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Pharmacology drug classes > GI Drugs > Flashcards

GI Drugs Flashcards

Learn Class, MOA, Adverse Effects/Unique Features

1
Q

Aluminum salts

A

Class: Low-systemic antacid
MOA: binds luminal H+ to produce H2O, CO2, or Cl- salts
Adverse Effects: Constipation, Hypophospatemia

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2
Q

Calcium salts

A

Class: Low-systemic antacid
MOA: binds luminal H+ to produce H2O, CO2, or Cl- salts
Adverse Effects: Constipation, hypercalcemia, hypophosphatemia, calcium-based kidney stones

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3
Q

Magnesium salts

A

Class: Low-systemic antacid
MOA: binds luminal H+ to produce H2O, CO2, or Cl- salts
Adverse Effects: Diarrhea, hypermagnesemia

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4
Q

Sodium salts

A

Class: high-systemic antacid
MOA: Binds luminal H+ to produce H2O, CO2, or Cl- salts
Adverse Effects: Gas/flatulence, hypernatremia, metabolic alkalosis

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5
Q

Simethicone

A

Class: Supplemental antacid
MOA: surfactant that decreases surface tension of gas bubbles in the GI tract to create one, easily passable gas bubble
Adverse Effects: none listed

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6
Q

Cimetidine

A

Class: H2 receptor antagonist
MOA: Reversibly inhibits H2-receptors on the basolateral membrane of parietal cells
Adverse Effects: Nausea, diarrhea, constipation, headache
Unique characteristics: gynechomastia in men, galactorrhea in women, neutropenia, thrombocytopenia, prototypical CYP450 inhibitor

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7
Q

Famotidine

A

Class: H2 receptor antagonist
MOA: Reversibly inhibits H2-receptors on the basolateral membrane of parietal cells
Adverse Effects: Nausea, diarrhea, constipation, headache

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8
Q

Nizatidine

A

Class: H2 receptor antagonist
MOA: Reversibly inhibits H2-receptors on the basolateral membrane of parietal cells
Adverse Effects: Nausea, diarrhea, constipation, headache

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9
Q

Ranitidine

A

Class: H2 receptor antagonist
MOA: Reversibly inhibits H2-receptors on the basolateral membrane of parietal cells
Adverse Effects: Nausea, diarrhea, constipation, headache

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10
Q

Lansoprazole

A

Class: Proton pump inhibitors
MOA: irreversibly binds sulfhydryl groups of H/K-ATPase at parietal cell secretory sites, inhibiting gastric acid secretion
Adverse Effects: Nausea, diarrhea, dyspepsia, increased risk for C diff infection, HA, dizziness

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11
Q

Dexlansoprazole

A

Class: Proton pump inhibitors
MOA: irreversibly binds sulfhydryl groups of H/K-ATPase at parietal cell secretory sites, inhibiting gastric acid secretion
Adverse Effects: Nausea, diarrhea, dyspepsia, increased risk for C diff infection, HA, dizziness

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12
Q

Omeprazole

A

Class: Proton pump inhibitors
MOA: irreversibly binds sulfhydryl groups of H/K-ATPase at parietal cell secretory sites, inhibiting gastric acid secretion
Adverse Effects: Nausea, diarrhea, dyspepsia, increased risk for C diff infection, HA, dizziness
Unique Characteristics: prototypical CYP450 inhibitor

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13
Q

Esomeprazole

A

Class: Proton pump inhibitors
MOA: irreversibly binds sulfhydryl groups of H/K-ATPase at parietal cell secretory sites, inhibiting gastric acid secretion
Adverse Effects: Nausea, diarrhea, dyspepsia, increased risk for C diff infection, HA, dizziness

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14
Q

Pantoprazole

A

Class: Proton pump inhibitors
MOA: irreversibly binds sulfhydryl groups of H/K-ATPase at parietal cell secretory sites, inhibiting gastric acid secretion
Adverse Effects: Nausea, diarrhea, dyspepsia, increased risk for C diff infection, HA, dizziness

