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GI Exam 1 > GI Meds > Flashcards

GI Meds Flashcards

(52 cards)

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1
Q

Guanylate Cyclase-C (GC-C) Agonists

A

● Linaclotide (Linzess)
● Plecanatide (Trulance)

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2
Q

Chloride Channel activator

A

Lubiprostone (Amitiza)

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3
Q

What is OIC?

A

Opioid Induced Constipation:
● Chronic opioid use is very common in US medicine. (Opioid Epidemic)
● Opioids cause decreased motility and decrease peristalsis.
● Potential for constipation and ileus.

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4
Q

Management of OIC?

A

● Prophylactic laxative or stool softener
● Increase fluid intake

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5
Q

Peripherally-Acting Opioid Antagonists

A

● Naloxegol (Movantik)
● Methylnaltrexone (Relistor)
● Naldemedine (Symproic)

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6
Q

Peripherally-Acting Opioid Antagonists indication/MOA

A

Blocks action at the mu receptor
Indication: Opioid-induced constipation

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7
Q

Black Box Warnings of Guanylate Cyclase-C (GC-C) Agonists

A

Risk of serious dehydration in pediatric patients younger than 2 years

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8
Q

Antiemetics include:

A

Anticholinergic Agents:
Dopamine Receptor Antagonists:
● Phenothiazines: Promethazine (Phenergan),
Prochlorperazine (Compazine)
● Benzamide: Metoclopramide (Reglan)
5-HT3 Receptor Antagonists:

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9
Q

Antacids and Acid Reducers:

A

PPIs
Histamine 2 receptor agonists
Antacids/alkalinizing agents
Mucosal Protective Agents
Anti-Diarrheals (Antimotility) Agents

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10
Q

Laxatives include

A

Bulk-Forming Laxatives
Osmotic Laxatives
Stimulant Laxatives
Lubricant Laxative
Stool Softener (Surfactant)
Guanylate Cyclase-C (GC-C) Agonists
Peripheral acting Opioid receptor antagonists
Chloride Channel Activator

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11
Q

Anticholinergic Agent

A

Scopolamine

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12
Q

Scopolamines form of medication

A

72- hour transdermal patch

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13
Q

D2 Receptor Antagonists - Phenothiazines MOA

A

● Promethazine (Phenergan)
● Prochlorperazine (Compazine)
Selectively antagonize the
Dopamine D2 receptors centrally

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14
Q

BOX WARNINGS for D2 Receptor Antagonists - Phenothiazines

A

○ Promethazine - severe respiratory depression and death in Pts under 2.
○ Promethazine - severe tissue injury and gangrene with injectable form.
○ Prochlorperazine - not be used in patients with dementia-related psychosis.

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15
Q

Anticholinergic Side effects

A

Hot as hell
Blind as a bat
Dry as as bone
Red as a beet
Mad as a hatter
Stuffed as a pipe

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16
Q

Side Effects of Phenothiazines

A

Significant drowsiness, sedation, extrapyramidal symptoms (dystonia, Parkinson’s symptoms), hypotension

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17
Q

D2 Receptor Antagonists - Benzamides MOA

A

○ Increases gastric motility by blocking
intestinal Dopamine receptors.
○ Increases LES tone and stimulates
contractions, thereby increasing GI
motility and decreasing the sensation
of nausea.

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18
Q

Contraindications of D2 Receptor Antagonists - Benzamides

A

Confirmed or suspected bowel obstruction, perforation, or hemorrhage

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19
Q

Hyperprolactinemia can occur as a side effect of ____

A

D2 Receptor Antagonists - Benzamides
(Dopamine inhibits prolactin release)

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20
Q

Box Warning of D2 Receptor Antagonists - Benzamides

A

can potentially cause Tardive Dyskinesia, which is often
irreversible. Risk increases with longer duration of treatment and
higher total cumulative dose

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21
Q

5-HT3 Receptor Antagonists

Study These Flashcards
A

● Ondansetron (Zofran)
● Granisetron

22
Q

5-HT3 Receptor Antagonists MOA

Study These Flashcards
A

○ Act as anti-nausea medication by
blocking Serotonin (5-HT3) receptors
on afferent nerves in the gut.

23
Q

For which medication are we concerned about QT prolongation as an adverse effect?

