Advanced Pharmacology 6521 Mid Term
Anti-diarrheals
Stops further occurrence of diarrhea. Notable medicines are Loperamide
"Immodium", Diphenoxylate Hcl with Atropine "Lomotil", Bismuth subsalicylate
"Pepto bismul"
Pepto s/e: black stools and tongue
Laxatives
Used to ease or stimulate defecation
Soften the stool
Increase stool volume
Hasten fecal passage through the intestine
Facilitate evacuation from the rectum
*Misuse comes from misconceptions of what constitutes normal bowel function
Fiber Laxatives
absorbs water, softening feces and increasing their mass. Can be digested by
colonic bacteria, whose subsequent growth increases fecal mass. ex. Bran,
veggies and fruits.
Meds: mehylcellulose, psyllium, polycarbophil
Surfactant Laxatives
Meds: Docusate sodium (Colace)
Docusate calcium (Surfak)
temporary treatment of constipation
* avoid if narrowing of intestines
Give with a full glass of water or juice
,Stimulant Laxatives
bisacodyl: (tablets: give at night to have BM in am , no crushing or chewing, no
milk or antacids;Suppositories: BM within 15-60 min, may cause proctitis);
senna: BM 6-12 hours after. May cause pink or brown urine.
castor oil: acts on small intestine 2-6 hour BM. Limit to only when prep for
radiology procedures. Chill and mix in juice.
* easily abused,
Give with a full glass of water.
Osmotic Laxatives
Salts draw water into the intestine causing fecal mass to soften and swell
stimulating peristalsis. Low dose 6-12 hours, high dose 2-6 hours.
magnesium hydroxide,
magnesium citrate,
polyethylene glycol,
lactulose (can be used to lower blood ammonia in liver disease)
* Increase fluid intake. Not good for kidney disease. Sodium phosphate
exacerbates cardiac disease.
Miscellaneous Laxatives
Lubiprostone, mineral oil, glycerin suppository, polyethylene glycol- electrolyte
solution, Sodium picosulfate / magnesium oxide/anhydrous citric acid
antiemetic
a medication that is administered to prevent or relieve nausea and vomiting
Ondesetron
Class: 5HT3 receptor antagonist
, Zofran
Indication: Chemotherapy N/V, postoperative N/V, radiation induced N/V
Oral or Parental
* Prolonges QT interval (leading to torsades de pointes)
Glucocorticoids used as antiemetic
Not approved by FDA. Solumedrol and dexamethasone. Given IV.
Metoclopramide (Reglan)
controls post-op NV
suppresses emesis and increases upper GI mobility
Cannabinoids
Dronabinol (marinol) and Nabilone (cesamet). Suppresses CINV.
Alosetron (Lotronex)
Used for IBS-D in women that has lasted > 6 months
Blocks 5-HT3 receptors resulting in firm stool and decrease in urgency and
frequency of defecation
Can cause constipation
PPIs
Proton-pump inhibitors - pronounced and long-lasting reduction of gastric acid
production - destroyed by stomach acid (take on empty stomach) - work really
well - "attack from the back" - used as a controller
Ex. Omeprazole (Prilosec)
Mesalamine
treats ulcerative colitis
Ranitidine (Zantac)
H2 receptor antagonist. Potent inhiitor of gastric acid secretion
Indications: GERD, ulcers, H. pylori, reflux, indigestion
Anti-diarrheals
Stops further occurrence of diarrhea. Notable medicines are Loperamide
"Immodium", Diphenoxylate Hcl with Atropine "Lomotil", Bismuth subsalicylate
"Pepto bismul"
Pepto s/e: black stools and tongue
Laxatives
Used to ease or stimulate defecation
Soften the stool
Increase stool volume
Hasten fecal passage through the intestine
Facilitate evacuation from the rectum
*Misuse comes from misconceptions of what constitutes normal bowel function
Fiber Laxatives
absorbs water, softening feces and increasing their mass. Can be digested by
colonic bacteria, whose subsequent growth increases fecal mass. ex. Bran,
veggies and fruits.
Meds: mehylcellulose, psyllium, polycarbophil
Surfactant Laxatives
Meds: Docusate sodium (Colace)
Docusate calcium (Surfak)
temporary treatment of constipation
* avoid if narrowing of intestines
Give with a full glass of water or juice
,Stimulant Laxatives
bisacodyl: (tablets: give at night to have BM in am , no crushing or chewing, no
milk or antacids;Suppositories: BM within 15-60 min, may cause proctitis);
senna: BM 6-12 hours after. May cause pink or brown urine.
castor oil: acts on small intestine 2-6 hour BM. Limit to only when prep for
radiology procedures. Chill and mix in juice.
* easily abused,
Give with a full glass of water.
Osmotic Laxatives
Salts draw water into the intestine causing fecal mass to soften and swell
stimulating peristalsis. Low dose 6-12 hours, high dose 2-6 hours.
magnesium hydroxide,
magnesium citrate,
polyethylene glycol,
lactulose (can be used to lower blood ammonia in liver disease)
* Increase fluid intake. Not good for kidney disease. Sodium phosphate
exacerbates cardiac disease.
Miscellaneous Laxatives
Lubiprostone, mineral oil, glycerin suppository, polyethylene glycol- electrolyte
solution, Sodium picosulfate / magnesium oxide/anhydrous citric acid
antiemetic
a medication that is administered to prevent or relieve nausea and vomiting
Ondesetron
Class: 5HT3 receptor antagonist
, Zofran
Indication: Chemotherapy N/V, postoperative N/V, radiation induced N/V
Oral or Parental
* Prolonges QT interval (leading to torsades de pointes)
Glucocorticoids used as antiemetic
Not approved by FDA. Solumedrol and dexamethasone. Given IV.
Metoclopramide (Reglan)
controls post-op NV
suppresses emesis and increases upper GI mobility
Cannabinoids
Dronabinol (marinol) and Nabilone (cesamet). Suppresses CINV.
Alosetron (Lotronex)
Used for IBS-D in women that has lasted > 6 months
Blocks 5-HT3 receptors resulting in firm stool and decrease in urgency and
frequency of defecation
Can cause constipation
PPIs
Proton-pump inhibitors - pronounced and long-lasting reduction of gastric acid
production - destroyed by stomach acid (take on empty stomach) - work really
well - "attack from the back" - used as a controller
Ex. Omeprazole (Prilosec)
Mesalamine
treats ulcerative colitis
Ranitidine (Zantac)
H2 receptor antagonist. Potent inhiitor of gastric acid secretion
Indications: GERD, ulcers, H. pylori, reflux, indigestion
