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Pharmacology > Nausea/Vomiting/Constipation/Diarrhoea drug > Flashcards

Nausea/Vomiting/Constipation/Diarrhoea drug Flashcards

1
Q

note the more important drugs (just tap to see)

A

N/V:
- chemotherapy induced (the 3 classes) + motion sickness (H1/M1 drugs)

contipation

  • break it down into physiological or mechanical cause and then the general drugs for them
  • common approach: osmotic and bulk forming laxatives, stimulant laxatives
  • others are less frequently used

diarrhea:

  • opioid antagonist = for rapid acting control (loperamide)
  • kaolin/pectin
  • bismuth compounds = for infectious diarrhea
  • others are less frequently used

meq:
will test more important conditions or more more severe conditions

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2
Q

what are the different types of GIT drugs?

A
  1. nausea and vomiting
  2. diarrhoea and constipation
  3. anti-peptic ulcer
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3
Q

what are the mechanisms that trigger nausea and vomiting?

A
  1. chemoreceptor trigger zone in CNS (floor of 4th ventricle) - has dopamine receptors, neurokinin receptors and 5-HTC receptors too
  2. GIT (5-HTC receptor)
  3. vestibular system (in the ear)
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4
Q

what are the classes of drugs used in combatting chemotherapy-induced vomiting?

A
  1. serotonin 5-HTC antagonist
  2. corticosteroids
  3. neurokinin receptor antagonist
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5
Q

what are drug examples of serotonin 5-HTC antagonists and the MOA?

A

any -setron

works by inhibiting 5-HTC receptor in GIT (not so much in chemoreceptor trigger zone because 5-HTC is less significant there)

NOTE: does not work for delayed nausea

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6
Q

what is the side effect of serotonin 5-HTC antagonist?

A

QT prolongation

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7
Q

what are the drug examples of corticosteroids and the MOA?

A

dexamethasone

targets vomiting more so than nausea

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8
Q

what are the drug examples of neurokinin receptor antagonist and its MOA?

A

any -prepitant

inhibits the neurokinin receptors in CTZ

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9
Q

what is the side effect of neurokinin receptor antagonist?

A

many DDI’s

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10
Q

what are other drugs that can help with nausea and vomiting, that are not specific for helping chemotherapy-related?

A
  1. dopamine receptor antagonists

2. muscarinic and histamine receptor antagonists

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11
Q

how do we cure anxiety-induced nausea and vomiting?

A

can give benzodiazepines (e.g. lorazepam and diazepam)

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12
Q

moving past anti-nausea and vomiting, let’s go to diarrhoea and constipation drugs - what are the drug classes to cure diarrhoea?

A
  1. make poop harder
  2. increase transit time
  3. cure H. pylori
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13
Q

moving past anti-nausea and vomiting, let’s go to diarrhoea and constipation drugs - what are the drug classes to cure constipation?

A
  1. make poop softer

2. decrease transit time

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14
Q

what are the anti-diarrhoea drugs that help make poop harder?

2 types

A
  1. kaolin/pectin
    - absorbs bacterial toxin/fluid
  2. bile salt resin
    - binds to bile salt and prevents diarrhoea caused by excessive focal bile salt
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15
Q

what are the anti-diarrhoea drugs that help to decrease transit time?

2 types

A
  1. opioid antagonist
    - shuts down GIT motility and secretion
  2. somatostatin-like peptides e.g. octreotide
    - decreases intestinal motility and secretion; and also in the gall bladder and pancreas so that you decrease those secretions as well
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16
Q

what are the anti-diarrhoea drugs that help to cure H. pylori?

2 types

A

in antimicrobials, you still about OAC (omeprazole, amoxicillin and clarithromycin)

but here, we think about:

  1. bismuth compounds
    - binds to the enterotoxin and is mucoprotective
  2. products of lactobacillus acidophilus
    - competitive inhibition with h. pylori for the intestinal wall
17
Q

what are the anti-constipation drugs that help to make poop softer?

3 types

A
  1. bulk-forming laxative
    - absorbs water and forms bulks that stimulate peristalsis
  2. osmotic laxative
    - induces water osmosis into poop
  3. surfactant
    - decreases surface tension so water can enter poop
18
Q

what are the anti-constipation drugs that help to decrease transit time?

4 types

A
  1. opioid antagonist
    - inhibit the receptors that decrease GI motility and secretion
  2. Chloride channel activators
    - increase secretion and motility in small intestine
  3. stimulant laxative
    - produce colonic contractions = increase peristalsis
  4. 5-HT4 receptor antagonist
    - increase peristalsis and colonic movement
19
Q

what are the drug classes for anti-peptic ulcer drugs?

A

HAP (help) Suffering Busy Misses Clear Amassing Asshole work

[receptor/electrolyte stuff]
H: h2 receptor antagonist
A: antacid
P: proton pump inhibitor

[protective mucosal stuff]
S: sulfacrate
B: bismuth compounds
M: misoprostol

[antibiotics]
C: clarithromycin
A: amoxicillin
M: metronidazole/omeprazole

minus the antibiotics and anti-protozoal, we’ll talk about the rest

20
Q

what are examples of and the MOA of antacids?

A

antacids are any weak base

MOA: neutralises acid to form salt and H2O

21
Q

what is the administration of antacids?

A

not very potent so you need to give a lot

either given as a liquid (faster) or tablet

22
Q

what is the side effect/precautions of antacids?

A
  • metabolic alkalosis and milk-alkali syndrome
  • DDI’s
  • Na salt and fluid retention = no good for HTN or renal insufficiency

hence, can be given with Mg and Al supplements

23
Q

what are examples of and MOA of proton pump inhibitors?

A

omeprazole

inhibits H/K ATPase and hence inhibits gastric acid secretion by gastric parietal cells

24
Q

what is the administration of proton pump inhibitors?

A

taken on empty stomach

25
Q

what are the side effects/precautions of proton pump inhibitors

A

honestly, relatively safe

26
Q

what is the MOA of sulfacrate?

A

forms a protective gel over the ulcer and stimulates mucosal prostaglandin and bicarbonate secretion

27
Q

what is the MOA of bismuth?

A

same as sulfacrate

28
Q

what is the MOA of misoprostol?

A

analogue for PGE1 and binds to the receptor to stimulate mucus and bicarb secretion

Pharmacology (11 decks)

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