Katzung Chapter 62 Drugs Used in the Treatment of Gastrointestinal Diseases

Gastrin

Binds to gastrin/cholecystokinin receptor on parietal cells and causes the secretion of H+ ions thru the H+/K+ ATPase pump

Histamine

Binds to histamine type 2 receptors on parietal cells and causes the secretion of H+ ions thru the H+/K+ ATPase pump

Acetylcholine

Binds to muscarinic type 3 receptors on parietal cells and causes the secretion of H+ ions thru the H+/K+ ATPase pump

Antacids

Weak bases that react with gastric hydrochloric acid to form a salt and water for the treatment of intermittent heartburn and dyspepsia

Sodium bicarbonate

SB- Antacid that couples with hydrochloric acid to form carbon dioxide and sodium chloride

Calcium carbonate

CC- Antacid that couples with hydrochloric acid to form carbon dioxide and calcium chloride

Magnesium hydroxide

MH- Antacid that couples with hydrochloric acid to form magnesium chloride and water

Aluminum hydroxide

AH- Antacid that couples with hydrochloric acid to form aluminum chloride and water

H2-receptor antagonists

Reduce acid secretion stimulated by histamine, gastrin and acetylcholine by binding to histamine type 2 receptors for the treatment of GERD, peptic ulcer disease and bleeding from stress related gastritis

Cimetidine

C— H2-receptor antagonists

Ranitidine

R— H2-receptor antagonists

Famotidine

F— H2-receptor antagonists

Nizatidine

N— H2-receptor antagonists

Proton pump inhibitors

Form a covalent disulfide bond with the H+/K+-ATPase, irreversibly inactivating the protein

Omeprazole

O- Proton pump inhibitors

Esomeprazole

E- Proton pump inhibitors

Lansoprazole

L- Proton pump inhibitors

Dexlansoprazole

D- Proton pump inhibitors

Rabeprazole

R- Proton pump inhibitors

Pantoprazole

P- Proton pump inhibitors

Sucralfate

Negatively charged sucrose sulfate binds to positively charged proteins in the base of ulcers or erosion, forms a physical barrier and stimulates mucosal prostaglandin and bicarbonate secretion

Bismuth subsalicylate

Creates a protective layer against acid and pepsin in ulcers and erosions, reduces infectious diarrhea, direct antimicrobial effects and binds enterotoxins

Neostigmine

Acetylcholinesterase inhibitor, enhances gastric, small intestine, and colonic emptying to treat hospitalized patients with acute large bowel distention

Metoclopramide

Dopamine D2-receptor antagonists to treat impaired gastric emptying and an antiemetic

Macrolides

Directly stimulates motilin receptors on GI smooth muscle

Psyllium

P- Natural plant laxative (bulk forming)

Methylcellulose

M- Natural plant laxative (bulk forming)

Polycarbophil

Synthetic laxative (bulk forming)

Docusate

Stool softener

Glycerin

G- Osmotic laxative agent, soluble but nonabsorbable compounds

Mineral oil

Lubricates fecal material and retards water absorption

Magnesium hydroxide

MH- Osmotic laxative agent, soluble but nonabsorbable compounds

Sorbitol

S- Osmotic laxative agent, soluble but nonabsorbable compounds

Lactulose

L- Osmotic laxative agent, soluble but nonabsorbable compounds

Magnesium citrate

MC- Osmotic laxative agent, soluble but nonabsorbable compounds

Senna

S- Stimulant laxatives, direct stimulation of the enteric nervous system causing colonic electrolyte and fluid secretion

Bisacodyl

B- Stimulant laxatives, direct stimulation of the enteric nervous system causing colonic electrolyte and fluid secretion

Lubiprostone

Chloride channel activator laxative, stimulates the type 2 chloride channel in the small intestine that increases chloride-rich fluid secretion into the intestine and stimulates intestinal motility

Linaclotide

Minimally absorbed, 14-amino acid peptide that stimulates intestinal chloride secretion, approved for chroinc constipation and IBS

