GIT Drugs Flashcards
The Digestive Tract is sometimes known as
Gastrointestinal Tract
In digestion, food and drink are broken down into small parts (called nutrients) that the body can absorb and use as energy and building blocks for cells.
Gastrointestinal disorders include such conditions as constipation, irritable bowel syndrome, hemorrhoids, anal fissures, perianal abscesses, anal fistulas, perianal infections, diverticular diseases, colitis, colon polyps and cancer.
Common medical conditions involving the GIT
• Diarrhea
• Constipation
• Peptic ulcer and gastroesophageal reflux disease (GERD)
• Chemotherapy-induced emesis
It is loose, watery stools (bowel movements) or an increased frequency and decrease consistency of fecal discharge.
Diarrhea
You have diarrhea if you have loose stools three or more times in one day.
True or False
True
It is a diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer.
Acute Diarrhea
Symptoms of Diarrhea
Dehydration
It is to eject matter from the stomach through the mouth.
Vomiting
Factors that promote diarrhea
• Acute GI Infections
• Drugs like Antacids, Antibiotics, Autonomic drugs, Colchicine, Iron, laxatives
• Bile salts malabsorption
• Chronic gastroenteritis resulting from
Anemia, Diabetes, Neuropathies
• Emotional stress
• Colon disorders, Colitis
It prevents dehydration
Oral rehydration salts / Oral Glucose - Electrolyte Solution (Oresol)
Oral rehydration salts/ Oral Glucose-Electrolyte Solution (Oresol) contains
Sodium, Chloride, Potassium, Glucose and Citrate (245 mOsm/L)
Antimotility Agents
Opioids: Diphenoxylate (+atropine), Loperamide, Paregoric, Opium tincture, Difenoxin (metabolite of diphenoxylate)
Adsorbents
Kaolin-Pectin mixture
Polycarbophil
Attapulgite
Treatment and prevention of traveler’s diarrhea
Bismuth Sub salicylate
Antisecretory Drugs
• Bismuth Sub salicylate
• Enzymes (lactase)
• Bacterial Replacement (lactobacillus)
An analog of somatostatin, blocks the release of serotonin
It is for patients with carcinoid tumors (secretes serotonin)
Octreotide
Refers to infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.
Chronic Constipation
It is generally described as having fewer than three bowel movements a week.
Constipation
Signs/Symptoms of Constipation
• Abdominal pain
• Bloating
• Distension
• Changes in the frequency or consistency of stools
• Aging
• Change of routine
• Overuse of laxatives
They draw water into the colon to allow easier passage of stool.
Oral osmotic
Side Effects of Oral osmotic (Phillips’ Milk of Magnesia, Miralax)
Bloating
Cramping
Diarrhea
Nausea
Gas
Increased thirst
Absorb water to form soft, bulky stool, prompting normal contraction of intestinal muscles
Oral bulk formers
Side Effects of Oral bulk formers
Bloating
Gas
Cramping
Increased constipation if not taken with enough water
Add moisture to stool to allow strain-free bowel movements
Oral Stool Softeners
Examples of Oral Stool Softener
• Colace
• Surfak
Examples or Oral Bulk Formers
• Benefiber
• Citrucel
• FiberCon
• Metamucil
Examples of Oral osmotics
• Phillips’ Milk of Magnesia
• Miralax
SE of Oral Stool Softener
Electrolyte imbalance with prolonged use
Trigger rhythmic contractions of intestinal muscles to eliminate stool
Oral Stimulants
Examples of Oral Stimulants
• Dulcolax
• Senokot
SE of Oral Stimulants
Belching
Cramping
Diarrhea
Nausea
Urine discoloration with senna and cascara derivatives
Trigger rhythmic contractions of intestinal muscles and soften stool
