Advanced Pharmacology 6521 Mid Term
Anti-diarrheals - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer Lubiprostone, mineral oil, glycerin suppository,
polyethylene glycol- electrolyte solution, Sodium picosulfate / magnesium
oxide/anhydrous citric acid
, Advanced Pharmacology 6521 Mid Term
antiemetic - Answer a medication that is administered to prevent or relieve nausea and
vomiting
Ondesetron
Class: 5HT3 receptor antagonist - Answer 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 - Answer Not approved by FDA. Solumedrol and
dexamethasone. Given IV.
Metoclopramide (Reglan) - Answer controls post-op NV
suppresses emesis and increases upper GI mobility
Cannabinoids - Answer Dronabinol (marinol) and Nabilone (cesamet). Suppresses
CINV.
Alosetron (Lotronex) - Answer 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 - Answer 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 - Answer treats ulcerative colitis
Ranitidine (Zantac) - Answer H2 receptor antagonist. Potent inhiitor of gastric acid
secretion
Indications: GERD, ulcers, H. pylori, reflux, indigestion
ADR: Pain, constipation, diarrhea, headache. Can cause jaundice
Ulcers treatment - Answer likely caused by H. pylori. Treat with antibiotic and pepto
bismol, proton pump inhibitors (prilosec, prevacid, aciphex, nexium, protonix), H-2
blockers (zantac, pepcid, tagamet, nazatidine), antacids, and cytoprotective agens
(carafate, cytotec)
irritable bowel syndrome (IBS) - Answer periodic disturbances of bowel function, such
as diarrhea and/or constipation, usually associated with abdominal pain. Intermittent
diarrhea and constipation with pain.
Treat and prevent symptoms:
Antispasmodics, bulk forming agents, antidiarreheals and tricyclic antidepressants.
Anti-diarrheals - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer Lubiprostone, mineral oil, glycerin suppository,
polyethylene glycol- electrolyte solution, Sodium picosulfate / magnesium
oxide/anhydrous citric acid
, Advanced Pharmacology 6521 Mid Term
antiemetic - Answer a medication that is administered to prevent or relieve nausea and
vomiting
Ondesetron
Class: 5HT3 receptor antagonist - Answer 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 - Answer Not approved by FDA. Solumedrol and
dexamethasone. Given IV.
Metoclopramide (Reglan) - Answer controls post-op NV
suppresses emesis and increases upper GI mobility
Cannabinoids - Answer Dronabinol (marinol) and Nabilone (cesamet). Suppresses
CINV.
Alosetron (Lotronex) - Answer 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 - Answer 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 - Answer treats ulcerative colitis
Ranitidine (Zantac) - Answer H2 receptor antagonist. Potent inhiitor of gastric acid
secretion
Indications: GERD, ulcers, H. pylori, reflux, indigestion
ADR: Pain, constipation, diarrhea, headache. Can cause jaundice
Ulcers treatment - Answer likely caused by H. pylori. Treat with antibiotic and pepto
bismol, proton pump inhibitors (prilosec, prevacid, aciphex, nexium, protonix), H-2
blockers (zantac, pepcid, tagamet, nazatidine), antacids, and cytoprotective agens
(carafate, cytotec)
irritable bowel syndrome (IBS) - Answer periodic disturbances of bowel function, such
as diarrhea and/or constipation, usually associated with abdominal pain. Intermittent
diarrhea and constipation with pain.
Treat and prevent symptoms:
Antispasmodics, bulk forming agents, antidiarreheals and tricyclic antidepressants.