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15
Q

Rabeprazole

A

Class: Proton pump inhibitors
MOA: irreversibly binds sulfhydryl groups of H/K-ATPase at parietal cell secretory sites, inhibiting gastric acid secretion
Adverse Effects: Nausea, diarrhea, dyspepsia, increased risk for C diff infection, HA, dizziness

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16
Q

Sucralfate

A

Class: Surface acting anti-ulcer agent
MOA: cross-links w/ itself in response to stomach acid to create a sticky polymer that adheres to epithelial cells around the ulcer’s crater
Adverse Effects: Constipation d/t conjugated Al(OH)3

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17
Q

Misoprostol

A

Class: misoprostol
MOA: reduces gastric acid release from parietal cells and stimulates cytoprotective actions of gastric mucosa
Adverse Effects: diarrhea, cramping, HA, dizziness

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18
Q

Bismuth subsalicylate

A

Class: bismuth antiulcer agents
MOA: prevents microbial attachment to mucosa, inactivates enterotoxins, disrupts bacterial cell wall
Adverse Effects: constipation, black regularly formed stools

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19
Q

Dolasetron

A

Class: Serotonin Receptor Antagonist
MOA: blocks serotonin receptors at vagal nerve terminals and block signal transmission to CTZ
Adverse Effects: HA, constipation/diarrhea, serotonin syndrome, QT prolongation, Torsade de pointes

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20
Q

Granisetron

A

Class: Serotonin Receptor Antagonist
MOA: blocks serotonin receptors at vagal nerve terminals and block signal transmission to CTZ
Adverse Effects: HA, constipation/diarrhea, serotonin syndrome, QT prolongation, Torsade de pointes
Unique characteristic: sustained-release allows for once daily administration

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21
Q

Ondansetron

A

Class: Serotonin Receptor Antagonist
MOA: blocks serotonin receptors at vagal nerve terminals and block signal transmission to CTZ
Adverse Effects: HA, constipation/diarrhea, serotonin syndrome, QT prolongation, Torsade de pointes

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22
Q

Palonosetron

A

Class: Serotonin Receptor Antagonist
MOA: blocks serotonin receptors at vagal nerve terminals and block signal transmission to CTZ
Adverse Effects: HA, constipation/diarrhea, serotonin syndrome, QT prolongation, Torsade de pointes
Unique Characteristic: sustained-release allows for once daily administration

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23
Q

Aprepitant

A

Class: neurokinin-1 receptor antagonist
MOA: blocks NK1 receptors in the CTZ and vomit center
Adverse effects: dyspepsia, constipation, diarrhea, dizziness, fatigue, somnolence
Unique Characteristic: given up to 3 hours prior to anesthesia induction to control vomiting

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24
Q

Fosaprepitant

A

Class: neurokinin-1 receptor antagonist
MOA: blocks NK1 receptors in the CTZ and vomit center
Adverse effects: dyspepsia, constipation, diarrhea, dizziness, fatigue, somnolence

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25
Q

Netupitant

A

Class: neurokinin-1 receptor antagonist
MOA: blocks NK1 receptors in the CTZ and vomit center
Adverse effects: dyspepsia, constipation, diarrhea, dizziness, fatigue, somnolence
Unique characteristic: longer half-life

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26
Q

Fosnetupitant

A

Class: neurokinin-1 receptor antagonist
MOA: blocks NK1 receptors in the CTZ and vomit center
Adverse effects: dyspepsia, constipation, diarrhea, dizziness, fatigue, somnolence
Unique characteristic: longer half-life

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27
Q

Rolapitant

A

Class: neurokinin-1 receptor antagonist
MOA: blocks NK1 receptors in the CTZ and vomit center
Adverse effects: dyspepsia, constipation, diarrhea, dizziness, fatigue, somnolence

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28
Q

Diphenhydramine

A

Class: Histamine-1 Receptor Antagonist
MOA: blocks H1 receptors in the VC and vestibular system
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP

