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pharmacology > IBS/IBD > Flashcards

IBS/IBD Flashcards

1
Q

Function of muscarinic M2 and M3 receptors in GI tract

A

release Ach to increase motility, relaxes sphincters, and stimulates secretion

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2
Q

neostigmine/bethanechol

A

acetylcholinesterase inhibitor to treat post-op bladder distention and urinary retention

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3
Q

antispasmodics

A

ex: dicyclomine, hyoscyamine

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4
Q

5-HT3 receptor antagonists

A

“setron” drugs

act on motility/nausea receptor

extrinsic primary afferent neuron (EPAN)

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5
Q

alosetron (Lotronex)

A

indication: women w/ D-IBS

AE: constipation, restricted in women with serve IBS

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6
Q

5-HT4 receptor agonists

A

act on serotonin receptors in the intestine and promote intestinal peristalsis, increase gastric emptying and decrease esophageal reflux

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7
Q

prucalopride (Resolor)

A

5-HT4 agonist

indication: idiopathic chronic constipation

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8
Q

tegaserod (Zelnrom)

A

5-HT4 agonist

indication: C-IBS

AE: higher incidence of MI, stroke, unstable angina

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9
Q

lubiprostone (Amitiza)

A

prostanoid derivative (PGE1)

acts on chloride channels to produce chloride-rich secretions

indication: idiopathic chronic constipation and C-IBS

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10
Q

lactitol

A

osmotic laxative (disaccharide)

loosoens stools and facilitates bowel movements

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11
Q

methylnaltrexone

A

mu-opioid antagonist w/o affecting receptors in CNS (only acts on peripheral receptors)

indication: opioid-induced constipation

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12
Q

alvimopan (Entereg)

A

mu-opioid antagonist w/o affecting receptors in CNS (only acts on peripheral receptors)

indication: short-term use after bowel resection surgery ( no more than 15 doses or no longer than 7 days)

approved for use in hospitalized patients

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13
Q

eluxadoline (Viberzi)

A

mixed mu-opioid agonist, kappa opioid receptor agonist

indication: D-IBS in adult men and women

AE: pancreatitis and sphincter of Oddi spasm

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14
Q

teduglutide (Gattex)

A

GLP2 analogue

indication: improve intestinal absorption associated with SBS

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15
Q

rifaximin (XIfaxan)

A

antibiotic

indication: E.coli and Traveler’s diarrhea (resitant to absorption in colon)

investigational use in D-IBS

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16
Q

linaclotide

A

cGMP agonist ( increase cGMP)

stimulates secretion interstitial fluid and accelerates intestinal transit

indication: C-IBS

17
Q

sulfasalazine, olsalazine, mesalamine, balsalazide

A

5-aminosalicylates

MOA: inhibit inflammatory mediators derived COX and LOX pathways, interfere w/ cytokine production

indication: IBD (Crohn’s and UC)

18
Q

budesonide, prednisone, prednisolone

A

glucocorticoids

MOA: inhibit cytokine production, inhibit transcription of COX, phospholipase A2, and NF-kB

indication: IBD

19
Q

prednisolone, prednisone

A

rectally administered glucocorticoid used for lower systemic absorption

20
Q

azathioprine and 6-mercaptourine

A

purine analog

indication: induction and maintenance of remission of UC and Crohn’s

MOA: inhibition of purine metabolism, DNA synthesis and repair

50-60% achieve remission

AE: routine CBC and liver function tests required, dose-related toxicities N/V, bone marrow suppression, and hepatic toxicity

21
Q

methotrexate

A

anti-folate

indication: induction and maintenance of remission of Crohn’s disease

22
Q

pemetrexed

A

anti-folate

indication: Tx of malignant pleural mesothelioma

23
Q

anti-folate

A

MOA: inhibition of dihydrofolate reductase (enzyme for thymidine and purine synthesis)

AE: rare for IBD in low doses, bone marrow depression, megaloblastic anemia, alopecia, and mucositis in chemotherapeutic doses

24
Q

infliximab (Remicade)

A

monoclonal antibody that recognizes human TNFa

indication: acute and chronic tx of Crohn’s and UC

25
Q

adalimumab (Humira)

A

humanized IgG1

26
Q

certolizumab (Cimzia)

A

TNFa inhibitor

27
Q

vedolizumab (Entyvio)

A

monoclonal atibody for tx of UC and Crohn’s

MOA: binds to T cells and blocks integrin to result in gut-selective anti-inflammatory activity

pharmacology (3 decks)

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