Rectal Suppositories
Examples of Rectal Suppositories
• Dulcolax
• Pedia-Lax
SE of Rectal Suppositories
Rectal irritation
Diarrhea
Cramping
Most Common Forms of Ulcer
- Helicobacter pylori-associated ulcers 2. NSAID-induced ulcers
- Stress ulcers
Signs and Symptoms of Ulcer
Epigastric burning pain
Nocturnal pain
It is relieved by food
Duodenal Ulcer
It worsens with food
Gastric Ulcer
Diagnosis for Peptic Ulcer
• Upper GI endoscopy or radiography
• Endoscopic-mucosal biopsy for culture , histology or urese
• Non-endoscopic-serologic antibody detection test
It neutralizes gastric acid
Antacids
Examples of Antacid
- Aluminum hydroxide
- Magnesium hydroxide (Milk of magnesia/ MOM)
- Calcium carbonate
- Sodium carbonate (baking soda)
SE of Aluminum
Constipation
SE of Magnesium
Diarrhea
SE of Sodium
Fluid Retention
SE of HCO3
Alkalosis
SE of Calcium
Kidney Stones
Interactions: Al, Mg, Ca+ Tetracycline/ Fluroquinolones
Histamine congeners
H2-Receptor Antagonists
Examples of H2-Receptor Antagonists
Cimetidine
Ranitidine
Famotidine
Nizatidine
Examples of Proton Pump Inhibitors
Omeprazole
Lansoprazole
Esomeprazole
Pantoprazole
Rabeprazole
It inhibits H+/K+ATPase pump in gastric parietal cells
It degrades in acidic environment, formulated as delayed-release capsules
Proton Pump Inhibitors
Examples of Prostglandins
Misoprostol
PGE, analog
It prevents NSAID-induced ulcer, abortifacient
Prostaglandins
aluminum salt of sucrose
Sucralfate
It is also anti-H.pylori
Colloidal Bismuth Subnitrate
Examples of Mucosal Protectants
• Sucralfate
• Octa sulfate
• Colloidal Bismuth Subnitrate
Regimens to eradicate H.Pylori
• PPI-Based 3-drug Regimen
• Bismuth-Based 4-drug Regimen
PPI-based 3 –drug regimen
PPI + Clarithromycin + Amoxicillin or Metronidazole
10 to 14 days
Bismuth –based 4-drug-regimen
PPI + Subsalicylate + Metronidazole + Tetracycline or Amoxicillin or Clarithromycin
7 days
Retrograde movement of gastric contents from the stomach into the esophagus.
It is caused by defective lower esophageal sphincter pressure and function.
Gastroesophageal Reflux Disease [GERD]
Signs and Symptoms of GERD
Heartburn or Pyrosis
Complications of GERD
Esophagitis
Esophageal CA
Diagnosis GERD
Endoscopy
Omeprazole trial
Esophageal manometry
It is used to assess the mucosa 25 hr. ambulatory pH monitoring
Endoscopy
for candidates of antireflux surgery
Esophageal Manometry
GERD Treatment
Phase I: Lifestyle changes and antacids and/or low dose H2RAs or PPIs
Phase II: High dose H2RAs or PPIs
Phase III: Surgery
It is triggered by impulse to the vomiting center in the medulla
- Chemoreceptor trigger zone (CTZ) associated with chemically induced
vomiting (ex: chemotherapy)
Vomiting
It blocks serotonin receptor on sensory vagal fibers in the gut wall
Selective Serotonin Receptor Inhibitors
Examples of Selective Serotonin Receptor Inhibitors
Ondansetron
Granisetron
Dolasetron
Palonosetron
Examples of Cannabinoids
Marijuana
Nabilone
Dronabinol
It is used in chemotherapy induced vomiting
Corticosteroids
SE of Corticosteroids
Mood changes
Hyperglycemia
Example of Corticosteroids
Dexamethasone
Example of Benzodiazepines
Lorazepam
Example of Substance P/ Neurokinin 1 Receptor Antagonist
Aprepitant
GI symptoms and disease are common in ____ patients and may significantly impact quality of life and nutritional status.
Chronic Kidney Disease [CKD]
GI disorders may range from mild symptoms such as ___ to life threatening ailments such as ___.
dysquesia
hemorrhage
