GI

Question 1

IBD Drugs

Answer 1

• Corticosteroids & Glucocorticoids
• Aminosalicylates
• Anti-Metabolites
• Biologics

Question 2

What are the Corticosteroids & Glucocorticoids?

Answer 2

Prednisone/-nisolone

Budenoside

Question 3

*What are the Aminosalicylates?

Answer 3

Mesalamine, Sulfasalazine

Question 4

*What are the Anti-Metabolite to tx IBD?

What is it?

Answer 4

Azathioprine

- purine analog… i.nhibits purine syn. and DNA replication

Question 5

What are the Biologics?

What does {-mab] stand for?

Answer 5

Monoclonal Abs (MAbs): Infliximab (remicade) & Adalimumab (humira) 
- mab = monoclonal Ab

Question 6

Monoclonal Abs target what?

Answer 6

TNF-alpha

Question 7

*Human mAb used for IBD:

Answer 7

Adalimumab (humira)

Question 8

Chimeric mAb used for IBD:

Answer 8

Infliximab (remicade)

Question 9

*What does Azathioprine turn into?

What are the interactions?

Answer 9

it’s a prodrug —> 6-mercaptopurine

- w ethanol - think LR - metabolism

Question 10

Promethazine is used for what?

Answer 10

Nausea

- dopamine D2 antagonist

Question 11

What is the serotonin 5HT3 antagonist used to tx nausea?

Answer 11

Ondansetron

[-setron] - serotonin

Question 12

What are the 2 dopamine D2 -Receptor antagonists used to Tx NAUSEA?

Answer 12

Metoclopramide, Promethazine

promethazine just seems to be stronger and also has anti-histamine and anti-muscarinic effects

Question 13

*Magnesium Hydroxide, also called ______, is what type of drug and used to tx what?
side effect?

Answer 13

Milk of Magnesia

• antacid for GERD
• ADR: side effect

Question 14

H2RA suffix

tx?

Answer 14

• TIDINE
• think H = acid, so treat acid reflux
• altho, “histamine R atagonist” on parietal cells

Question 15

PPI suffix

tx?

Answer 15

-PRAZOLE
proton pump inhibitors on parietal cell (luminal side) … irreversible.
tx GERD

Question 16

*Gas-X drug name?
- MOA
- absorbed?
- interactions
What else can tx GAS?

Answer 16

SIMETHICONE
- inert silicone polymer 
- reduces surface tension of bubbles
- not absorbed 
- interactions: levothyroxine
other Gas Tx: alpha, galactosidase, activated charcoal, lactase enzyme

Question 17

Sulfasalazine
tx
side effect
ADR's
MOA

Answer 17

is an AMINOSALICYLATE
(see SALA in name)
prodrug of MESALAMINE (azo bond cleaved)

MOA: local anti-inflamm esp LKT

Side Effects: urine yellow orange (think sulfur)

ADR’s: *folate Xu (think F in name), HA, N, alopeica, anorexia, hemolytic anemia, hep, panc, male infert, etc.

Tx: *IBD!!

Question 18

*Budesonide
tx:
MOA:
metabolism:

Answer 18

Tx: IBD, Asthma, COPD
MOA: immunosuppression 
Metabolism. 90% 1st pass
(capsules have delay release until pH is >5.5 in duod. for IBD)
for IBD, max tx is 3 mo

Question 19

*ADALIMUMAB
tx
moa
c/i
adrs

Answer 19

mu = human
mab = monoclonal Ab
TX: IBD
MOA: anti-TNF-alpha - reduce inflamm.
C/I: acute hep B, MS, active infx, etc. 
ADR's: *infusion-related rxns... can pre-medicate to avoid w ex. tylenol

Question 20

*AZATHIOPRINE
becomes what?
MOA
TX
interactions

Answer 20

aza = N
prine = purine
thio = replace O
ANTI-METABOLITE or purine analog
---> 6-mercaptopurine
MOA: inhibits purine syn and dna rep
TX: IBD
Interactions: ethanol
onset 1-3 mo

Question 21

*METOCLOPRAMIDE
tx
moa
adrs

Answer 21

opramide = think dopamine = think pyramid-al effects
dopamine = think dope a person up so they aren’t nauseous
tx: nausea
moa: antagonizes dopamine R and @ high doses blocks serotonin R in brain
ADR’s: extrapyramidal effects dt dopamine suppression (parkinson’s like sxs)

Question 22

*BISACODYL
tx
moa
adr
onset

Answer 22

think "piss off your colon" bis a col
STIMULANT LAXATIVE
tx constipation
*avoid w bowel obstruction
adr: electrolyte disturbance 
onset: 10-12 hrs (mb longer than senna) 
interactions: jalap, oleander

Question 23

*DOCUSATE
other name
tx
onset
moa

Answer 23

doc = dookie; sate = satiate it to soften
STOOL SOFTENER
aka Colace
SODIUM VERSION vs calcium
tx constipation
onset: 12-72 hrs.. or *rectally 2-15min
moa: enhance incorp. of water and fat into stool

Question 24

Opiate-like drugs are used to tx?

Answer 24

Diarrhea

LOPERAMIDE (immodium), DIPHENOXYLATE & ATROPINE (lomotil)