Drugs used for constipation and diarrhea. Drugs promoting digestion Flashcards
List the types of laxatives
Bulk laxatives Osmotic laxatives Bowel irritants Stool softeners Anti-opioid laxatives Chloride channel activators
Salt/osmotic laxatives:
MgSO4, NA2SO4
Lactulose
Glycerol
Bulk laxatives
Bulk laxatives:
Fiber, methylcellulose
Take 1-3 days to work
Osmotic laxatives
Rapid onset, 30 mins thru 3 hours
PEG plus ions used prior to colonoscopy
Magnesium hydroxide
Magnesium citrate
Sodium phosphate, bisphosphate
Mannitol
Sorbitol
Lactulose
these 3 cause significant meteorism.
Bowel irritants
Take 1-12 hours to work.
Castor oil - the harshest, can ‘cleanse whole bowel’
massive diarrhea then no poop for days
Senna oil, Rhubarb, easier
Biscacodyl
Phenolphythalein - used in hungary, high risk in pregnancy and can cause arrythmia
Stool softeners
Paraffin oil - lubricant. can be very pleasant and frequently used, leading to chronic granuloma formation in the GI.
Glycerin
Docusate
Anti-Opioid laxatives
Naloxone
Methylnaltrexone
Chloride channel activators
Lubiprostone
Lincaclotide
These are indicated for IBS induced constipation.
Enhance Cl secretion into bowel., have minimal absorption.
Antidiarrheal drugs classes
4
Opioids
Parasympatholytics
Octreotide
Absorbing Astringint materials
What are the antidiarrheal opioids
u agonist opioids
Loperamide
Diphenoxylate
Loperamide pumped out of CNS by P glycoprotein
Diphenoxylate mixed with atropine to prevent abuse and euphoric doses. Atropine also inhibits bowel motility.
What is octreotide used for
Diarrhea caused by carcinoid syndrome
its a somatostatin analog
What are the absorbing and astringent antidiarrheals
Kaolin Klay Plus Pectin
and
Bismuth subsalicylate- Peptobismol
They absorb bacterial toxins that are stimulating diarrhea, and have weak antibacterial effects.
What substances are used to promote digestion
10% HCl solution, drtank through a straw
Pancreatic enzyme replacement therapy.
Pancreatin -
A commercial mix of pancreatic enzymes, lipases, amylases, peptidases, etc. taken orally with meals.
Bitters
Similar to the irritants, promoting gastric/GI secretion and motility.
What are the hepatoprotective drugs
N-Acetylcystein – > antidote to NAPQI poisoning from paracetamol. Administered Orally, due to significant risk of anaphylaxis if given i.v.
Regenerates glutathione
Silbinine - Antioxidant that is used with minimal helpfulness in amanita phalloides poisoning. amanatin inhibits RNA pol.
Vitamin B supplements
Antioxidants
What are the sources of hepatotoxicity
Halothane Paracetamol Alcohol All the TB drugs Amiodarone Methotrexate, Azathioprine MANY drugs
Biliary tract pharma
Bile acid binding resins: Cholestyramine, Cholesevelam, Cholestipol
Can be used for hypercholesterolemia, and also to treat Diarrhea due to Small intestine resection
Ursodiol: Used as bile acid supplement in liver disease, primary biliary sclerosis, or gallstones. Out-dated treatment for gall stone dissolution, now cholecystectomy.
