Drugs for Diarrhea, Abdominal Pain and Constipation Flashcards
4 agents used for treatment of diarrhea
Prostaglandin inhibitors
Opiod agonists
Serotonin (5HT3) antagonists
Cl- channel inhibitors
Loperamide belongs to which class?
What is the MOA?
What are the side-effects?
Opiod agonists
Interferes with peristalsis (slows transit time) by acting on circular and longitudinal ms. Does not exhibit analgesic/opiate-like effects
Anti-cholinergic effects: dizziness, fatigue, drowsiness, urinary retention, etc.
Diphenoxylate belongs to which class?
What is the MOA?
What is given in small quantities with it?
What are the side-effects?
Opiod agonists
Inhibits GI motility and slows GI propulsion
Atropine
Anti-cholinergic: dizziness, drowsiness and urinary retention, etc.
Eluxadoline belongs to which class?
What is the MOA?
What is the indication for it?
What are the side-effects?
What are the contraindications?
Opiod agonists
Agonist at mu and kappa receptors in GI tract
Antagonist at delta opiod receptors in GI (decreased stomach, pancreas, biliary tract secretions)
IBS-diarrhea sub-type
S-E: pancreatitis in high risk pts. w/o a Gb (do not use on pts. with a h/o liver, pancreatic or Gb dz)
Biliary duct obstruction, alcoholism, h/o pancreatitis, severe hepatic impairment
Alosetron belongs to which class?
What is the MOA?
What is the indication for it?
What is the major side-effect?
Serotonin antagonists
Selectively blocks GI-based 5HT3 receptors
Chronic, sever IBS-diarrhea sub-type that is non-responsive to other conventional therapies (women)
Ischemic colitis (black box warning).
Crofelemer belongs to which class?
Comes from?
What is the MOA?
What is the indication?
What are the side-effects?
Cl- channel blockers
Dark red sap from tree bark
Inhibits Cl- secretion by blocking cAMP-stimulated CFTR and Ca++-activated Cl- channels (CaCC)
Non-infectious diarrhea in HIV/AIDS (for pts. on antiviral therapy)
GI-related, infections (respiratory/urinary)
What drug class is used for abdominal pain/spasm?
What are the 3 drugs?
Anti-muscarinic agents
Hyoscyamine
Dicyclomine
Clidinium/Chlordiazepoxide
What are the side-effects associated with anti-muscarinics?
Classic anti-cholinergic-based: dry mouth, urinary retention, constipation, drowsiness, mental confusion, blurred vision, etc.
What 4 drug classes are used to treat constipation?
Laxative/cathartic agents
Peripheral opiod antagonists
Guanylate cyclase-C agonists
Selective chloride (C2) channel activators
Linaclotide belongs to which class?
What are the indications?
Guanylate cyclase-C agonists (uses CFTR ion channel)
IBS-constipation sub-type
Chronic idiopathic constipation (CIC)
Lubiprostone belongs to which class?
What is the MOA?
What are the indications?
Selective chloride (C2) channel activators
PGE-1 derivative that increases intestinal fluid secretion by activating GI specific Cl- channels in luminal cells
IBS-constipation sub-type (IBS-C)
Chronic idiopathic constipation (CIC)
Opioid-induced constipation** (OIC)
Methylnaltrexone belongs to which class?
What is the MOA?
What is the indication?
Peripheral opiod antagonists
Inhibits peripheral mu-opiod receptor anatgonists
Opioid-induced constipation (OIC)
What are the 5 classifications of laxatives and cathartics?
Stimulants Osmotics Salines Bulk-forming Stool softeners
What are 4 examples of bulk-forming laxatives/cathartics?
How long until efficacy is seen?
What are some adverse effects?
There are lots of drug interactions. What 2 bulk-forming agents are most prone to drug interactions?
Fiber/bran
Psyllium
-cellulose
Polycarbophil
2-4 days
Bloating/obstruction
Psyllium and celluloses
Stool softeners are AKA as… (2)
What are 3 types?
When is efficacy seen?
What are the adverse-effects?
Surfactant or Emollient
Docusate salts
Mineral oil
Anionic surfactants
1-3 days
GI-related
