gi drugs n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
GI Drugs PowerPoint Presentation
Download Presentation
GI Drugs

Loading in 2 Seconds...

play fullscreen
1 / 18

GI Drugs - PowerPoint PPT Presentation


  • 170 Views
  • Uploaded on

GI Drugs. By Dr. L. Saarmann. Anti- diarrheals. Adsorbents – coat mucosa, bind to toxins and eliminated in feces Anticholinergics – see neuro drugs Opiates – decrease motility. Laxatives. Bulk-forming – absorb water, distend bowel Emollient – lower surface tension, lubricate

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'GI Drugs' - suzuki


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
gi drugs

GI Drugs

By

Dr. L. Saarmann

anti diarrheals
Anti-diarrheals
  • Adsorbents – coat mucosa, bind to toxins and eliminated in feces
  • Anticholinergics – see neuro drugs
  • Opiates – decrease motility
laxatives
Laxatives
  • Bulk-forming – absorb water, distend bowel
  • Emollient– lower surface tension, lubricate
  • Saline – incrosmotic pressure
  • Stimulants – inc. peristalsis
  • Hyperosmotic – inc fecal water content
antacids
Antacids
  • combines with H+ ions to form water

so H+ is pulled out of circulation and

leads to increased pH of stomach.

  • Changes in pH decrease pepsin (digestive) activity
h2 antagonists
H2 antagonists
  • Parietal cells of stomach produce H+ ions.
  • H2 antagonists bind to H2 receptors on parietal cells so receptors become unresponsive to acetylcholine and gastrin
  •  decreased H+
proton pump inhibitors
Proton Pump Inhibitors
  • Bind irreversibly to H+/K+ATPase.
  • Cuts off energy to proton pump
  •  blocks all acid secretion.
anti diarrheals1
Anti-diarrheals
  • Adsorbents– coats mucosa, bind to toxins and eliminated in feces
    • SE: inc bleeding time; constipation, tinnitus, metallic taste, blue gums, confusion w/ high doses by elderly
      • bismuth subsalicylate [PeptoBismol]
      • attapulgite [Keopectate]
  • Anticholinergics– The prototypical anticholinergic, atropine,decr output of gastric/intestinal secretions; decr GI motility & tone
    • SE: increasing heart rate, depressing salivary and bronchial secretion, decrease sweating, dilate pupils, inhibit micturition, causes constipation
  • Opiates– decreases motility
    • SE: drowsiness, dizziness, N/V/A/C, urinary retention, flushing, rash urticaria
      • diphenoxylate & atropine [Lomotil] Rx
      • loperamide [Imodium] OTC
      • paregoric & tincture of opium
laxatives1
Laxatives
  • Bulk-forming – absorb water, distend bowel
    • SE: impaction above stricture, fluid overload
    • Drugs: Fiber based
      • methylcellulose [Citrucel]
      • psyllium [Metamucil]
  • Emollient – decrease surface tension, bring fat & water into stool, lubricate
    • SE: rash, decr vit. absorption, lipid pneumonia (only if liq form is aspirated)
      • mineral oil
      • dusocate [Colace]
  • Saline – increase osmotic pressure in intestine
      • magnesium salts [MOM, Fleets Enemas]
  • Stimulants – increase peristalsis
    • SE: rash, gastric irritation, malabsorption of nutrients
      • phenolthalene (off market)
  • Hyperosmotic – increase fecal water content of large intestines
    • SE: abd. Bloating
      • polyethylene [GoLytely]
      • lactulose [Cephulac]
antacids1
Antacids
  • Action - Combine c H+ to form water  incrpH of stomach.

Changes in pH decrpepsin (digestive) activity.

