through peristalsis

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14
Q

Bulk Laxatives
- Adverse Effect

A

No serious adverse effects
- Slow Acting
- Good for Children

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15
Q

Magnesium Salt

A

Osmotic Laxative

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16
Q

Magnesium Salt
- MOA

A

Creates an Osmotic Load
= Traps volume in bowel lumen

  • Build up of water in lumen (distension) resulting in peristaltic movement and cleansing of the bowel (purgation)
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17
Q

Magnesium Salt
- Adverse Effects

A
  • Diarrhea
  • Should be avoided in young children
  • Should be avoided in patients with renal dysfunction
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18
Q

Lactulose

A

Osmotic Laxative
- Semisynthetic disaccharide

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19
Q

Osmotic Laxative
- MOA:

A

Pulls water from the body and into the bowels
- Allows for peristalsis by softening stools

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20
Q

Polyethylene Glycol (PEG)
- MOA

A

Osmotic Laxative
- Binds water and causes water to be retained in the stool

Used for Chronic Constipation

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21
Q

Lubiprostone
- MOA

A

Treats Opioid-Related Constipation

Activates Chloride Channel-2 on apical membrane cells of the small intestine
–> Promotes Chloride
–> Promotes Fluid Secretion

22
Q

Naloxegol
- MOA

A

Treats Opioid-Related Constipation

Mu Receptor Antagonist
- Is pegylated (Limits entry into CNS)
= Blocks Mu Receptor in GI, does not block Mu Receptor in Brain

23
Q

Prucalopride

A

5-HT(4) activator in GI tract
= Stimulates Colonic Propulsive Activity

Used when other laxatives have failed for chronic constipation

24
Q

Codeine

A

Opioid
- Treats Diarrhea

25
Diphenoxylate
Opioid - Treats Diarrhea
26
Diphenoxylate - MOA
Mu Receptor Agonist - Activation results in inhibition of peristalsis in colon - Enhances Anal Sphincter Tone - Delays absorption of feces through bowels --> Increases fluid absorption from feces --> Drying effect on stool
27
Diphenoxylate - Adverse Effect
Constipation Paralytic Ileus (Impaired motor activity of bowel, non physical) Delays transit of invasive diarrheas
28
Loperamide
Opioid - Treats Diarrhea Specifically good for traveler's diarrhea
29
Loperamide - MOA
Mu Receptor Agonist - Activation results in inhibition of peristalsis in colon - Enhances Anal Sphincter Tone - Delays absorption of feces through bowels --> Increases fluid absorption from feces --> Drying effect on stool
30
Loperamide - Adverse Effect
Constipation Paralytic Ileus (Impaired motor activity of bowel, non physical) Delays transit of invasive diarrheas
31
Opioid (GI) - MOA
- Increase tone and rhythm contractions of intestine - Decrease Propulsion in Colon = Constipation
32
Racecadotril
Treats Diarrhea Prodrug of Thiorphan - Which inhibits enkephalinase Enkephalins - Delta Receptor Agonists --> Inhibits Intestinal Secretions (Fluid, Cl-)
33
Racecadotril - MOA
1. Inhibits Enkephalinase 2. Build up of Enkephalins 3. Greater action on Delta Receptors 4. Greater inhibition of intestinal secretions Combined with rehydration therapy - To replenish lost fluids and prevent dehydration
34
Racecadotril - Adverse Effects
- Less risk for constipation than Loperamide - Higher risk for itch than Loperamide
35
Bismuth Subsalicylate
Bulk Forming Agent - Anti Secretory - Anti Microbial
36
Eluxadoline - MOA
Treats IBS with Diarrhea - Mixed Mu and K Opioid Receptor Agonist - Delta Receptor Antagonist --> Acts on enteric nerves to slow peristalsis
37
Linaclotide
Treats IBS with Constipation - Synthetic Peptide that acts as an Guanylate Cyclase C Receptor Agonist in intestinal epithelial cells --> Increases cGMP levels --> Augments Chloride and Bicarbonate secretions
38
Prednisolone
Glucocorticoids for acutely reducing inflammation in IBS/IBD - Not to be used for long term due to side effects
39
Budesonide
Glucocorticoids for acutely reducing inflammation in IBS/IBD - Not to be used for long term due to side effects
40
Methotrexate - MOA
Anti-inflammatory agent for IBS/IBS Folic Acid Antagonist - Cytotoxic and Immunosuppressant Activity Inhibits Dihydrofolate Reductase (DHFR) --> Inhibiting DNA Synthesis --> Thus, Inhibits Purine Synthesis which results in an anti inflammatory response
41
Sulfasalazine
Anti-inflammatory agent for IBS/IBS Sulfonamide sulfapyridine linked to 5-aminosalicyclic acid (5-ASA)
42
Sulfasalazine - MOA
- Decreases superoxide generation by acting as a free radical scavenger - Inhibits leukotriene production (An inflammatory mediator) - Decreases neutrophils chemotaxis
43
Sulfasalazine - Adverse Effects
Hypersensitivity - Caused by sulfapyridine component
44
Cyclosporine - MOA
Immunosuppressant for IBS/IBD - Cyclic Peptide that binds to cyclophilin and inhibits calcineurin --> Decreases IL-2 Synthesis and the Proliferation of T-Cells
45
Cyclosporine - Adverse Effects
- Nephrotoxicity --> Caused by vasoconstriction of renal arteries - Hepatotoxicity - Hypertension Dampens Immune Response --> More prone to infection
46
Azathioprine - MOA
Immunosuppressant for IBS/IBD - Is converted into Mercaptopurine which interferes with purine/DNA synthesis --> Dampens Immune Response
47
Azathioprine - Adverse Effects
Bone Marrow Depression - Reduced production of blood cells
48
Infliximab - MOA
Chimeric neutralizing antibody against Tumour Necrosis Factor a (TNFa) - Prevents adhesion and propagation of inflammation
49
Adalimumab - MOA
Humanized monoclonal antibody against TNFa
50
Golimumab - MOA
Humanized monoclonal antibody against TNFa
51
Vedolizumab - MOA
Humanized monoclonal antibody against alpha 4 beta 7 (a4b7) integrin on T-helper (Th) lymphocytes Prevents Th Lymphocytes from interacting with mucosal adhesion molecule-1 (MCAM-1) on GI tract epithelial cells --> Reduces inflammation
52
Ustekinumab - MOA
Humanized monoclonal antibody Targets p40 protein subunit of IL-12 and IL-23 - Prevent binding of these cytokines to their corresponding IL-12 and IL-23 receptors on immune cells --> Decreases inflammation

PHARM 233 (10 decks)

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