GI Medications - Final Study Guide Flashcards
What is the mechanism of action for cholinergic drugs?
Mimic acetycholine (Ach)
What affect do cholinergic drugs have on the GIT?
Increases motility and secretion
Describe the use for Motegrity
What drug would you give for chronic idiopathic constipation?
Metoclopramide
Drug for delayed gastric emptying or diabetic gastroparesis
What is the mechanism of action for anticholinergic drugs?
They block acetylcholine (Ach)
What affect do anticholinergic drugs have on the GIT?
Decrease motility and secretion
If a patient has mild GERD symptoms what type of drug would you recommend? Give possible side effects.
Antacids
Al: constipation, bone issues
Mg: diarrhea
If a patient has mild –> moderate GERD symptoms what type of drug would you recommend? Name one.
H2 Blockers
Ranitidine
If a patient has moderate –> severe GERD symptoms what type of drug would you recommend? Name one. What are the possible side effects
PPIs - Omeprazole
Side Effects: •Headache •Diarrhea •B12 deficiency •Hypomagnesemia
What would you recommend for a patient with GERD and a swallowing disorder?
ODT, IV, compounding suspension or mixing with applesauce
Briefly describe the drug treatment of someone with H. Pylori
3 or 4 drugs regimens
Inhibiting COX-1 can lead to three toxicities. Name them.
- GI
- Blood
- Renal
There are four drug tactics for treating diarrhea. Name them.
- Anti-motility
- Soluble Fibers
- Bacterial replacement
- Lactase enzymes
What is Loperamide? Give the method of action
Antimotility diarrhea medication
Bind to opioid receptor and block Ach release
What are the three broad categories of constipation medication? Name specific drugs in each category
- Drugs work in 1-3 days: (Emollients- Miralax, stool softeners)
- Drugs work in 6-12 hours: Bisacodyl tab, Senna
- Drugs work in 1-6 hours: Bisacodyl suppl, Mg citrate, MoviPrep (used for colonoscopies)
What is the first drug choice for IBS-D? Name the other one
1st: Loperamide (Imodium)
2nd: Alosetron (serotonin antagonist, only women)
What medications can exacerbate GERD?
Asprin Bisphosphonates Iron NSAIDs Potassium chloride
What is antacids’ method of action?
- Decrease the activation of pepsinogen
* Neutralize gastric fluid
Describe Ranitidine.
What is its MOA?
Side Effects?
H2-Receptor Antagonists (HSRA)
MOA: reduce basal acid secretion and pepsin production
SE: constipation, diarrhea, dry mouth, dry skin (from internet)
*Ok for pregnant women and children
Describe Omeprazole.
What is its MOA?
Side Effects?
Nutrition/counseling points?
PPI - Proton Pump Inhibitor (for moderate to severe GERD)
MOA: block gastric acid secretion by inhibiting H+/K+ adenosine triphosphatase in gastric parietal cells
SE: headache, diarrhea, constipation, Vit B12 deficiency, hypomagnesemia
D
• Take on empty stomach before bed
•OK for children and elderly
What is the preferred regimen for H. pylori treatment?
3-drug treatment: antibiotics + bismuth subsalicylate + PPI or H2RA
What are the dietitian counseling points for H. pylori drug treatment?
Antibiotics: finish therapy, call MD if diarrhea
Bismuth subsalicylate: don’t take if asprin allergy, black stools, constipation, black hairy tongue
Tetracyline: avoid dairy and antacids
Describe Loperamide.
What is its MOA?
Side Effects?
It is an antimotility drug for diarrhea treatment
MOA: Binds to opioid receptors in GI tract inhibiting release of acetylcholine. This reduces propulsive peristalsis and increases intestinal transit time
SE: (rare) dizziness, constipation
What are common causes of constipation in adults?
- Inadequate fiber or fluid intake**
- Systemic disease
- Medications (opiods, anticholinergics, psychotripics, Ca and Fe supplements)
