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Flashcards in GI Drugs Deck (68):
1

Mineral oil

Laxative

Emollient (Nonabsorbable, lubricate the bowel)

2

Erythromycin

Prokinetic (antibiotic)

Motilin agonist

3

Al(OH)3

Antacid

4

Dimenhydrinate

Antiemetic

H1 antagonist

 

Use:

Motion sickness

5

Cisapride

Prokinetic

Serotonin 5-HT4 agonists

(PULLED)

6

Psyllium

Laxative

Bulk-forming + lot of water = constipation relief

Nonabsorbable. Forms large hydrophilic mass, which reduces transit time (with lots of water, osmotic pull draws water inside lumen)

7

Diphenoxylate is metabolized (hepatic) to ___ (active metabolite 200-400X more potent than diphenoxylate alone)

Difenoxin

8

Certolizumab

IBD drug

Biologic

Anti-TNF-alpha

Polyethylene glycolated Fab fragments of human anti-TNF

9

Tegaserod

Prokinetic

Serotonin 5-HT4 agonists

 

(CURRENTLY ONLY FOR EMERGENCY USE)

10

Rabeprazole

PPI

11

Lansoprazole

PPI

12

Colloidal busmuth compounds

Protectant

13

Kaolin (hydrated aluminum silicate) + pectin

Antidiarrheal

Bulk/gel-forming agent (with little water)

Increases flow resistance and increases formed stools (reabsorbs water)

 

14

Prochlorperazine

Antiemetic

Dopamine D2 antagonist

15

Propantheline

Muscarinic (M3) antagonist → block M3 receptors on parietal cells = decreasing proton pump activity

16

Bethanecol

Prokinetic

Muscarinic M3 agonist

17

Pirenzepine

Muscarinic (M1) antagonist → blocks release of histamine from paracrine ECL cells

18

Trihexethyl

Muscarinic (M3) antagonist → block M3 receptors on parietal cells = decreasing proton pump activity

19

Sucralfate

Protectant

  1. Complexes with protein at ulcer to form protective layer
  2. Stimulates PG secretion
  3. Decreases back-diffusion of H+
  4. Binds to, and inactivates, pepsin and bile salts
  5. Suppresses H. pylori infection - this decreases further acid secretion

20

Scopolamine

Antiemetic

Atropine-like muscarinic antagonist

 

Use: 

Motion sickness

Available as patch

21

Neostigmine

Prokinetic

Acetylcholinesterase inhibitor

22

Prednisolone

IBD drug

Steroid (glucocorticoid)

Oral

23

Glycopyrrolate

Muscarinic (M3) antagonist → block M3 receptors on parietal cells = decreasing proton pump activity

24

Carbenoxolone

Protectant

Increae secretion/viscocity of mucus (PG-type mechanism without PG side effects)

N/A in USA

25

Granisetron

Antiemetic

5-HT3 antagonist

26

Azathioprine

IBD drug

Immune modifier 

Purine analog

27

Asacol

IBD drug

Aminosalicylates (5-ASA)

Mesalamine-only formulation

Coated 5-ASA - dissolves at pH 7 (in ileum and colon)

 

28

Nizatidine

H2 antagonist

 

(decreases cAMP)

29

Pentasa

IBD drug

Aminosalicylate (5-ASA)

Mesalamine-only formulation

Time-release micro-granules that release 5-ASA throughout the small intestine

30

Infliximab

IBD drug

Biologic

Anti-TNA-alpha

31

Hydrocortisone

IBD drug

Steroid (glucocorticoid)

Enema, foam, or suppository*

32

Meclizine

Antiemetic

H1 antagonist

 

Use:

Motion sickness

33

Ranitidine

H2 antagonist

 

(decreases cAMP)

34

6-mercaptopurine

IBD drug

Immune modifier

Purine analog

35

Dicyclomine

Antidiarrheal → reduces contractile activity

Muscarinic (M3) antagonist → block M3 receptors on parietal cells = decreasing proton pump activity

 

36

Cholestyramine

Antidiarrheal (anti-lipid med)

Ion-exchange resin

Binds water and bile salts → slows movement

37

Famotidine

H2 antagonist

 

(decreases cAMP)

38

Misoprostol

Protectant

Inhibit adenylate cylase (parietal cells) → decreases cAMP

Decreases acid secretion and increases bicarbonate/mucus secretion

39

Rhubarb

Natural laxative

40

Prednisone

IBD drug

Steroid (glucocorticoid)

Oral

41

Loperamide

Antidiarrheal

Opiate

Increase flow resistance, decrease propulsion and secretion

42

Omeprazole

PPI

43

Sulfasalazine

IBD drug

Aminosalicylate (5-ASA)

Sulfapyridine + 5-ASA

44

Rowasa

IBD drug

Aminosalicylate (5-ASA)

Enema formulation of 5-ASA (mesalamine)

45

Aloe

Natural laxative

46

Adalimumab

IBD drug

Biologic

Anti-TNF-alpha

Complete human IgG1 antibody

47

Frangula

Natural laxative

48

___ was added to diphenoxylate to reduce abuse potential (slight diffusion across BBB)

Atropine

49

Esomeprazole

PPI

50

Dicyclomine

Muscarinic (M3) antagonist → block M3 receptors on parietal cells = decreasing proton pump activity

51

Mg(OH)3

Antacid

52

Ondansetron

Antiemetic

5-HT3 antagonist

 

53

Balsalazide

IBD drug

Aminosalicylate (5-ASA)

4-aminobenzoyl-beta-alanine + 5-ASA

54

Dronabinol

Antiemetic

Oral formulation of THC

 

Uses:

Chemo-induced emesis (when other drugs fail)

Appetite stimulant in AIDS patients

55

NaHCO3

Antacid

56

Milk of magnesia

Laxative

Saline (inorganic salts → water movement into intestine based on osmotic gradient)

57

Olsalazine

IBD drug

Aminosalicylate (5-ASA)

5-ASA + 5-ASA (diaminosalicylate)

58

Castor oil

Laxative

Secretory/stimulant (opens Cl- channels → water and electrolyte movement into intestine)

59

Canasa

IBD drug

Aminosalicylate (5-ASA)

Suppository formulation of 5-ASA (mesalamine)

 

 

60

Rifaximin

Treatment for IBD-D

61

Cimetadine

H2 antagonist

 

(decreases cAMP)

62

CaCO3

Antacid

63

Senna

Natural laxative

64

High doses of diphenoxylate may cause ___, which is reversed by ___. 

  1. Respiratory depression
  2. Naloxone

65

Bismuth subsalicylate

Antidiarrheal

Anti-secretory agent

Decreases net fluid secretion

66

Methotrexate

IBD drug

Immune modifier

DHF reductase inhibitor

67

Diphenoxylate 

Antidiarrheal

Opiate (atropine added to decrease opiate effects)

Increase flow resistance, decrease propulasion and secretion

68

Metoclopramide

Prokinetic & Antiemetic

Dopamine D2 antagonist

 

Remember: D2 receptors are inhibitory of cholinergic effects. By this method, we are inhibiting an inhibitor, thus increasing cholinergic effects (the goal of prokinetics)