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29
Q

Dimenhydrinate

A

Class: Histamine-1 Receptor Antagonist
MOA: blocks H1 receptors in the VC and vestibular system
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP

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30
Q

Hydroxyzine

A

Class: Histamine-1 Receptor Antagonist
MOA: blocks H1 receptors in the VC and vestibular system
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP

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31
Q

Promethazine

A

Class: Histamine-1 Receptor Antagonist
MOA: blocks H1 receptors in the VC and vestibular system
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP

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32
Q

Meclizine

A

Class: Histamine-1 Receptor Antagonist
MOA: blocks H1 receptors in the VC and vestibular system
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP

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33
Q

Cyclizine

A

Class: Histamine-1 Receptor Antagonist
MOA: blocks H1 receptors in the VC and vestibular system
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP

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34
Q

Doxylamine

A

Class: Histamine-1 Receptor Antagonist
MOA: blocks H1 receptors in the VC and vestibular system
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP

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35
Q

Chlorpromazine

A

Class: Phenothiazine Dopamine-2 receptor antagonist
MOA: blocks D2 receptors in the CTZ
Adverse Effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, arrhythmias

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36
Q

Perphenazine

A

Class: Phenothiazine Dopamine-2 receptor antagonist
MOA: blocks D2 receptors in the CTZ
Adverse Effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, arrhythmias

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37
Q

Prochlorperazine

A

Class: Phenothiazine Dopamine-2 receptor antagonist
MOA: blocks D2 receptors in the CTZ
Adverse Effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, arrhythmias

38
Q

Metoclopramide

A

Class: Dopamine-2 receptor antagonist
MOA: blocks D2 receptors in the CTZ
Adverse Effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision, arrhythmias

39
Q

Scopolamine

A

Class: Muscarinic-1 receptor antagonist
MOA: blocks M1 receptors in neural pathways from the vestibular nuclei in the inner ear to the brain stem and from the reticular formation to the VC
Adverse effects: Drowsiness, dry mouth, constipation, urinary retention, blurred vision

40
Q

Dronabinol

A

Class: Cannabinoids
MOA: stimulation of CB1 and CB2 receptors in VC/CTZ to minimize release of serotonin from vagal afferent terminals
Adverse effects: euphoria, irritability, vertigo, sedation, drowsiness, impaired cognition, memory, hallucinations, distorted sense of time, xerostomia, increased HR and BP, appetite stimulation
Unique Characteristic: schedule III drug, large first-pass effect

41
Q

Nabilone

A

Class: Cannabinoids
MOA: stimulation of CB1 and CB2 receptors in VC/CTZ to minimize release of serotonin from vagal afferent terminals
Adverse effects: euphoria, irritability, vertigo, sedation, drowsiness, impaired cognition, memory, hallucinations, distorted sense of time, xerostomia, increased HR and BP, appetite stimulation
Unique characteristic: schedule II drug, metabolized to several active metabolites

42
Q

Sulfasalzine

A

Class: 5-ASA
MOA: inhibition of prostaglandin and leukotriene formation via arachidonic acid pathway, reduction in macrophage chemotaxis
Adverse effects: aspirin allergy
Unique characteristic: sulfa drug

43
Q

Mesalamine

A

Class: 5-ASA
MOA: inhibition of prostaglandin and leukotriene formation via arachidonic acid pathway, reduction in macrophage chemotaxis
Adverse effects: aspirin allergy
Unique characteristic: single 5-ASA molecule

44
Q

Olsalazine

A

Class: 5-ASA
MOA: inhibition of prostaglandin and leukotriene formation via arachidonic acid pathway, reduction in macrophage chemotaxis
Adverse effects: aspirin allergy
Unique characteristic: 2 5-ASA molecules

45
Q

Balsalazine

A

Class: 5-ASA
MOA: inhibition of prostaglandin and leukotriene formation via arachidonic acid pathway, reduction in macrophage chemotaxis
Adverse effects: aspirin allergy
Unique characteristic: inert carrier + 5-ASA

