Lower Gi Drugs

Front 1

Dietary fiber, methycellulose, psyllium, and polycarbonphil- Class, MOA, AE

Back 1

Class: bulk forming laxatives
MOA: inert materials that arent absorbed by GIT-- absorbs water in lumen -- swell to form sort mass-- induces peristalsis by stretching bowel lumen
AE: bloating, flatulence, Must be suspended in enough water though b/c will cause fecal impaction otherwise

Front 2

Bulk forming laxatives- Use

Back 2

- best laxatives fro chronic use-- mimic effect of well balanced diet-- dietary fiber is hte best though.

Front 3

Bisacodyl, Senna/Sennosides, Castor Oils- Class, Use, MOA

Back 3

Class: Contact laxatives/stimulant laxatives
MOA: inhibit absorption of water & stimulate peristalsis
Use: Acute use-- produce stool in 2-8 hrs-- do NOT use chronically-- can cause dependance

Front 4

Contact laxatives/cathartics-Use, MOA, AE

Back 4

MOA; not known
Use: produce semi formed stool in 2-8 hrs
AE: chronic use results in dependence

Front 5

Osmotic laxatives/cathartics- MOA, Drugs, Use, AE

Back 5

MOA: these are salts or sugars that are not easily absorbed--so have osmotic effect and hold water in the GIT
Drug: MgOH, -- Mg binds the Cl in stomach and isnt absorbed well, lactulose (disach that is not absorbed), Polyethylene glycol
Use: polyethylene glycol used to prepare bowel for diagnostic procedures
AE; do NOT use chronically

Front 6

Mineral oil (lubricating agent)- MOA, DI, AE

Back 6

MOA: poorly absorbed and coats & lubricates the fecal mass
Use: constipation
DI: decrease absorption of fat soluble vitamins-- ADEK
AE: lipid pneumonitis (when oil is aspirated), oil can leak from anus

Front 7

Surface active agent- Drug name, MOA, DI, AE

Back 7

Drug- docusate sodium= stool softener
MOA: detergent effect to break and soften the fecal mass
DI: may increase solubility and absorption of other drugs
AE: hepatotoxicity in animal model

Front 8

Lubiprostone- MOA, AE/CI, Use

Back 8

Use: new drug for chronic idiopathic obstruction
MOA: activate Cl channel on intestinal brush border to increase fluid secretion
AE: may be contraindicate in pregnancy

Front 9

Absorbents- MOA, Use, Classes/Drugs

Back 9

Use: antidiarrheals
MOA: absorb xs water to make gel like mass
Classes--Bulk forming agents-- dietary fiber/cellulose-- benefit watery diarrhea
Hydrated aluminum silicate

Front 10

Hydrated aluminum silicate- MOA, AE/interactions, CI

Back 10

MOA: antidiarrheal, absorbent, insoluble AL salt that absorbs xs water
AE/interactions: can interfere w/ phosphate absorption
CI: renally cleared, systemic effects in pts w/ impaired renal fx

Front 11

Opioids- Use, MOA, CI

Back 11

Use: anti diarrheal
MOA: decrease intestinal motility by inhibiting peristalsis via constriction of circular smooth muscle and relaxation of longitudinal muscle
Ci: UC-- contributes to toxic megacolon, abuse potential, not used in diarrhea caused by organisms that can penetrate teh mucosa

Front 12

Opioids- Use, Drug names

Back 12

Use: inhibit peristalsis/ anti diarrheal
Drug names: Paregoric, Loperamide (can cross BBB, but pumped back out), Lumotil-- diphenoxylate and atropine-- opioid + anticholinergic

Front 13

Anticholinergics: drugs, Use, AE

Back 13

Drugs-- propantheline, dicyclomine, atropine
Use: Mostly IBS, anti diarrheal
AE: sedation, dry mouth, constipation, antichol SE

Front 14

Colloidal bismuth compounds- MOA, Drugs, AE, Use

Back 14

MOA-- bismuth will absorb xs water and bind microbial toxins-- H pylori activity
Salicylate-- inhibits PG synthesis
Drugs-- bismuth subsalicate (pepto), bismuth citrate (if salicylate CI
AE: darkening of tongue/stools
Use: nonspecific, ETEC
CI: ASA allergy, Reyes

Front 15

Sulfasalazine- MOA, AE, CI,

Back 15

MOA: converted in bowel to sulfapyridine and aminosalicylate, so sulfapyridine-- antimibrobial activity and aminosalicylate-- anti inflam and can improve UC
CI: allergies sulfas or salicylates

Front 16

Mesalamine- MOA

Back 16

- simmilar to sulfasalazine w/o sulfa moiety

Front 17

Inflixamab- MOA, AE, Use

Back 17

MOA: mAb that inactivates TNF alpha and suppresses immune fx
AE: hypersensitivty and autoimmune d/p
Use: parenteral only-- CROHNS