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GI System notability

Drugs Affecting Gastrointestinal Motility

TermDefinition
Chemical Stimulants Drugs Bisacodyl (Dulcolax): Very popular OTC laxative Cascara (Generic): Reliable agent that leads to intestinal evacuation Castor Oil (Neoloid): Old standby for thorough evacuation of the intestine Senna (Senokot): Reliable drug, similar to cascara (OTC)
Chemical Stimulants Actions Actions Begin working at the beginning of the small intestine and increase motility throughout the rest of GI tract by irritating nerve plexus
Chemical Stimulants Pharmacokinetics Pharmacokinetics Most of these agents are only minimally absorbed and exert their therapeutic effects directly in the GI tract
Chemical Stimulants Contraindications Contraindications Allergy Acute abdominal disorders
Chemical Stimulants Caution Caution Heart block, CAD, debilitation Pregnancy and lactation
Chemical Stimulants Adverse Effects Adverse Effects GI: diarrhea, abdominal cramping, nausea CNS: dizziness, headache, weakness Sweating, palpitations, flushing, fainting Cathartic dependence Castor oil: blocks absorption of fats and fat-soluble vitamins
Chemical Stimulants Drug-Drug Interactions Drug-Drug Interactions Other prescribed medications
Bulk Stimulants Drugs Methylcellulose (Citrucel) Polycarbophil (FiberCon) Psyllium (Metamucil)
Bulk Stimulants Actions/Indications Actions/Indications Increase motility by increasing size of fecal material, which will increase fluid in the GI tract, cause more stretch on GI tract, stimulate local stretch receptors, and activate local GI activity
Bulk Stimulants Pharmacokinetics Pharmacokinetics Oral / Not generally absorbed systemically
Bulk Stimulants Contraindications Contraindications Allergy / Acute abdominal disorders
Bulk Stimulants Caution Caution Heart block, CAD, debilitation Pregnancy and lactation
Bulk Stimulants Adverse Effects Adverse Effects GI: diarrhea, abdominal cramping, nausea CNS: dizziness, headache, weakness Sweating, palpitations, flushing, fainting
Bulk Stimulants Drug-Drug Interactions Drug-Drug Interactions Other prescribed medications
Osmotic Laxatives Drugs Magnesium sulfate (Epsom salts) Magnesium citrate (Citrate of Magnesia) Magnesium hydroxide (Milk of Magnesia) Lactulose (Constilac)
Osmotic Laxatives Drugs continued Polyethylene glycol (MiraLAX) Polyethylene glycol electrolyte solution (GoLYTELY) Sodium picosulfate with magnesium oxide (Prepopik)
Osmotic Laxatives Actions/Indications Actions/Indications Draw more water into GI tract and stimulate increased GI motility
Osmotic Laxatives Pharmacokinetics Pharmacokinetics Rates vary based on oral, suppository, or IV form
Osmotic Laxatives Contraindications Contraindications Lactulose: appendicitis, acute surgical abdomen, fecal impaction, intestinal obstruction
Osmotic Laxatives Caution Caution Lactulose: Diabetes Magnesium: Renal insufficiency Polyethylene glycol: seizures
Osmotic Laxatives Adverse Effects Adverse Effects GI: diarrhea, abdominal cramping, abdominal bloating, nausea; dehydration: dry mouth, dizziness, light-headedness CNS: dizziness, headache, weakness Sweating, palpitations, flushing, fainting Rectal irritation
Osmotic Laxatives Drug-Drug Interactions Drug-Drug Interactions Other prescriptions Magnesium: neuromuscular junction blockers
Lubricants Drugs Docusate (Colace) Has a detergent action on the surface of the intestinal bolus, making a softer stool Glycerin (Sani-Supp) Hyperosmolar laxative used to gently evacuate the rectum without systemic effects higher in the GI tract
Lubricants Drugs continued Mineral Oil (Agoral) Forms a slippery coat on the contents of the intestinal tract
Lubricants Pharmacokinetics Pharmacokinetics Not absorbed systemically Excreted in feces Contraindications Allergy Acute abdominal disorders
Lubricants Caution Caution Heart block, CAD, debilitation Pregnancy and lactation
Lubricants Adverse Effects Adverse Effects GI: diarrhea, abdominal cramping, nausea; leakage and staining with mineral oil CNS: dizziness, headache, weakness Sweating, palpitations, flushing, fainting
Lubricants Drug-Drug Interactions Drug-Drug Interactions Frequent use of mineral oil can interfere with absorption of the fat-soluble vitamins A, D, E, and K
Gastrointestinal Stimulants Drugs Dexpanthenol (Ilopan) Increases acetylcholine levels and stimulates the parasympathetic system
Gastrointestinal Stimulants Drugs continued Metoclopramide (Reglan) Blocks dopamine receptors and makes the GI cells more sensitive to acetylcholine Leads to increased GI activity and rapid movement of food through the upper GI tract
Gastrointestinal Stimulants Actions Actions Stimulate parasympathetic activity within the GI tract Increase GI secretions and motility
Gastrointestinal Stimulants Indications Indications Rapid movement of GI contents is desirable
Gastrointestinal Stimulants Pharmacokinetics Pharmacokinetics Rapidly absorbed Metabolized in the liver Excreted in the urine
Gastrointestinal Stimulants Contraindications Contraindications Allergy / GI obstruction
Gastrointestinal Stimulants Caution Caution Pregnancy & Lactation
Gastrointestinal Stimulants Adverse Effects Adverse Effects Nausea, vomiting, diarrhea, intestinal spasms, cramping, decreased blood pressure and heart rate, weakness, and fatigue
Gastrointestinal Stimulants Drug-Drug Interactions Drug-Drug Interactions Digoxin / Cyclosporine Alcohol
Antidiarrheal Drugs Bismuth Subsalicylate (Pepto-Bismol): Coats the lining of the GI tract and soothes irritation stimulating local reflexes to cause excessive GI activity and diarrhea
Antidiarrheal Drugs Continued Opium Derivatives (Paregoric): Stimulates spasm within the GI tract, stops peristalsis and diarrhea Crofelemer (Fulyzaq): Symptomatic relief of noninfectious diarrhea in adults on HIV/AIDS antiretroviral medication
Antidiarrheal Drugs Continued Loperamide (Imodium): Has a direct effect on the muscle layers of the GI tract; slows peristalsis and allows increased time for absorption of fluid and electrolytes
Antidiarrheal Drugs Actions Slow the motility of the GI tract through direct action on the lining of the GI tract
Antidiarrheal Drugs Indications Indications Relief of symptoms of acute or chronic diarrhea Reduction of volume of discharge from ileostomies Prevention and treatment of traveler’s diarrhea
Antidiarrheal Drugs Pharmacokinetics Pharmacokinetics Vary depending on agent
Antidiarrheal Drugs Contraindications Contraindications Allergy
Antidiarrheal Drugs Caution Caution Pregnancy Lactation History of GI obstruction History of acute abdominal conditions Diarrhea due to poisonings
Antidiarrheal Drugs Adverse Effects Adverse Effects Constipation Abdominal distension / Abdominal discomfort Nausea / Dry mouth / Toxic megacolon Fatigue / Weakness / Dizziness
Antidiarrheal Drugs Drug-Drug Interactions Drug-Drug Interactions Depends on the drug
Created by: garmijos
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