46
Q

Tofacitinib

A

Class: JAK inhibitor
MOA: sequestration of free-floating and bound JAK-1 and JAK-3 to inhibit gene transcription and cytokine release
Adverse Effects: lymphopenia, neutropenia, anemia, fatigue, increased LDL and HDL

47
Q

Adalimumab

A

Class: TNF-α inhibitor
MOA: binds and neutralizes membrane-associated and soluble TNF-α to block leukocyte migration
Adverse Effects: reactivation of TB, liver injury, HA, arthralgia, fatigue

48
Q

Golimumab

A

Class: TNF-α inhibitor
MOA: binds and neutralizes membrane-associated and soluble TNF-α to block leukocyte migration
Adverse Effects: reactivation of TB, liver injury, HA, arthralgia, fatigue
Unique Characteristic: only indicated for ulcerative colitis

49
Q

Certolizumab

A

Class: TNF-α inhibitor
MOA: binds and neutralizes membrane-associated and soluble TNF-α to block leukocyte migration
Adverse Effects: reactivation of TB, liver injury, HA, arthralgia, fatigue
Unique Characteristic: only indicated for Crohn disease

50
Q

Infliximab

A

Class: TNF-α inhibitor
MOA: binds and neutralizes membrane-associated and soluble TNF-α to block leukocyte migration
Adverse Effects: reactivation of TB, liver injury, HA, arthralgia, fatigue

51
Q

Vedolizumab

A

Class: α4 Integrin inhibitor
MOA: limits integrin-associated cell adhesion and subsequent trans-endothelial migration of leukocytes
Adverse Effects: Infusion-related side effects, anti-medication antibody formation
Unique characteristics: increased risk for malignancies

52
Q

Natalizumab

A

Class: α4 Integrin inhibitor
MOA: limits integrin-associated cell adhesion and subsequent trans-endothelial migration of leukocytes
Adverse Effects: Infusion-related side effects, anti-medication antibody formation
Unique characteristics: progressive multifocal leukoencephalopathy (infection w/ JC virus)

53
Q

Ustekinumab

A

Class: IL-12/-23 Inhibitors
MOA: Binds to p40 subunit of IL-12/-23 to block activation and differentiation of naive T cells and NK cell activation
Adverse Effects: reactivation of TB, infusion/injection-related allergic reactions, HA, arthralgia, fatigue

54
Q

Loperamide

A

Class: opioid agonist
MOA: interferes w/ peristalsis via direct action on circular and longitudinal muscles of intestinal wall
Adverse Effects: dizziness, fatigue, drowsiness, urinary retention
Unique characteristics: cardiac toxicities that can lead to death

55
Q

Diphenoxylate

A

Class: opioid agonist
MOA: exerts local and central effect on GI smooth muscle cells to inhibit GI motility and slow excess GI propulsion
Adverse Effects: dizziness, fatigue, drowsiness, urinary retention
Unique characteristic: opioid agonist + atropine (to curb abuse)

56
Q

Eluxadoline

A

Class: opioid agonist
MOA: mu and kappa receptor agonist in GI tract to slow peristalsis, delta receptor antagonist to decrease stomach/pancreas/biliary secretions
Adverse Effects: dizziness, fatigue, drowsiness, urinary retention
Unique Characteristic: hepatic/pancreatic toxicity

57
Q

Alosetron

A

Class: Serotonin receptor antagonist
MOA: selective blockade of GI serotonin receptors to regulate visceral pain, colonic transit, and GI secretions
Adverse Effects: Ischemic colitis
Unique characteristics: requires special prescriber program, only indicated in chronic severe IBS-D that is not responsive to other conventional therapies

58
Q

Crofelemer

A

Class: Chloride channel inhibitor
MOA: inhibition of chloride anion secretion by blocking CFTR and calcium-activated chloride channels
Adverse Effects: abd distention, elevated AST/ALT/bilirubin, respiratory/urinary infections
Unique characteristics: indicated in non-infectious diarrhea for HIV/AIDS pts

