Santos Flashcards
Ondesetron, Granisetron, Dolesetron, Palonesetron
- block 5-HT3R
- for chemo- or post-op induced vomiting
- AE: SERROTONIN SYNDROME and QT PROLONGATION
Aprepitant, Netupitant, Rolapitant
- blocks NK-1R
- for chemo-induced vomiting
- metabolized by CYP3A4 -> Aprepitant decreases INR in ptxs on Warfarin
- QT prolongation if used w/ cisapride
Diphenhydramine, Dimenhydrinate, Meclinizine
- blocks H1R
- prevent motion sickness/vertigo and chemo induced vomiting
- 1st 2 have SEDATING properties
Hyoscine (Scopalamine)
- blocks M1R
- prevent motion sickness/vertigo
- transdermal patch
Metoclopramide
- blocks D2R
- for chemo induced vomiting
- SAFE DURING PREGNANCY
Prochlorperazine and Promethazine
- anti-psychotic
- blocks D2R -> antiemetic
- EXTRAPYRAMIDAL symptoms
Olanzapine
- anti-psychotic
- blocks D2R -> antiemetic
Droperidol
- anti-psychotic
- blocks D2R -> antiemetic
- EXTRAPYRAMIDAL symptoms and QT PROLONGATION
Dronabinol
- CB1R agonist
- appetite stimulant in AIDS ptxs
- prevent chemo-induced nausea
Pyridoxine (vit. B6) + Doxylamine (H1 receptor blocker)
-treat nausea/vomiting in PREGNANCY
Diazepam and Lorazepam
-reduce anticipatory vomiting from anxiety in chemo ptxs
when do you NOT want to give anti-diarrheals?
-bloody diarrhea, fever, systemic toxicity
Bismuth Subsalicylate (pepto-bismol)
- anti-diarrheal
- treats H. pylori and TRAVELERS DIARRHEA
- AE: REYE’S SYNDROME, hearing loss, dark stools, black tongue
Loperamide
- uOpiod receptor agonist -> anti-diarrheal
- does NOT cross blood brain barrier
- used for Travelers diarrhea
- not used in children <2 y/o
Diphenoxylate and Difenoxin
- uOpiod receptor agonist -> anti-diarrheal
- CROSSES blood brain barrier
- Schedule V CONTROLLED substance by DEA
- used w/ ATROPINE -> promote constipation and prevent abuse
- AE: TOXIC MEGACOLON
Cholestyramine, Colestipol, Colesevelam
- sequester excess bile salts/acid -> prevent diarrhea
- can exacerbate fat malabsorption
- 1st 2 prevent absorption of drugs
Octreotide
- SST analogue
- inhibit secretion of 5-HT and GI peptides (VIP) -> treat secretory diarrhea
- for variceal bleeding, dysmotility, acute pancreatitis
Calcium polycarbophil and Carboxymethylcellulose
- bulk forming agents
- for chronic diarrhea in IBS
Crofelemer
- inhibit cAMP-stimulated CFTR Cl- channels and Ca2+ activated Cl- channels on the luminal enterocyte -> prevent water loss
- treat diarrhea associated with ART therapy in HIV/AIDS ptxs
the most important NT in the ENS
5-HT
-released by enterochromaffin cells (ETC) -> + gut reflexes
pro kinetic drugs
-treat constipation -> increase COORDINATED GI motility
Bethanechol and Carbchol
-+ M3 receptor at myenteric plexus -> increase ACh -> increase motility
Neostigmine
-AChE inhibitor -> increase ACh at myenteric plexus -> increase motility
Metoclopramide and Domperidone
-D2R blockers -> increase ACh and GI motility
Meoclopramide
- both D2R blocker and 5-HT4R agonist -> increase ACh and GI motility
- AE: TARDIVE DYSKINESIA
Cisapride
- 5-HT4R agonist and weak 5-HT3R antagonist -> increase ACh and GI motility
- AE: cardiac -> FATAL ARRYTHMIAS and QT PROLONGATION
Tegaserod
- PARTIAL 5-HT4R agonist -> increase ACh and GI motility
- for constipation w/ IBS
motilin
-release from M cells and ETC cells -> increase GI motility
erythromycin (macrolide)
- bind to GPCR like motilin -> increase GI motility (only gastric and small bowel)
- used for diabetic gastroparesis
Psyllium, Methylcellulose, Polycarbophil
- bulk-forming laxatives
- colloids absorb water -> distention -> peristalsis
Docusate
- ANIONIC stool surfactant/softener
- lower stool surface tension -> promote water and lipid penetration
Mineral oil and Glycerin suppository
-other stool surfactant agents
Magnesium hydroxide (milk of magnesia) and Magnesium citrate
- osmotic laxatives
- for bowel cleansing before procedures or constipation
- AE: hypermagnasemia or ABUSED BY BULEMICS
Senna***
- stimulant laxative -> + ENS
- prolonged use -> MELANOSIS COLI
Bisacodyl
- stimulant laxative
- safe for long term use
Castor oil
- stimulant laxative
- AE: unpleasant taste and toxic effects on ENS
Lubiprostone
- chloride secretion activator
- + type 2 chloride channels (ClC-2)
Linaclotide and Plecanatide
- chloride secretion activators
- bind type 2 chloride channels and + guanylate cyclase
- NOT USED IN PEDIATRICS
Methylnaltrexone and Alvimopan
- opioid receptor antagonists (u-Opioid receptors)
- AE: CV TOXICITY
Methylnaltrexone
for opioid induced constipation
Alvimopan
for post-op ileus