Methylnaltrexone bromide

MB- Opioid receptor antagonists laxative

Alvimopan

A- Opioid receptor antagonists laxative

Loperamide

L- Opioid agonists, antidiarrheal agents

Diphenoxylate

D- Opioid agonists, antidiarrheal agents

Cholestyramine

Bile salt binding resins, may decrease diarrhea caused by excess fecal bile acids

Alosetron

Serotonin 5-HT3 receptor antagonists, approved for the treatment of severe IBS with diarrhea predominant in women

Dicyclomine

Antispasmodics (anticholinergics) used to treat IBS

Ondansetron

O- Serotonin 5-HT3 antagonists, used to treat nausea and vomiting

Granisetron

G- Serotonin 5-HT3 antagonists, used to treat nausea and vomiting

Dolasetron

D- Serotonin 5-HT3 antagonists, used to treat nausea and vomiting

Palonosetron

P- Serotonin 5-HT3 antagonists, used to treat nausea and vomiting

Aprepitant

A- Neurokinin 1 receptor antagonists (central blockade in the area postrema), prevention of acute and delayed nausea and vomiting from chemotherapeutic regimens

Fosaprepitant

F- Neurokinin 1 receptor antagonists (central blockade in the area postrema), prevention of acute and delayed nausea and vomiting from chemotherapeutic regimens

Prochlorperazine

Proc— Phenothiazines- antipsychotic agent with antiememtic actions

Promethazine

Prom— Phenothiazines- antipsychotic agent with antiememtic actions

Trimethobenzamide

T— Phenothiazines- antipsychotic agent with antiememtic actions

Droperidol

Butyrophenones- antipsychotic with antiemetic actions

Diphenhydramine

D- H1 Antihistamines, antiemetic

Dimenhydrinate

D- H1 Antihistamines, antiemetic

Meclizine

M- H1 Antihistamines, antiemetic

Scopolamine

S- H1 Antihistamines, antiemetic

Lorazepam

Benzodiazepines, antiemetic before the initiation of chemotherapy to reduce anticipatory vomiting or vomiting caused by anxiety

Dronabinol

Δ9-tetrahydrocannabinol-THC, antiemetic

Sulfasalazine

S- Aminosalicylates used to treat mild to moderate Crohn disease and ulcerative colitis

Mesalamine

M- Aminosalicylates used to treat mild to moderate Crohn disease and ulcerative colitis

Olsalazine

Aminosalicylates used to treat mild to moderate ulcerative colitis for patients intolerant of sulfasalazine

Balsalazide

B- Aminosalicylates used to treat mild to moderate ulcerative colitis

Prednisone

P- Corticosteroid used to treat acute episodes of Crohn disease or ulcerative colitis

Prednisolone

P,L- Corticosteroid used to treat acute episodes of Crohn disease or ulcerative colitis

Hydrocortisone

H- Corticosteroid used to treat acute episodes of ulcerative colitis

Budesonide

B- Corticosteroid used to treat acute episodes of mild to moderate Crohn disease or ulcerative colitis

Methylprednisolone

M- Corticosteroid used to treat acute episodes of Crohn disease or ulcerative colitis

Azathioprine

A— Purine anti-metabolites with immunosuppressive properties used for remission maintenance or steroid reduction in Crohn disease and ulcerative colitis

6-mercaptopurine

6M— Purine anti-metabolites with immunosuppressive properties used for remission maintenance or steroid reduction in Crohn disease and ulcerative colitis

Infliximab

I- Monoclonal antibodies to human TNF used to treat inflammatory bowel disease

Adalimumab

A- Monoclonal antibodies to human TNF used to treat inflammatory bowel disease

Certolizumab

C- Monoclonal antibodies to human TNF used to treat inflammatory bowel disease

Golimumab

G- Monoclonal antibodies to human TNF used to treat inflammatory bowel disease

Natalizumab

N- Monoclonal antibodies to human integrin used to treat inflammatory bowel disease

Pancrelipse

Pancreatic enzyme supplements from procine containg amylase, lipases and proteases

Ursodiol

Reduces the secretion of cholesterol from the liver and reabsorption in the intestines used to treat gallstones

Tegaserod

Serotonin 5HT4 receptor partial agonist used to treat IBS with constipation predominant