gi transit, speed gastric emptying time

prokinetic indications

cholinomimetic agents

muscarinic m3 receptor on myenteric plexus synapse

acetylcholinisterase inhibitor, ohilvie's syndrome

acute colonic pseudoobstruction

substituted benzamines

blocks dopamine d2 receptor, anti nausea, antiemetic. includes prolactin, cholinergic smooth muscle stimulation

methomoglobinemia

qt interval prolongation, cardiact arrest, sudden death

5ht4 agonist enteric neurons acetylcholine release 5ht3 antagonist

parkinsonism syndrome, restlessness

cardiac arrythmias

directly stimulates motilin receptor onset of migrating motor complex

antipsychotic agents potent antiemetic and sedative properties inhibits dopamine and muscarinic antihistamine

dioperidol

anti emetic due to dopaminergic blockade metoclopramide and trimethobenzamide dopamine receptor blockade

lorazepam and diazepam

before the initiation of cemotherapy to reduce anticipatory vomiting

dronabinol

major psychoactive compound

appetite stimulant

dexamethasone, methylprednisolone

tx of chemo induced vomiting

prototypic muscarinic receptor antagonist most effective for motion sickness

prophylaxis of motion sickness clear for tetranogenic potential

h2 antihistamines

motion sickness, lesser morning sickness anti emetic properties is base on anti cholinergic, anti histamine and sedation

potent antiemetics. blocks d2 receptor in ctz antagonize amorphin induced vomiting

difficult or infrequent passage of stools

tx of constipations

laxatives

indigestible, hydrophillic colloids that absorbs water forming or bulky emollient gels

do not give to pc with crohns diseas, obstruction, intestinal strictures

natural plant producs

synthetic fibers

soluble but not absorbable compound. results to increase stool liquidation

purgatives

magnesium oxide

reduce ammonia levels in hepatic encephalopathy

rectal burning

sorbitol

complete colonic cleansing before git endoscopy

induce bowel movements through direct stimulation of enteric ns, colonic electrolyte, fluid secretion

not to be given in px with hpn, chf, and renal impairment

aloe, senna, cascara

side effects of anthraquinone derivatives

diphenylmethane derivatives

dulcolax

phased out in market due to cardiac toxicity

hydrolyzed in small intestine local irritant that stimulates inyestinal motility

soften stool materials, permits h2o and lipides to penetrate

softeners

example of stool surfactants

clear, viscous oil that lubricates fecal material

cannot be given to patients with bloody diarrhea, fever, and systemic toxicity

tx of fecal impaction and debilitated adults

side effects of mineral oil

fat-soulble vitamins

mild to moderate acute diarrhea control diarrhea caused by IBS and IBD

example of antidiarrheal

examples of bile salt resins

diarrhea caused by excess bile acids, crohn's disease and resection of terminal ileum

SE of bile salt resins

half life of somatostatin

half life of ocreotides

inhibits the secretion of gastrin, cholecystokinin, glucagon, growth hormone, insulin secretion, pancreatic polypeptide, vasoactive intestinal peptide, and 5ht3

inhibition of endocrine tumor

carceroid and VIPoma

SE of somatostatin and ocreotide

blocks 5ht3 receptor in the affarebt neurons distention induced sensory and motor reflex activation colonic motility

diarrhea predominant ibs

adr of serotonin 5htr receptor antagonist

inhibits muscarinic cholinergic receptor in the enteric plexus; smooth muscles

examples of antispasmodics

hyosyamine

dicyclomine

resembles serotonin in structure

tx for IBS with predominant constipation

IBD

immune mediated chronic intestinal condition

backwash ileitis

involves the rectum, extends proximally to involve the colon

mouth to anus; rectum is spared

perirectal fistulas, fissures abscesses, anal stenosis

tx for crohn's disease

purine anti metabolite

glucocorticoids

mainstay of therapy for mild to moderate ulcerative colitis

examples of azo compounds

mesalamine compounds

reduces absorption of the oarent drug from the small intestine

resident bacteria cleanse the azo bonds by means of

5 asa group are bound together

bound to 4-aminobenzoyl-b-alanine secretory diarrhea

contains time release microgranules

oated in ph-sensitive resinthat dissolves at ph7

delivered at high concentration to the rectum and the sigmoid colon

side effect of mesalamin compounds

induction and maintenance of remission of UC and CD post operative prophylaxis of cd