Give the classes of Physical and Physiological drugs for Constipation
Physical
- Bulk-forming Laxatives
- Stool Surfactant Agents/ Softener
- Osmotic Laxatives
Physiological
- Cl channel activators
- Opioid Receptor Antagonist
- Stimulant Laxatives
- Serotonin 5HT4 agonist
Bulk-forming laxatives
- Types, Names
- MOA
- AE [2]
Plant Fibers - Psyllium, Methylcellulose
Synthetic Fibers - Polycarbophil
Absorb water, increase mass, distends colon, peristalsis
AE
- flatulence from bacterial digestion
- pulling water in interferes with absorption of drugs
Stool Surfactant/ Softener
- Names
- MOA
- AE of one of them
Docusate, Mineral Oil
oil lubricates, prevent water absorption from stool
- Lower surface tension, more water and lipids enter stool
AE of oil: interfere w fat soluble vitamin absorption
Osmotic Laxatives [3]
AE
Sugars - Sorbitol
Salts - Mg(OH)2, Sodium Phosphate
Balanced Polyethylene Glycol - PEG
Sugars lead to flatulence;
Need hydrate
Salt leads to electrolyte imbalances;
PEG is better cos isotonic plus less flatulence
Stimulant Laxative [2]
MOA
Aloe
Bisacodyl
- migrating colonic contractions, peristalsis, stimulate ENS
What are Bisacodyl and PEG ?
PEG - osmotic laxative
Bisacodyl - stimulant
- used together for colonic cleansing before colonscopy
Chloride Channel Activator and which channel
Cl,,, think L
Lubiprostone (think lube yay)
- Type II Cl channel
Opioid receptor antagonists
Methylnaltrexone Bromide MNTXb
Alvimopan
MOA
- they dont enter BBB hence analgesic is ok
- block mu opioid receptor
Anti-diarrhea Opioids slows down ENS
5HT4 agonists
Prucalopride (pride suffix) / Brand name Prudac
Receptors on submucosal intrinsic primary afferent neuron IPAN to stimulate ENS
What is Docusate
Surfactant
What is Psyllium
Bulk fiber
What is Bisacodyl
Simulant
What is PEG
Osmotic
What is Prucalopride
5HT4 agonist
What is methylnaltrexone bromide
Opioid blocker
What is Alvimopan
Opioid blocker
