GI B3 drugs

Question 1

Bismuth subsalicylate –

Answer 1

salicylate and magnesium aluminum silica clay used to treat travelers diarrhea.

Question 2

Kaolin + Pectin –

Answer 2

binds water to increase stool bulk and provide symptomatic relief from mild diarrhea.

Question 3

Probiotics –

Answer 3

recolonization of the gut with non-pathogenic bacteria as therapy for acute diarrhea, antibiotic-associated diarrhea, and infectious diarrhea.

Question 4

Loperamide -

Answer 4

μ opioid receptor agonist that can be therapeutic for diarrhea due to inhibition of peristalsis and therefore increasing transit time. Does not penetrate the CNS.

Question 5

Diphenoxylate -

Answer 5

μ opioid receptor agonist used to treat diarrhea. CNS effects at high doses.

Question 6

Fiber –

Answer 6

unfermented fiber more effective in drawing water into the lumen.

Question 7

Magnesium and phosphate salts –

Answer 7

osmotically mediated water retention due to lack of

absorption.

Question 8

Lactulose –

Answer 8

a non-absorbed sugar fermented by bacteria to organic acids causing osmotic
retention of fluid.

Question 9

Polyethylene glycol –

Answer 9

not absorbed and causes osmotic retention of water.

Question 10

Docusate salts –

Answer 10

reduce stool surface tension.

Question 11

Bisacodyl –

Answer 11

causes enteric mucosal irritation/inflammation to increase intestinal water
accumulation.

Question 12

Senna –

Answer 12

plant derivative stimulant laxative.

Question 13

Lubiprostone –

Answer 13

activates Cl- channels to increase intestinal fluid secretion and intestinal motility.

Question 14

Linaclotide –

Answer 14

activates guanylate cyclase C receptors on the luminal surface of intestinal
epithelial cells to stimulate cGMP production leading to fluid and electrolyte secretion.

Question 15

Methylnaltrexone –

Answer 15

a peripherally acting μ opioid receptor antagonist that increases motility.

Question 16

Sulfasalazine, Mesalamine –

Answer 16

5ASA’s used as first line therapy for ulcerative colitis. Inhibition of IL-1 and TNF-α, lipoxygenase pathway, free radical and oxidant scavenging.

Question 17

Prednisone –

Answer 17

a glucocorticoid used to treat acute IBD attacks.

Question 18

Budesonide –

Answer 18

enteric release synthetic steroid.

Question 19

6 Mercaptopurine, Azathioprine, Methotrexate –

Answer 19

immunosuppressive agents used to prevent

inflammation. Used to maintain remission and treat fistulas.

Question 20

Infliximab, Adalimumab, Certolizumab pegol –

Answer 20

immunoglobulin-based therapy that inhibits

TNF-α. Used to treat moderate to severe Crohn’s and ulcerative colitis.

Question 21

Natalizumab –

Answer 21

immunoglobulin-based therapy that inhibits α4-integrin to prevent leukocyte
migration to sites of inflammation. Used to treat moderate to severe Crohn’s disease.