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Flashcards in Anti-inflammatory Drugs Deck (84)
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1

Imodium: class

Antidiarrheal

2

Imodium: MOA

Inhibits preganglion cholinergic nerves in colon submucosa and myenteric plexus, slowing transit time

3

Imodium: indication

Mild to moderate diarrhea without obstruction

4

Does Imodium cross the blood brain barrier?

Nope

5

Kaopectolin: class

Antidiarrheal

6

Kaopectolin: MOA

Clay and pectin combo absorb fluids and bacterial toxins

7

Kaopectolin: indication

Mild diarrhea

8

Kaopectolin: Dx-Dx

Can absorb meds and decrease their concentration

9

Fiber: class

Antidiarrheal

10

Fiber: MOA

Absorbs and binds fluids, provides stool bulk

11

Fiber: indication

mild to moderate diarrhea, constipation

12

Fiber: Dx-Dx

Can bind to meds/vitamins/minerals

13

Bismuth subsalicylate: class

Antidiarrheal

14

Bismuth subsalicylate: MOA

Salicylate = antisecretory
Bismuth = antimicrobial

15

Bismuth subsalicylate: indication

Mild, unspecific diarrhea, traveler's diarrhea, part of the H. pylori regimen

16

Bismuth subsalicylate: side effect

Discolored stool

17

Bismuth subsalicylate: contraindications

Pregnancy

18

Octreotide: class

Antidiarrheal

19

Octreotide: MOA

Inhibits bowel secretions; dose-related impact on motility; splanchnic arteriole contraction

20

Octreotide: indication

Diarrhea secondary to bowel dysmotility, carcinoid, VIP-oma, vagotomy, dumping syndrome, short bowel syndrome, HIV diarrhea; GI bleeds

21

Octreotide: side effect

Steatorhea, gallstones (>50% in long term use)

22

Octreotide: contraindications

Bowel obstruction

23

Octreotide: Dx-Dx

Insulin, PO hypoglycemics, BBs, CBs

24

Senokot: class

Antidiarrheal

25

Senokot: MOA

Induces mild inflamation, fluid retention, stimulated bowel motility

26

Senokot: indication

Constipation without obstruction

*(then why is it an antidiarrheal???)*

27

Mesalamine: class

5ASA anti-inflammatory

28

Mesalamine: MOA

Local colon anti-inflammatory
Systemic prostaglandin inhibition

29

Mesalamine: indication

Ulcerative colitis, proctosigmoiditis

30

Mesalamine: Dx-Dx

Inhibits folate absorption, so you need to supplement it.

31

Sulfasalazine: class

5ASA anti-inflammatory

32

Sulfasalazine: MOA

Local colon anti-inflammation
Systemic prostaglandin inhibition

33

Sulfasalazine: indication

Ulcerative colitis, Crohn's disease

34

Sulfasalazine: contraindication

G6PD deficiency

35

Sulfasalazine: Dx-Dx

Inhibits folate absorption

36

What is so neat baout the pharmycokinetics of sulfasalazine?

(I think it's neat...but I'm a nerd)

Colonic bacteria cleave away the sulapyridine and release the active 5ASA to do it's thing in the colon.

(I think that's clever!)

37

Azathioprine: class

Purine analogue

38

Azathiprine: MOA

Inhibits DNA/RNA/Protein synthesis

39

Azathioprine: indication

Steroid sparing in steroid dependent CD, UC
Helps maintain remission

40

Azathioprine: Dx-Dx

Use with 5ASA increases the risk of myelosuppression

41

MTX:

How I've missed thee

42

MTX: class

Purine analogue

43

MTX: MOA

Inhibits protein synthesis and IL-1; increases release of adenosine

44

MTX: indication

CD, UC

45

What is important to know about MTX dosing?

Use lower doses for CD and for fewer side effects

46

Remicade: class

TNFa compound

47

Remicade: MOA

Decreased T-helper 1 cell activation & proliferation;
Decrease IL-12 and leukocyte migration;
Increase apoptosis in activated cells

48

Remicade: indication

Acute and maintenance Tx for severe CD, UC

49

Remicade: side effects

TB activation; HBV reactivation

50

Remicade: CD statistics

60% see sxs improvement; 30% see remission

51

Remicade: UC statistics

50-70% see sxs improvement; 33% see remission

52

Actigall: class

Gallstone dissolution agent

53

Actigall: MOA

Reduces hepatic secretion of cholesterol

54

Actigall: indication

Gallstones
Gallstone prevention in rapid wt loss
Primary biliary cirrhosis

55

Actigall: side effects

H/A, diarrhea

56

Actigall: what's the down side?

Dissolution takes months and the risk of recurrence is ~50%

57

Amitiza: class

Ca++ channel activator laxative

58

Amitiza: MOA

Activated Ca++ channels increase bowel secretions and motility

59

Amitiza: indication

Chronic idiopathic constipation
IBS constipation
Opioid constipation

60

Amitiza: side effect

Peripheral edema

***As a side note, you may remember that CCBs also cause peripheral edema. This just proves that pharmacology is black magic.

61

How do you take Amitiza?

With food

62

Linzess: class

cGMP agonist laxative

63

Linzess: MOA

Agonizes cGMP on bowel luminal surface, resulting in increased bowel secretions and motility

64

Linzess: indication

IBS-C in adults who did not respond to PEG; chronic idiopathic constipation in adults

65

Linzess: contraindication

66

What has to go along with an Rx for Linzess?

FDA med guide

67

How do you take Linzess?

30 minutes before meals on an empty stomach

68

MiraLax: class

Osmotic laxative

69

MiraLax: moa

Causes H2O secretion in stool and increases stool frequenct

70

MiraLax: indication

Occasional constipation
*short term use only*

71

MiraLax: side effect

Electrolyte imbalance

72

MiraLax: contraindication

Bowel obstruction

73

Lactulose: class

Osmotic laxative

74

Lactulose: MOA

Synthetic saccharide increases osmosis;
enhances secretion on NH3 into gut - then converts it to NH4 which cannot cross back

75

Lactulose: indication

Px and Tx of PSE

76

What dietary consideration need to be made on Lactulose?

Need a diet low in galactose

77

MgCitrate: class

Mg++ laxative

78

MgCitrate: MOA

Osmotic retention of bowel fluid distends colon and increases peristalsis

79

MgCitrate: indication

Occasional constipation; study prep

80

MgCitrate: contrindication

Low salt diet

81

Your Pt is going to call you and complain if you don't tel them this...

Chilling it makes it more palatable

82

Natalizumab: class

Anti-integrin

83

Natalizumab: MOA

Inhibits intergrins on leukocyte surfaces;
Inhibits their adhesion to vascular endothelium and migration into tissues

84

Natalizumab: indication

Severe, refractory CD