GI Drugs Flashcards
What are three strategies for protecting the gastric mucosa from acid exposure?
- Inhibit secretion (H2)
- Prevent contact of acid to stomach wall
- Neutralize acid
Histamine (H2) inhibitors
Ranitidine (prokinetic)
Famotidine
Name 3 H:K ATPase (proton pump) inhibitors (PPI)
Omeprazole
Pantoprazole
Lansoprazole
Name a mucosal coating, chelating, and complexing agent
Sucralfate
What are some examples of emetics?
- Dopamine (D2) agonist- apomorphine
- Adrenergic (a2) agonist - xylazine
- Irritants
What are the sites of action for antiemetic drugs?
- Chemoreceptor Trigger Zone
- Gut afferents (sensory)
- Gut efferents
- Cerebral cortex
- Vestibular apparatus
- Vomiting center
What are some antiemetics?
- Histamine (H1) inhibitors: diphenhydramine
- Neurokinin (NK1) antagonists: maropitant
- Dopamine (D2/5HT3) antagonists: metoclopramide
- Serotonin (5HT3) antagonists: Ondansetron
- Adrenergic (a2) antagonists (phenothiazines): chlorpromazine, acepromazine
What are the classes of prokinetics?
- Mixed 5HT3 antagonists/5HT4 agonists: metoclopramide, cisapride
- Motilin agonists: erythromycin
- Anticholinesterases: Ranitidine
- Muscarinic agonists: Bethanechol
Diarrhea is associated with what?
Excessive flow through lumen of the bowel
- increased propulsive contractions
- decreased mixing contractions
What are a few classes of antidiarrheals?
Opioid (mu) receptor agonists: diphenoxylate (CNS +, ENS +++), loperamide (CNS -, ENS +++)
MOA: promote segmental, not propagated contractions, may cross BBB
Absorbents: Kaolin, Activated charcoal
What are some antibiotics used for GI disease and what are their uses?
Enrofloxacin - specific infections
Tetracyclin - SI dysbiosis
Uses: prophylaxis: gram +/- in upper SI; gram - and anaerobes in LI
What are some examples of probiotics used for GI treatment?
- Enterococcus fascism (Fortiflora, Purina)
- Bifidobacterium animalis (Prostora Max, Iams)
What are examples of prebiotics that are used to treat GI disorders?
- poly-saccharides in soluble fiber: pectins/gums
- mixed soluble and insoluble fibers: beet pulp
What classes of anti-inflammatories/immunosuppressives are used to treat GI disorders?
- prednisolone/prednisone
- dexmethasone
- sulfasalazine
What are the classes of Laxatives and Purgatives?
Osmotic agents: magnesium sulfate (Epsom salts)
Bulk forming +/- osmotic agents: indigestible sugars (lactulose)
Lubricants: mineral oil (liquid paraffin)