Study These Flashcards
A

5-HT3 Receptor Antagonists
Odansetron (Zofran)

24
Q

Proton Pump Inhibitors (PPIs) MOA

Study These Flashcards
A

○ Block gastric acid secretion and decrease
intragastric H+.
○ Done by inhibiting hydrogen-potassium
ATPase pump on the luminal surface of
parietal cells

25
Maximum acid inhibition for PPIs is reached after ____ days of use.
3-4
26
Histamine 2 Receptor Antagonists
● Famotidine (Pepcid, Zantac 360) ● Cimetidine (Tagamet) ● Nizatidine (Axid)
27
Histamine 2 Receptor Antagonists MOA
Blocks Histamine 2 receptors on parietal cells, preventing histamine-induced acid secretion. ■ Decreases gastric acidity
28
Long term Cimetidine has been associated with _____
Gynecomastia.
29
Antacid (Alkalinizing) Agents
● Calcium Carbonate (Tums) ● Sodium Bicarbonate (Alka-Seltzer) ● Magnesium and Aluminum Hydroxide (Maalox brand discontinued, Mylanta)
30
Antacid (Alkalinizing) Agents MOA
○ These are all considered “buffers” and interact with H+ in the gastric lumen, neutralizing the acid, raising the pH.
31
Calcium carbonate- Should not be taken if _____
frequent kidney stones or in patients with hypercalcemia
32
Mucosal Protective Agents
Sucralfate (Carafate) Misoprostol (Cytotec)
33
Sucralfate (Carafate) MOA and Indications
○ Acts primarily by forming a physical barrier over the injured epithelium and also increasing the secretion of mucous. Indications - ○ Duodenal Ulcers ○ GERD in pregnancy
34
Misoprostol (Cytotec) MOA
Mechanism of Action: A prostaglandin analogue, which stimulates mucous production and weakly inhibits the proton pump.
35
Misoprostol (Cytotec) Indications
○ Peptic Ulcer Disease ○ Prevention of NSAIDs induced gastric ulcers. ○ Cervical Ripening and Labor Induction (Given vaginally). ○ Medical termination of pregnancy before 70 days
36
Misoprostol (Cytotec) BBW
Contraindicated during pregnancy (other than for induction) because it may cause birth defects, abortion, or premature birth (BBW) ○ Do not use in a female patient within childbearing age, unless you ensure they are not pregnancy and are on birth control (BBW)
37
Bismuth Subsalicylate MOA
○ Antisecretory, antimicrobial, and antiinflammatory action. ○ Reduces irritation of stomach and intestinal lining through inhibition of prostaglandin
38
Bismuth Subsalicylate contraindications
Children with a recent history of viral infection. It is converted to salicylic acid (like Aspirin) and increases risk of Reye’s Syndrome.
39
Opiate Receptor Agonists
● Loperamide (Imodium) ● Diphenoxylate + Atropine (Lomotil
40
Opiate Receptor Agonists MOA
These bind to opioid receptors in the bowel and lead to decreased bowel peristalsis (↓ propulsion) and decreased secretions (↓ motility). This equals increased intestinal transit time and harder stool.
41
Loperamide Indications
Mild/moderate, acute, non-febrile, non-bloody diarrhea ■ Chronic diarrhea associated with Irritable Bowel Syndrome.
42
Opiate Receptor Agonists contraindications
○ Some forms of significant infectious diarrhea ○ Contraindicated in diarrhea secondary to Inflammatory Bowel Disease.
43
Loperamide BBW
potential to cause Torsades and sudden cardiac death if taken at too high of a dose.
44
Stool Softener
Docusate Sodium (Colace)
45
Docusate Sodium (Colace) MOA
○ Reduces surface tension of the oil-water interface of the stool resulting in enhanced incorporation of water and fat, leading to softer feces.
46
Bulk-Forming Laxatives (Fiber)
● Psyllium (Metamucil) ● Methylcellulose (Citrucel) ● Polycarbophil (FiberCon) ● Wheat dextrin (Benefiber)
47
Bulk-Forming Laxatives (Fiber) MOA
● These are polysaccharides or cellulose derivatives that resist digestion and retain water ● Fiber promotes intestinal motility by increasing the bulk of the stool. ● The result is increased frequency of stooling and softer consistency of stool.
48
Osmotic Laxatives
● Sodium Phosphate (Fleet Enema) ● Lactulose (a synthetic disaccharides) ● Polyethylene Glycol (MiraLax, GoLytely) ● Glycerin (can be suppository) Saline-type osmotic laxatives: ● Magnesium Hydroxide (Milk of Magnesia) ● Magnesium Sulfate (Epsom Salt) ● Magnesium Citrate
49
Osmotic Laxatives MOA
● These increase the luminal osmolality, creating an inward osmotic force, pulling water from the vasculature into the lumen of the intestines.
50
______ is the safest and most gentle Osmotic Laxative.
Polyethylene Glycol
51
Stimulant Laxatives
● Senna (Ex-Lax) ○ “Sennosides” ● Bisacodyl (Dulcolax)
52
Stimulant Laxatives MOA
○ Also known as “irritant laxatives,” these work by irritating the intestinal wall, which leads to an accumulation of fluid and electrolytes, which increases motility and produces a bowel movement.

GI Exam 1 (5 decks)

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