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40 Cards in this Set
- Front
- Back
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D2 receptors found on the GI tract's Enteric Nervous system are ?
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Inhibitory
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What does metoclopramide do?
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It inhibits the D2 receptors found in the ENS which inhibits the inhibitory stimulus on the GI tract thus Increasing motility
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Major side effect of metoclopramide is?
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extrapyramidal effects
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Tardive dyskinesia
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is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur
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MOA of Tegaserod?
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5-HT4 partial agonist
Stimulation of ENS neurons that leads to neurotransmitter release |
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What does tegaserod do in the GI tract?
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Stimulates motility
Accelerates transit in esophagus, stomach, small bowel, ascending colon Stimulates chloride secretion |
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Contraindicated in severe hepatic or renal failure
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Tegaserod
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What did the FDA approve Tegaserod for?
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IBS of woman <55y/o and no other medication works
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How is erythromycin used as a gastric stimulant?
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Stimulation of Motilin Receptor
Intense gastric contractions dumping of gastric contents into small bowel |
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Laxation
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Laxation: evacuation of material from rectum
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Catharsis
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Catharsis: evacuation of material from entire colon
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Name the common fiber supplements taken?
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Bran
Psyllium hydrophilic mucilloid [Metamucil] Methylcellulose [Citrucel] Calcium polycarbophil [Fibercon] |
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Osmotic (Saline) Laxatives
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Magnesium hydroxide
[Milk of Magnesia] Magnesium sulfate [Epsom salts] Magnesium citrate [Citroma] Sodium phosphate [Phosphsoda] |
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Stimulant (Irritant) Laxatives
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Senna
Cascara sagrada (n/a in U.S.) Castor oil |
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Lactulose • Sorbitol • Mannitol
are.... |
Hydrolyzed in colon to short-chain fatty acid
Osmotically draw water into lumen Stimulate peristalsis |
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Trapping of ammonia produced by colonic bacteria;conversion to polar ammonium ion and decreases circulating ammonia levels
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Lactulose
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Polyethylene Glycol is an?
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Heavy Osmotic
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Lubriprostone
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Activates ClC2 receptor (located in luminal epithelium of intestine increasing water
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________ laxatives ONLY can be used chronically, long-term
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Bulk forming
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Laxative abuse may lead to....
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Steatorrhea,
Protein-losing enteropathy with hypoalbuminemia, Osteomalacia (excessive Ca2+ loss in stool) |
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Osmotic & Stimulant laxatives used long-term can cause:
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Electrolyte depletion
Serum electrolyte abnormalities Dependence (rebound constipation) (stimulants) |
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Treatment of Diarrhea should be focused on?
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Hydration
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Which agents are useful in diarrhea?
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Bulk-Forming Agents
Bismuth Bile Acid Sequestrants Antimotility and Antisecretory Agents |
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AVOID ANTIDIARRHEALS IN DIARRHEAL ILLNESS CAUSED BY
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Vibrio cholera, EIEC (invasive organsims)
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How do Bile acid sequestrants work?
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In conditions like Ulcerative colitis and Crohn's disease there can be inflammation at the terminal ileum. Therefore, bile acids can not be reabsorbed and will act to increase osmotic pressure. Therefore, if we make the bile acid insoluble in water by adding a bile acid sequestrant then there will not be an increase in the osmostic pressure in the colon.
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Name the 3 Bile acid sequestrants?
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Cholestyramine • Colestipol • Colesevalam
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How do opioids work for diarrhea?
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They bind to the MU(new) receptor in the intestines and decrease transit time. Opioids that do not cross the BBB are favored.
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Which opioids do not cross BBB?
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Loperamide [Imodium]
Diphenoxylate / atropine [Lomotil] |
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Somatostatin analoug
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Octreotide
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Nausea / Vomiting
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5-HT3 Receptor Antagonists
NK1 Receptor Antagonists D2 Receptor Antagonists Cannabinoid Receptor Agonist |
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Serotonin 5-HT3 Antagonists
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Ondansetron [Zofran] – prototype
Dolasetron [Anzemet] |
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Drugs of choice in:
Prevention of cancer chemotherapy-induced vomiting |
Ondansteron and Dolasetron and all other drugs in it's class
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Drug of choice in:
Prevention and treatment of postoperative vomiting |
Ondansteron and Dolasetron
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Drug of choice in:
Prevention of nausea and vomiting caused by radiation therapy |
Ondansteron and Dolasetron
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_______ should not be used with drugs that cause QT prolongation
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Dolasetron
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Anaphylactoid reactions have been reported with _____.
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Ondansteron
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Neurokinin Receptor Antagonists
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Aprepitant
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For prevention and treatment of nausea and vomiting (acute and delayed phases) occurring with highly emetogenic cancer chemotherapy
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Aprepitant
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What Cannabinoid is used as an antiemetic?
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Dronabinol
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Use: prophylaxis of chemo-induced emesis when conventional antiemetics have failed
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Dronabinol
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