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GI
UMKC SOM Pharmacology
21
Medical
Graduate
11/25/2013

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Term
Antacids
MOA
PK
TU
AE
DI
Definition
NaHCO3, CaCO3, MgOH2, AlOH3
Neutralize the gastric acid
Inhibit pepsin
NaHCO3 is the only systemic one
Lots
Na: Na and H2O retention
Ca: Milk alkali syndrome
Mg: Diarrhea
Al: Constipation
FQs and Fe salts will have dec BA, in addition to tetracycline and keto
Term
Simethicone
MOA
PK
TU
AE
DI
Definition
Defoaming action
physiologically inert
Term
H2 antagonists
MOA
PK
TU
AE
DI
Definition
Cimetidine, Ranitidine, Famotidine, Nizatidine
Comp inhibit gastric acid secretion, reduce volume of gastric acid
Dose adjust in renal pts
GERD, Tx duodenal ulcers
Confusion in elderly. C: can cause prolactin secretion, gynoecomastia
Theophylline, warfarin interactions
Term
PPIs
MOA
PK
TU
AE
DI`
Definition
Omeprazole, esomeprazole, lansoprazole, pantoprazole
Prodrugs that form a complex with the H/K ATPase, irreversible action
Accumulates in parietal cells
Hepatic metabolism
*NSAID ulcer prophylaxis
N/V/D, CNS, *CAP colonized URT
O: highest rate of DI, CYP inhibitor
Clopidogrel blocked by PPI (no stent)
Term
Misoprostol
MOA
PK
TU
AE
DI
Definition
Prostaglandin Analog, block secretion of acid and stimulate the mucus and bicarb'
-
prevention of NSAID induced gastric ulcers in high risk pts
*Abortive with Mifepristone, N/V/D
none
Term
Sucralfate
MOA
PK
TU
AE
DI
Definition
Aluminum complex of sucrose sulfate. When pH < 4, protects ulcers with bandaid
Absorbs pepsin, stim EGF
Tx ulcers
Al3 can accumulate in renal dx
FQs, AA, H2 antagonists, cimetidine
Term
Bulk Forming
MOA
PK
TU
AE
DI
Definition
Bran, psyllium, cellulose, polycarbophil
Absorb H2O and increase bulk
Can lead to diarrha, dec K,dehydration, loss of bowel funct
Term
Emolient
MOA
PK
TU
AE
DI
Definition
Docusate
Surfactants that soften stool
Electrolyte acc in renal dx
Term
Luibricant
MOA
PK
TU
AE
DI
Definition
Mineral Oil
coat the stool with oil
Fat soluble vit malabsorption, anal pruritis, *aspiration pneumonia
Term
Saline
MOA
PK
TU
AE
DI
Definition
Mg and Na compounds
Increase osm pressure in the colon, retaining water to increase volume
Hypermagnesia, hyperphosphatemia
Term
Stimulant
MOA
PK
TU
AE
DI
Definition
Anthaquinones, Senna, caster oil, Phenolphthalein, Bisadodoyl
Inihibits absorption, enhance secretion and effect motility
Abdominal discomfort, melanosis coli
Term
Hyperosmotic
MOA
PK
TU
AE
DI
Definition
Lactulose, sorbitol, glyercin, PEG soln
Exert and osmotic effect and may have some effect on intestinal motility
Discomfort, cramping, burning, pain
Term
Diphenyloxylate + Atropine
MOA
PK
TU
AE
DI
Definition
Opiod agonist, acts on mu R
Large doses penetrate the CNS
For diarrhea
Term
Bismuth Subsalicylate
MOA
PK
TU
AE
DI
Definition
Adsorption of bacterial toxins by the bismuth salts or local anti inflammatory actions of salicylate
For travelers diarrhea
Can cause black stools, salicylate tox
Term
Octreotide
MOA
PK
TU
AE
DI
Definition
Somatostatin analog, inhibits gastric acid, pepsin and gastrin, dec Sm mm contractility
For tumor/AIDS related diarrhea
Term
5HT3 Receptor Blockers
MOA
PK
TU
AE
DI
Definition
Ondesartan, Granisetron, Dolestron
R located in the CTZ, upper GI tract
Met by CYP450
Prevention of N/V, (chemo)
Cause constipation, diarrhea, HA
D: arrythmias
Term
D2 R antagonists
MOA
PK
TU
AE
DI
Definition
Metoclopramide, perchlorperzine, promethazine, chlorpromazine, haloperidol, Droperidol
D2 R is in the emetic pathway in CTZ
-
N/V of sorts
Sedation, explosive diarrhea, reversible impotence
Term
Metacloprimide
MOA
PK
TU
AE
DI
Definition
Enhances motility of sm mm, accelerates gastric emptying
Acc in renal dx, crosses BBB
-
Restlessness, worsens parkinsons dx
May accelerate absorption of many drugs
Term
Pancreatin, Pancrelipase
MOA
PK
TU
AE
DI
Definition
inactivation by gastric acid and pepsin
Dose adjust based on fecal content
Used to prevent steatorrhea
Term
Tegaserod Maleate
MOA
PK
TU
AE
DI
Definition
Short term ED tx IBD in women
Act 5HT3 R in GI tract
Inc GI motility, dec visceral sensation
Can cause stroke, MI, angina
Term
Alosetron
MOA
PK
TU
AE
DI
Definition
Tx diarrhea predominent IBS in women
5HT3 blocker,
Dec intestinal sec, motility, aff pain signals
Met CYP450
Dose related constipation
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