59
Q

Methylnaltrexone

A

Class: peripheral opioid antagonist
MOA: peripheral mu receptor blockade increases GI motility
Adverse Effects: abd pain, diarrhea, N/V

60
Q

Naloxegol

A

Class: peripheral opioid antagonist
MOA: peripheral mu receptor blockade increases GI motility
Adverse Effects: abd pain, diarrhea, N/V

61
Q

Alvimopan

A

Class: peripheral opioid antagonist
MOA: peripheral mu receptor blockade increases GI motility
Adverse Effects: abd pain, diarrhea, N/V
Unique Characteristics: increased risk for MI w/ use; only used in post-op ileus prevention

62
Q

Linaclotide

A

Class: Guanylate Cyclase-C agonists
MOA: binds GC-C on luminal surface of intestinal epithelium to increase cGMP stimulation of chloride/bicarb secretion
Adverse Effects: diarrhea, GERD, dyspepsia, N/V
Unique characteristic: indicated in IBS-C and chronic idiopathic constipation

63
Q

Lubiprostone

A

Class: selective chloride channel activators
MOA: PGE-1 analog that increases activation of GI specific chloride channels (CIC-2) in luminal cells of intestinal epithelium
Adverse Effects: Nausea, dyspepsia, dizziness

64
Q

Bisacodyl

A

Class: stimulant laxative
MOA: irritates enterocytes, GI smooth muscle cells to promote water and electrolyte accumulation in the lumen, prompting peristalsis to remove irritants
Adverse Effects: abdominal cramping, urine discoloration, fluid/electrolyte disturbances, perforated bowel (in GI obstruction)
Unique characteristics: faster onset (0.5 - 2 hours)

65
Q

Castor oil

A

Class: stimulant laxative
MOA: irritates enterocytes, GI smooth muscle cells to promote water and electrolyte accumulation in the lumen, prompting peristalsis to remove irritants
Adverse Effects: abdominal cramping, urine discoloration, fluid/electrolyte disturbances, perforated bowel (in GI obstruction)

66
Q

Glycerin

A

Class: stimulant laxative
MOA: irritates enterocytes, GI smooth muscle cells to promote water and electrolyte accumulation in the lumen, prompting peristalsis to remove irritants
Adverse Effects: abdominal cramping, urine discoloration, fluid/electrolyte disturbances, perforated bowel (in GI obstruction)
Unique characteristics: faster onset (0.5 - 2 hours)

67
Q

Senna

A

Class: stimulant laxative
MOA: irritates enterocytes, GI smooth muscle cells to promote water and electrolyte accumulation in the lumen, prompting peristalsis to remove irritants
Adverse Effects: abdominal cramping, urine discoloration, fluid/electrolyte disturbances, perforated bowel (in GI obstruction)

68
Q

Na+ picosulfate

A

Class: stimulant laxative
MOA: irritates enterocytes, GI smooth muscle cells to promote water and electrolyte accumulation in the lumen, prompting peristalsis to remove irritants
Adverse Effects: abdominal cramping, urine discoloration, fluid/electrolyte disturbances, perforated bowel (in GI obstruction)

69
Q

Lactulose

A

Class: Osmotic laxative
MOA: osmotically attracts and retains water in the colon to increase moisture, softness, and volume/bulk of stools
Adverse effects: electrolyte disturbances, N/V, diarrhea
Unique characteristic: used to trap ammonia in liver disease

70
Q

Magnesium citrate

A

Class: Osmotic laxative
MOA: osmotically attracts and retains water in the colon to increase moisture, softness, and volume/bulk of stools
Adverse effects: electrolyte disturbances, N/V, diarrhea

71
Q

Polyethylene glycol (PEG)

