ADVANCED PHARMACOLOGY 6521 MID TERM
1. Anti-diarrheals: Stops further occurrence of diarrhea. Notable medicines are
Loperamide "Immodium", Diphenoxylate Hcl with Atropine "Lomotil", Bismuth sub-
salicylate "Pepto bismul"
Pepto s/e: black stools and tongue
2. 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
3. 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
4. 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
5. 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.
, ADVANCED PHARMACOLOGY 6521 MID TERM
6. 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.
7. Miscellaneous Laxatives: Lubiprostone, mineral oil, glycerin suppository, poly-
ethylene glycol- electrolyte solution, Sodium picosulfate / magnesium oxide/anhy- drous
citric acid
, ADVANCED PHARMACOLOGY 6521 MID TERM
8. antiemetic: a medication that is administered to prevent or relieve nausea and
vomiting
9. 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)
10. Glucocorticoids used as antiemetic: Not approved by FDA. Solumedrol and
dexamethasone. Given IV.
11. Metoclopramide (Reglan): controls post-op NV
suppresses emesis and increases upper GI mobility
12. Cannabinoids: Dronabinol (marinol) and Nabilone (cesamet). Suppresses CINV.
13. 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 frequen- cy of
defecation
Can cause constipation
14. 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)
15. Mesalamine: treats ulcerative colitis
16. Ranitidine (Zantac): H2 receptor antagonist. Potent inhiitor of gastric acid se-
cretion
Indications: GERD, ulcers, H. pylori, reflux, indigestion
ADR: Pain, constipation, diarrhea, headache. Can cause jaundice
17. Ulcers treatment: likely caused by H. pylori. Treat with antibiotic and pepto bismol,
proton pump inhibitors (prilosec, prevacid, aciphex, nexium, protonix), H-2 blockers
1. Anti-diarrheals: Stops further occurrence of diarrhea. Notable medicines are
Loperamide "Immodium", Diphenoxylate Hcl with Atropine "Lomotil", Bismuth sub-
salicylate "Pepto bismul"
Pepto s/e: black stools and tongue
2. 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
3. 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
4. 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
5. 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.
, ADVANCED PHARMACOLOGY 6521 MID TERM
6. 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.
7. Miscellaneous Laxatives: Lubiprostone, mineral oil, glycerin suppository, poly-
ethylene glycol- electrolyte solution, Sodium picosulfate / magnesium oxide/anhy- drous
citric acid
, ADVANCED PHARMACOLOGY 6521 MID TERM
8. antiemetic: a medication that is administered to prevent or relieve nausea and
vomiting
9. 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)
10. Glucocorticoids used as antiemetic: Not approved by FDA. Solumedrol and
dexamethasone. Given IV.
11. Metoclopramide (Reglan): controls post-op NV
suppresses emesis and increases upper GI mobility
12. Cannabinoids: Dronabinol (marinol) and Nabilone (cesamet). Suppresses CINV.
13. 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 frequen- cy of
defecation
Can cause constipation
14. 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)
15. Mesalamine: treats ulcerative colitis
16. Ranitidine (Zantac): H2 receptor antagonist. Potent inhiitor of gastric acid se-
cretion
Indications: GERD, ulcers, H. pylori, reflux, indigestion
ADR: Pain, constipation, diarrhea, headache. Can cause jaundice
17. Ulcers treatment: likely caused by H. pylori. Treat with antibiotic and pepto bismol,
proton pump inhibitors (prilosec, prevacid, aciphex, nexium, protonix), H-2 blockers
