Please enable JavaScript.
Coggle requires JavaScript to display documents.
Pharmacology - GI (*Laxatives
osmotic laxatives (*Osmotic laxatives
…
Pharmacology - GI
*Osmotic laxatives
- non-absorbable contents in the gut bring in water and electrolytes
- distended bowel walls cause peristalsis and bowel movement
- polyethylene glycol
- magnesium citrate
-
*Diarrhea Differentials
- Inflammatory vs Non-inflammatory
- Non-inflammatory diarrhea either:
--> Uncomplicated watery diarrhea
--> absorption / secretion problem
-
*Non-Inflammatory Diarrhea
- Non-inflammatory diarrhea either:
--> Uncomplicated watery diarrhea
--> absorption / secretion problem
*Uncomplicated watery Diarrhea
- Non-inflammatory diarrhea either:
--> Uncomplicated watery diarrhea
--> absorption / secretion problem
Treatment = Uncomplicated watery Diarrhea
- 1st line = Mu oppioid agonists
--> loperamide
--> Diphenoxylate
- note Mu agonists close off BOTH diarrhea in the lumen and also GB slowing down Sphincter of Oddi
--> causes GB problems biliary colic
*Diphenoxylate
- Treatment = Uncomplicated watery Diarrhea
- 1st line = Mu oppioid agonists
- "DI PHEN OXY ATE"
--> DI PHEN = Diarrhea treatment
--> OXY = Oppioid for diarrhea
--> ATE = Atropine given with Diphenoxylate ALWAYS
--> stops high dose abuse
--> only LOW doses used for diarrhea
-
*Absorption / secretion problem watery Diarrhea
- Non-inflammatory diarrhea either:
--> Uncomplicated watery diarrhea
--> absorption / secretion problem
*GERD treatment
*H2 Blockers
- ramantidine, cemitidine
--> NEVER use cimetidine
--> potent CYP inhibitor of SICK FACES
--> can cross Blood BB and hit H1 histamine receptors
-
-
*Atropine
- works against ACh from the vagus stimulation
*Bismuth Chelates
- create a sugary layer that protects the GI mucosa
- not to be used with PPIs or Antacids
--> because they need an acidic environment to work and create the mucus layer of protection
- more used for Ulcer healing and NOT for prevention of PUD
-
*Antacids
- Metal Hydroxides
- Aluminium Hydroxide vs Magnesium Hydroxide
- "AluMINIMUM" = minimal feces = Constipation
- "Magnesium" = MAGOR Diarrhea
- Antacids usually have both these things together to counteract each other
-
*PGE1 analogs
- misoprostol = PGE1 analog
1,2,3 receptors for GASTRIC ACID and EMESIS
- ONLY 1 PUMP = H+/K+ ATPase for gastric acid
--> controlled by 3 different receptors
- 1,2,3 RECEPTORS for H+/K+ ATPase for gastric acid
- 1 PUMP
- 2 = H2 histamine
- 3 = M3 Ach for vagus
--> also 5HT3 serotonin at the vagus here for vomitting
--> target for serotonin blocker antiemetics