  • SE:
    • Mg preps  diarrhea
    • Ca++ & Aluminium preps  constipation
    • Systemic alkalosis with overuse
    • Ca++ starts and stops  Rebound hyperacidity
  • Interactions:
    • Chelate
      • combines with other drugs and lessens their absorption
    • Alters pH of stomach
      • increased absorption of basic drugs
      • decreased absorption of acidic drugs
    • Alter urine pH
      • increased excretion of acidic drugs
      • decreased excretion of basic drugs
    • Mg (MOM)
    • Al & Mg (Maalox, Mylanta,Riopan)
      • one causes diarrhea one causes constipation so they even out
    • Ca (Tums)
h2 antagonists1
H2 antagonists
  • Action - Parietal cells of stomach produce H+ ions. H2 antagonists bind to H2 receptors on parietal cells so receptors become unresponsive to acetylcholine and gastrin  decreased H+
  • SE: RARE
    • HA, dizziness, malaise, depression (elderly)
    • Myalgia, N/D/C, rash
    • Inc BUN and liver fx
    • Blood dyscrasias
    • Loss of libido, impotence
  • Drugs all are OTC so many misdiagnosed diseases (esoph. CA)
    • cimetidine [Tagamet]
    • famotidine [Pepcid]
    • nizatidine [Axid]
    • ranitidine [Zantac]
proton pump inhibitors1
Proton Pump Inhibitors
  • Bind irreversibly to H+/K+ATPase. Cuts off energy to proton pump  blocks all acid (H+) secretion.
  • Uses:
    • GERD, PUD,
    • NSAID induced stomachGI ulcers only
    • hypersecretory states (zollenger-ellison syndrome)
  • SE:
    • HA, dizziness,
    • N/V/D/A, rash, alopecia, fever, fatigue, back pain
    • Blood dyscrasias
  • Drugs
    • omeprazole [Prilosec] OTC
    • esomeprazole [Nexium]
    • lansoprazole [Prevacid] Delayed release capsules can be opened for dysphagia patients
proton pump inhibitors2
Proton Pump Inhibitors
  • SE:
    • HA, dizziness,
    • N/V/D/A, rash, alopecia, fever, fatigue, back pain
    • Blood dyscrasias
  • Drugs
    • omeprazole [Prilosec] OTC
    • esomeprazole [Nexium]
    • lansoprazole [Prevacid] Delayed release capsules can be opened for dysphagia patients
proton pump inhibitors3
Proton Pump Inhibitors
  • Interactions: cause higher plasma levels of these three drugs
    • Dilantin, coumadin
    • valium

Prevacid has the least interaction problems

other drugs
Other Drugs
  • sucralfate [Carafate] in an acid environ, Carafate becomes a thick negatively charged paste and binds to positively charges ulcers (fills them in and protects them from H+)
  • Take before meals
    • Pastelike
    • SE:
      • Constipation & nausea
    • Interactions:
      • Impede absorption of dilantin and coumadin
other drugs1
Other Drugs
  • misoprostol [Cytotec]
    • synthetic Prostaglandin E1 that protects stomach lining
    • Uses: prevent NSAID ulcers
    • SE: diarrhea, N/V, spotting, cramps,
      • miscarriage is possible
      • used as an abortive agent
drugs for ibd
Drugs for IBD
      • Aminosalicylatesdecrinflam (decr prostaglandins and leukotrienes)
    • mesalamine [Asacol]
      • SE: stomach cramps, diarrhea, N/V, rhinitis
      • decreases digoxin absorption
    • sulfasalazine [Azulfidine]
      • SE: GI, HA, allergy
      • decreases dilantin absorption
      • incr effects of oral hypoglycemics
  • BRMs
    • infliximab[Remicade] – monoclonal antibody
      • Given IV
      • SE: immunosuppression, liver damage, stomach pain
drugs for ibd1
Drugs for IBD
  • Other
  • for IBS (constipation reliever)
    • tegeserod[Zelnorm]
      • 5HT4 inhibitor
      • SE: HA, N, gas, back pain.
immunsuppressants for ibd
Immunsuppressantsfor IBD
  • Selectively suppress lymphocytes
  • azathioprine [Imuran] – antagonizes purine  suppression of T cells
  • cyclosporine [Sandimmune] &
  • tacrolimus [Prograf]
    • inhibit release of interleukin-2
    • don’t suppress bone marrow
    • Uses: prevent & tx transplant rejection
    • SE: infections
      • Imuran – problems with bone marrow, liver, ulcers
      • Cyclosporine – kidney, liver, neuro (tremors), HPT, high K+, hirsutism, gingival hyperplasia, nvd