L24- GI Drugs II (antidiarrheals)

Question 1

_______ agents will activate presynaptic receptors in the enteric nervous system in order to decrease gut peristalsis

Answer 1

opioid agonists

Question 2

list the opioid agonists

Answer 2

• loperamide

- diphenoxylate

Question 3

describe opioid agonist MOA

Answer 3

• activates pre-synaptic mu-opioid receptors in enteric nervous system
• inhibits ACh release
• decreases GIT peristalsis

Question 4

Loperamide is a (1) type drug, with (2) as a positive property and (3) as contraindications

Answer 4

1- opioid agonist

2- low addiction potential (no analgesic properties)

3- children, Pts with severe colitis

Question 5

Diphenoxylate is a (1) type drug, with (2) as AEs and (3) as contraindications

Answer 5

1- opioid agonist

2- CNS effects at high doses + opioid dependence with prolonged use

3- chidren, Pts with severe colitis

Question 6

list the anti-diarrheals

Answer 6

• opioid agonists
• somatostatin analogs
• bismuth compounds

Question 7

______ agents are analogs of an endogenous peptide regulator of enteric function

Answer 7

somatostatin analogs (octreotide)

Question 8

octreotide is a (1) type drug that is indicated for (2) and (3)

Answer 8

1- somatostatin analog

2- secretory diarrhea due to neuroendocrine tumors (carcinoid, VIPoma)

3- diarrhea via vagotomy, dumping syndrome, short bowel syndrome, AIDS

Question 9

list the AEs of octreotide

Answer 9

(somatostatin analog)

• dec pancreatic exocrine function
• -> steatorrhea + vit-ADEK deficiency

-inhibition of gallbladder contractility –> biliary sludge –> possible gallstone development

Question 10

______ agent controls diarrhea by decreasing fluid secretion in enteric tract due to coating action

Answer 10

bismuth compounds – bismuth subsalicyclate

Question 11

Bismuth subsalicyclate MOA (+ main indication)

Answer 11

(traveler’s diarrhea)

-coating action + salicyclate controls diarrhea via –> dec fluid secretion