Gi motility drugs Flashcards
Bisacodyl
Stimulant laxative
-increases secretion and peristalsis
—
-Constipation
—
-atonic colon
Sodium picosulfate
Stimulant laxative
-increases secretion and peristalsis
—
-Constipation
—
-atonic colon
Senna
Stimulant laxative
-increases secretion and peristalsis
—
-Constipation
—
-atonic colon
Dantron
Stimulant laxative
-increases secretion and peristalsis
—
-Constipation
—
-atonic colon
Methylcellulose
Bulk laxative
-increases peristalsis and aids consistency
—
-constipation
—
with high FODMAP
-bloating
-flatulence
sterculia
Bulk laxative
-increases peristalsis and aids consistency
—
-constipation
—
with high FODMAP
-bloating
-flatulence
Agar bran
Bulk laxative
-increases peristalsis and aids consistency
—
-constipation
—
with high FODMAP
-bloating
-flatulence
Ispaghula husk
Bulk laxative
-increases peristalsis and aids consistency
—
-constipation
—
with high FODMAP
-bloating
-flatulence
Magnesium salts
Osmotic laxatives
-increase osmotic pressure drawing water in to lumen
—
-constipation
-purge within an hour
—
-contraindicated with impaired renal function
Lactulose
osmotic laxative
semisynthetic fructose and galactose
-increases osmotic pressure
—
-constipation
-takes 2-3 days to work
—
-cramps
-flatulence
-diarrhea
Polyethylene glycol (PEG)
Osmotic laxative
-increases osmotic pressure, also immobilizes water in lumen
-doesn’t effect stool weight or transit time
—
-constipation
—
-nausea
-abdominal upset
Lubiprostone
Chloride channel 2 agonist
-promotes secretion
—
-opioid constipation
—
-nausea
Naloxegol
Mu opioid receptor antagonist
-Is peglated to prevent CNS absorption
—
-opioid constipation
—
-
Prucalopride
5-HT4 receptor agonist
-increases propulsive activity
—
-Used when other drugs fail for constipation
—
Codeine
Opioid
-activation of opioid receptors slowing peristalsis and secretion
—
-diarrhea
—
-dependance
-resp. failure
Loperamide
Mu opioid receptor agonist
-inhibits peristalsis
-increases sphincter tone
-Low CNS effects
—
-diarrhea
—
-constipation
-paralytic ileum (disc after 5d
Diphenoxylate
Mu opioid receptor agonist
-inhibits peristalsis
-increases sphincter tone
-Low CNS effects
—
-diarrhea
—
-constipation
-paralytic ileum (disc after 5d
Racecadotril
Prodrug of thiorphan
-inhibits enkephalinase
-enkephalins activate delta receptors lowing secretion
—
-diarrhea
-use with rehydration
—
-Itch
Bismuth Subsalicylate
Pepto contains clays
-act as bulk forming
-also anti secretory
—
-diarrhea
—
-black tongue
-reyes syndrome
Eluxadoline
-Mu and kappa agonist Delta antagonist
-slows transit
—
-IBS diarrhea
—
Linaclotide
synthetic peptide
-increases cGMP by guanylate cyclase C
-increases Cl- + HCO3 secretion
—
-IBS constipation
Methotrexate
Folic acid antagonist inhibiting DNA synthesis
-inhibits dihydrofolate reductase (DHFR)
—
-anti inflammatory for IBS/IBD
—
-blood issues
-liver cirrhosis
Sulfasalazine
-bound to 5-ASA delivers to large intestine
-lowers inflammation
—
-anti inflammatory for IBS/IBD
—
-Sulfa drug allergy
Cyclosporine
cyclic peptide immunosuppressant
-inhibits calcineurin
-inhibits cyclophilin
—
-immunosuppressant/ anti inflammatory for IBS/IBD
—
-nephrotoxicity
-hepatotoxicity
-hypertension
-increased infection chance
Azathioprine
Prodrug of mercaptopurine immunosuppressant
-inhibits DNA synthesis
—
-immunosuppressant/ anti inflammatory for IBS/IBD
—
-bone marrow depression
infliximab
Biologic
-antibody against TNF alpha
—
-anti inflammatory for IBS/IBD
—
-
Adalimumab
biologic
-antibody against TNF alpha
—
-anti inflammatory for IBS/IBD
—
Golimumab
biologic
-antibody against TNF alpha
—
-anti inflammatory for IBS/IBD
—
Vedolizumab
biologic
-antibody against Alpha 4 beta 7 on HTc
-prevents binding and activation with mucosal cells
—
-anti inflammatory for IBS/IBD
—
Ustekinumab
biologic
-antibody against p40 subunit of IL-12 and IL-23
—
-anti inflammatory for IBS/IBD
