GIT Pharma Flashcards
(26 cards)
What is the mechanism of action of 5-AMINO SALICYLIC ACID COMPOUNDS (5-ASA)?
Inhibition of PGs and LTs, interferes with production of inflammatory cytokines, may inhibit cellular functions of NKCs, mucosal lymphocytes, and macrophages, antioxidant activity
What are the overdose toxicity manifestations of tricyclics?
Agitation, delirium, neuromuscular irritability, convulsions, coma, respiratory depression, circulatory collapse, hyperpyrexia, cardiac conduction defects
What is the mechanism of action of Lubiprostone?
Chloride channel activator that activates type 2 chloride channels in the small intestine
What are the contraindications for Lubiprostone?
Pregnancy (category C)
What is IBS?
Irritable Bowel Syndrome
What are the adverse effects of tricyclic antidepressants (TCAs)?
Excessive sedation, fatigue, confusion, ECG abnormalities, cardiomyopathies, atropine-like effects, orthostatic hypotension, tremor, paresthesias, weight gain, severe arrhythmias
List the TCAs mentioned in the text.
- Amitriptyline
- Imipramine
What is the rationale for using TCAs in treating IBS?
They alter central processing of visceral perception from GIT and decrease GIT motility and secretions
What are the anticholinergics mentioned?
- Mebeverine (Colofac)
- Dicyclomine (Bentyl)
- Hyocyamine
What is the mechanism of action of Tegaserod?
Serotonin 5HT-4 receptor agonist
Why was Tegaserod withdrawn from the market?
Cardiotoxic effects
What is the clinical use of Alosetron?
Treatment of women with severe IBS with diarrhea as predominant symptom
What are the adverse effects of Alosetron?
Rare but serious GIT toxicity, constipation (30%), hospitalization due to constipation reported 1 in 1000 patients
What are the treatment goals for IBD?
- Controlling acute exacerbations
- Maintaining remission
- Preventing relapse
- Treating specific complications
What are the components of Azole compounds?
- Sulfasalazine: 5-ASA + sulfapyridine
- Olsalazine: 5-ASA + 5-ASA
- Balsalazide: 5-ASA + amino benzoyl-β-alanine
What is the pro-drug component of Sulfasalazine?
Combination of 5-ASA and sulfapyridine
What are the side effects of Sulfasalazine?
- Headache
- Nausea
- GIT upset
- Arthralgias
- Myalgias
- Bone marrow suppression
- Hypersensitivity reactions
- Folic acid deficiency
- Impairment of male fertility
- Interstitial nephritis
- Secretory diarrhea (olsalazine)
What are the oral formulations of Mesalamine?
- Asacol
- Pentasa
What are the rectal formulations of Mesalamine?
- Canasa (suppositories)
- Rowasa (enema)
What are glucocorticoids used for in IBD?
Induction of remission in moderate & severe IBD; not used for maintaining remission
What is the role of Methotrexate in IBD?
Steroid resistant or steroid dependent IBD; induction and maintenance of remission
What are the monoclonal antibodies used in IBD?
- Infliximab
- Adalimumab
- Golimumab
- Certolizumab
What are the drugs used for treatment of IBS?
- Fibers
- Osmotic agents
- Lubiprostone
- 5-HT4 agonists (Tegaserod)
- Prokinetics
- 5-HT3 antagonists (Alosetron)
- Anticholinergics
- TCAs
- SSRIs
- Anti-flatulents
- Loperamide
- Cholestyramine
