GI drugs

Question 1

Myxedema coma - adults

Cretinism - children

Answer 1

Hypothyroidism

Question 2

Grave’s Disease

Thyroid Storm/Thyrotoxic crisis

Answer 2

Hyperthyroidism

Question 3

Hypothyroidism Drugs

T3 ___________

• once a day
• increase Vit K degradation
• increase cardiac response to catecholamines
• caution: CV disease, CHF

T4 ___________
- twice a day

Adverse effects:

• weight loss
• *heat intolerance
• *tremors
• *sweat

Answer 3

Levothyroxine

Lio’s:
Liothyronine
Liotrix

Question 4

Hyperthyroidism drug

*Blocks thyroid hormone synthesis
Given 1x/day

Grave’s Disease
NOT in pregnancy

• Scalp lesions - birth defect
• Agranulocytes

Answer 4

Methimazole

Question 5

Hyperthyroidism drug

*Blocks thyroid hormone synthesis
Given multipleX/day
- Inhibit conversion of T4&raquo_space; T3

• Liver damage
• Agranulocytes

Answer 5

Propylthiouracil

Question 6

Hyperthyroidism drug

• Inhibit release of thyroid hormone
• Short term therapy = 2 weeks on high dose

Adverse effects:

• Metallic taste
• Mouth burning

Answer 6

Iodides

Question 7

Hyperthyroidism drug

Thyroid Cancer
NOT in pregnancy

Answer 7

Radiactive iodide

Question 8

Short-acting
Intermediate-acting
Long-acting

All end in -ONE

- Low dose treats cortisol insufficiency - Addison's 
High dose 
- decrease RA asthma 
- decrease organ rejection 
- dermatitis/psoriasis 
- allergic rxn 

MOA

• Anti-inflammatory effect
• Immunosuppressant
• want to withdrawal steroid slowly

Adverse effects:

• Osteoporosis
• Increase risk of infection
• Peptic Ulcers
• Cushing’s: Moon face, buffalo hump, hirsutism

Answer 8

Glucocorticoids

Question 9

Glucocorticoids

-

-

Answer 9

Short-acting

• cortisone
• hydrocortisone

Intermediate
- prednisone

Long-acting

• dexamethasone
• betamethasone

Question 10

• Antibiotics to kill H. pylori
• Meds to decrease acid in stomach
• PPI’s (end in -prazole)
• Antacids

Answer 10

How to treat peptic ulcer disease

Question 11

Type of Drug:
• ends in “PRAZOLE”

• MOA: inhibit 70-90% acid secretion

- AVE:
• Gastric atrophy
• GI infections
• Pneumonia
• Bone fractures

Answer 11

Proton-Pum Inhibitors (PPIs)

Question 12

Types of Laxatives

Drug: Psyllium

Polysaccharides and celluloses that swell in water to from a gel to soften the feces and increase its mass. Produces a soft stool in 1-3 days.

intestinal obstruction

Answer 12

Bulk Forming

Question 13

Types of Laxatives

Drug: Docusate

Increases entry of water into feces. Inhibits fluid reabsorption. Softens/lubricates the feces. Produces a soft stool in 1-3 days. Low effectiveness.

bitter taste

Answer 13

Stool Softeners

Question 14

Types of Laxatives

Drugs:
Magnesium hydroxide
Polyethylene glycol (Miralax)

Pull fluid into the intestine. Softens/expands fecal mass, increases peristalsis. Produces a semi-fluid stool in 3-12 hours. Low doses for constipation. Higher doses to empty the bowel for surgical or diagnostic procedures.

electrolyte imbalances
Use with caution in renal failure.
Must increase fluid intake

Answer 14

Magnesium hydroxide Polyethylene glycol (Miralax)

Osmotic laxatives

Question 15

Types of Laxatives

Drugs:
Bisacodyl – enteric coated, should not be chewed or crushed.

Senna – may color the urine yellow or brown.

Directly increase intestinal motility, increased secretion of fluid and electrolytes. Produce a semi-fluid stool in 3-12 hours.

Adverse effects:
colitis
Can cause dependence on laxatives to maintain normal bowel function.

Used occasionally for < 1 week.

Answer 15

Stimulants

Question 16

Histamin 2 (H2) blockers/Rec. Antagonists

- Uses:
•Gastric ulcer, duodenal ulcer
• Gastric reflux
•heartburn & indigestion
• Relieves pain in days
•heals ulcers in weeks-months

-AVE:
• rare- confusion, dizziness, agitation

-Blocks 40-70% of H+ secretion

Answer 16

Cimetidine