A

Class: Osmotic laxative
MOA: osmotically attracts and retains water in the colon to increase moisture, softness, and volume/bulk of stools
Adverse effects: electrolyte disturbances, N/V, diarrhea
Unique Characteristics: used as pre-surgical bowel prep

72
Q

Sorbitol

A

Class: Osmotic laxative
MOA: osmotically attracts and retains water in the colon to increase moisture, softness, and volume/bulk of stools
Adverse effects: electrolyte disturbances, N/V, diarrhea

73
Q

Magnesium Hydroxide

A

Class: Saline cathartic
MOA: create hyperosmolar solutions that pull fluid into the stool and inhibits reabsorption of water in the GI tract to increase stool volume, shortening transit time
Adverse Effects: electrolyte imbalance, hypernatremia

74
Q

Na+ phosphate

A

Class: Saline cathartic
MOA: create hyperosmolar solutions that pull fluid into the stool and inhibits reabsorption of water in the GI tract to increase stool volume, shortening transit time
Adverse Effects: electrolyte imbalance, hypernatremia

75
Q

Dietary fiber

A

Class: bulk forming cathartic
MOA: increase bulk volume and water content to increase GI motility, supports colonic bacteria fermentation and digestion
Adverse effects: bloating, obstruction

76
Q

Psyllium

A

Class: bulk forming cathartic
MOA: increase bulk volume and water content to increase GI motility, supports colonic bacteria fermentation and digestion
Adverse effects: bloating, obstruction
Unique characteristics: many drug interactions

77
Q

Methylcellulose/carboxymethylcellulose

A

Class: bulk forming cathartic
MOA: increase bulk volume and water content to increase GI motility, supports colonic bacteria fermentation and digestion
Adverse effects: bloating, obstruction
Unique characteristics: many drug interactions

78
Q

Calcium polycarbophil

A

Class: bulk forming cathartic
MOA: increase bulk volume and water content to increase GI motility, supports colonic bacteria fermentation and digestion
Adverse effects: bloating, obstruction

79
Q

Docusate

A

Class: stool softener
MOA: increases fluid secretion and inhibits water reabsorption to soften and lubricate already formed stool
Adverse Effects: N/V/D

80
Q

Mineral Oil

A

Class: stool softener
MOA: increases fluid secretion and inhibits water reabsorption to soften and lubricate already formed stool
Adverse Effects: N/V/D

81
Q

Hyoscyamine

A

Class: antimuscarinic agents
MOA: competitive inhibition of muscarinic receptors to decrease GI motility and spasms
Adverse Effects: dry mouth, urinary retention, constipation, drowsiness, mental confusion, blurred vision

82
Q

Dicyclomine

A

Class: antimuscarinic agents
MOA: competitive inhibition of muscarinic receptors to decrease GI motility and spasms
Adverse Effects: dry mouth, urinary retention, constipation, drowsiness, mental confusion, blurred vision

83
Q

Clidinium/chlordiazepoxide

A

Class: antimuscarinic agents
MOA: competitive inhibition of muscarinic receptors to decrease GI motility and spasms
Adverse Effects: dry mouth, urinary retention, constipation, drowsiness, mental confusion, blurred vision

84
Q

Drugs to treat CDI

A

Vancomycin
Metronidazole
Fidaxomicin

85
Q

H. Pylori Treatments

A

Bismuth subsalicylate
Metronidazole
Tetracycline
Omeprazole

86
Q

E. histolytica treatment

A

Metronidazole
Tinidazole
Paromomycin
Iodoquinol

87
Q

Giardia lamblia treatment

A

Tinidazole
Metronidazole
Nitazoxanide

88
Q

C. parvum treatment

A

Nitazoxanide

89
Q

Nematodes treatment

A 
Albendazole
Mebendazole
Ivermectin
Thiabendazole
Pyrantel pamoate
90
Q

Schistosoma treatment

A

Praziquantel

91
Q

Cestode treatments

A

Praziquantel
Niclosamide
Albendazole

Pharmacology drug classes (6 decks)

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