GI Drugs 2 Flashcards
what is the function of somatostatin?
- Decrease gastric acid and pepsinogen secretion
- Decrease pancreatic and small intestine fluid secretion
- Decrease gallbladder contraction
- Decrease insulin and glucagon release
- Decreases GI hormones
what type of drug is docusate?
it is a stool softener; dont give with mineral oil because then the effects will cancel out
a child with constipation predominant IBS is most often prescribed ______
poly-ethylene glycol because lubiprostone cannot be used in kids
which amino glycoside is well tolerated because the 5-ASA in that is linked to an inert unabsorbed carrier molecule? and thus works mainly int he ______
- balsalazide; terminal ileum and colon
methylcellulose and other ________ (type of laxative) should not be given to ____ and ______
bulk forming laxatives (psyllium and bran) should not be given to immobile patients or those on long term opioid therapy
lubiprostone stimulates __________ of the SI and thus ↑ intestinal motility;
what is a contraindication of lubiprostone?
type 2 chloride channels → ↑ secretion of chloride
CANNOT be used in kids
______ is a synthetic form of somatostatin and is used to treat _______ diarrhea
octreotide is used to treat secretory diarrhea (neuroendocrine tumors/ VIPoma) and diarrhea caused by vagotomy, dumping syndrome and short bowel syndrome
5-ASA is almost completely absorbed in the ______
jejunum; thus no therapeutic effect in the distal ileum, colon and rectum
__________ (amino glycoside) has the largest anatomic distribution of areas of the GI that it is effective
mesalamine (delayed response capsules specially but also pH sensitive)
constipation is defend as stool frequency less than ___ / week
< 3 /week
methotrexate inhibits _______ and ↓ the inflammatory actions of _____
dihydrofolate reductase; IL-1
________ type of renal stones are an AE of taking pancrelipase to treat pancreatic insufficiency
uric acid
does alvimopan and methylnaltrexone reverse the analgesic effects of opioids because they antagonize the mu receptors?
NO because these drugs do not cross the blood brain barrier and thus only act at the level of the gut to maintain normal motility
suppression of Th___ activity is an adverse effect of anti TNA alpha drugs
TH1 activity → severe infection and reactivation of latent tb
which of the glucocortocoids is preferred for long term use in patients?
budesonide because ↓ adverse effects because it has a rapid first pass metabolism so it has low systemic availability
glucocorticoids are usually never used for long term
what drugs are used for the most severe IBD’s?
- anti TNF α drugs: infliximab and adalimumab
________ (glucocorticoid) is given via enema for sigmoid and rectal IBD flares
hydrocortisone
MOA of lubricant laxatives such as______
mineral oil; they coat the fecal material and PREVENTS water reabsorption so it should not be given with docusate
what are the 3 bulk forming laxatives?
- methylcellulose
- psyllium
- bran
inhibition of the activity of nuclear factor kB (NF-kB) is the MOA of _______
aminosalicylates
most of the side effects of sulfasalazine is due to _______
systemic absorption of sulfapyridine group;
side effects: nausea, GI upset, headaches, myalgia, bone marrow suppression and HS reactions
natalizumab is indicated in treatment of ________
moderate to severe, unresponsive Crohn’s disease
_____, ______, and ____ are cathartics (stimulant laxatives)
which one is safer for use in pregnant patients
- castor oil, Senna, and bisacodyl
bisacodyl is more safe to pregnant patient beaucse it has minimal systemic absorption
which drug is an osmotic laxative that can be used for long term control?
- polyethylene glycol (PEG); it is common used for complete bowel preparation before GI endoscopy
