4 classes of laxatives
- Bulk-forming
- Stool-softeners
- Stimulants
- Osmotics
Bulk-forming
- introduce fibre that must be taken with a balance of water. Fiber that absorbs water, forming bulkier stool that passes more easily, must be taken with lots of water
Stool-softeners
- surfactant that lowers surface tension of stool allowing more water to enter stool. often given when constipation poses a risk (given with opioids)
Stimulants
irritate bowel, promoting peristalsis. This can cause diarrhea and cramping
Osmotics
draw water into GI tract. Can cause dehydration
serious side effect of Metamucil (Psyllium - bulk forming)?
if not taken with adequate water, can cause obstruction of esophagus or intestines. Prevent this by ensuring to take the medication with adequate water.
Opioid anti-diarrheal
- decrease GI motility via mu receptors, providing more time for water absorption
Non-opioid anti-diarrheal
- draw fluid out of the bowel to form bulk
Specific Side effects associated with phenothiazine anti-emetics
- extrapyramidal side effects: blocking the dopamine receptors in the brain, so person will have high levels of acetylcholine and go into the rigid parkinsonian movements. give med slowly.
3 classes of meds used to manage inflammatory bowel disease?
- 5-aminosalicyclic acid which reduces the production of prostaglandins which are associated with inflammation
- corticosteroids (prednisone) which is useful if patient not responsive to 5-ASA
- immunosuppressants - used as maintenance once disease is remission from 5-ASA or corticosteroids
4 classes of drugs reduce acid secretion for the management of PUD and GERD?
- H2-receptor antagonists
- proton pump inhibitors
- Anticholinergics
- Prostaglandins
H2-receptor antagonists
decrease acid secretion from the parietal
proton pump inhibitor
PPIs H+/K+ pump on parietal cells, reducing acid secretion in the therapy of PUD and GERD. Reduces acid secretion in stomach by irreversibly binding to the H+/K+ pump
Prostaglandins
exogenous (increase mucous production and promote bicarb ion release)
Anticholinergics
reduce gastric acid secretion
Drugs that neutralize acid
- antacids - composed of carbonate, hydroxide and bicarbonate compounds that neutralize the stomach acid. Can effect absorption of drugs especially those that require an acidic environment
Antibiotics
- pharmacotherapy of h. pylori infection
- antibiotics usually given with a drug that reduces acid secretion
- two or more antibiotics usually given at the same time to prevent resistance of antibiotics
