GI Pharmacology

Lecture 1 Autonomicsself study

1 Anatomy physiology of ANS
craniosaural
Entericnervoussystem
Anatomical thoracolumbar
ateIufEnfhses
physiological parasympathetic sympathetic
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2 EndOrganspecificity

cholinergicpreganglionic

adrenergicpostganglionic
 Kelly
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GB_gallbladder
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Decrease Acid Secretion
4th I tt
2 Antacids Tums
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constipation

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particulars tetracyclines andfluoroquinolones
clopidogrel pepticulcers

Anticholinergic
Agents Enhancing MucosalDefense
AbdominalpainBloating
blocksMreceptorsonsmoothGImuscles

bkhjyjiiiiig.gg iii Persichetti sina.it diiiiiiiyamine

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Tricyclic Antidepressants
AE blacktonguestool
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pepticulcers
MOAunclear
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enhanced
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5 Aminosalicylates
inflammatorysuppresors CI inhibits GImotilitysecretion
metalamine
avoidinconstipationpredominantBS
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SerotoninReuptake Inhibitors
AbdominalpainBloating
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Glucosteroids corticosteroids
inhibitexpressionofinflammatorymediators
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inflammatorymediators
teamuse
Predisone Prednisolone Budesonide
acutemoderate severeIBD mildtomoderateCrohn'sDisease
AEmoodchangesaffectsadrenalglandsslow
growth appetite
 Immunomodulators Biologics
Infliximab
6 mercaptopurine
tosevereCDuc
moderate
Prodrug
MOA anti TNFa antibodiesbindtoTNFx blockinflammation
purine endspurinesynthesise monoclonalantibody
apoptosis oft cells ADR cardiactoxicitynauseahepaticenzymeelevation
IBDtx assiststeroidtapering 6mercaptopurine redolizumab
TNFainducesremission rheumatoidAnneritis MoaAntiintegrinAaB of
blocksintegrinmediatedmigration leukocytesto
caution sumeundingtissue
gnuiteswitemitize
forptswhocan'trespondtoantiTna
piewithluminal perianaltistulizingCD
TPM't r AEnasopharyngitis
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ustifielayhab
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6methyl mercaptopurine inactive d
thioinosinic MoainhibitIL 1223mediatedactivationofTheanattocells
d batygiouric
acid acytokineexpression
liversideeteen
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adults
hibitor
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Slow GI Motility
usedfor
pinwheel vomiting
1 51473 Antagonists
1 Syntheticsomatostatin
CluImsubQ
Octueotide drugsendin setron
Dolasetron ondansetnen Alosetion
secretionof 5HTvip
MOAinhibit
MOA blockbothcentralperipheral 51173receptors
andotherhormones dintestinal
chemoptsgivewithdexamethasone
fluid dalmothityanastopaB
contraction tx motionsicknesspregnancy
Txfordianneacausedbyendocrine
tumor
AE prolongedQTinterval
Highdose Alpsshonbowelsyndetc
2 NKantagonists
2 OpioidReceptorAgonist mon.mnietntatnkredP
Loperamide
polapitant
MOAstimulateopioidreceptorsinENS substrateinteracts
inhibitpresynapcholinergic
actionspyprotein withPgpprotein
smoothmusclecontraction a 3 corticosteroid AEneutropeniaallergicr
mucosalabsorptionNgastrocolicretlex Dexamethasone
Moaunknownmayinhibithistaminerelease chemopts
Tx traveller'sdiarrheachronicdiarrhea 4 syntheticcannabinoids
Nabilone
3 Absorbents MOAstimulateCBIandblock sat3receptors
Bismuthsubsalicyclate
MOAreduces a secretion in vomitingcenter
P wanttoflatlinetherapy
cholestyramone 5 MIReceptorAntagonist 6 111ReceptorAntagonist
www.mmm scopolamine transdermalpatch medicine
blocksH1
Doxylaminet
pyridoxine
bite
malabsorptiondiarrhea MOAblockM1 vomitingvestibular
pharynx formotionsickness
ptsmotionsick blocksHaand
vertigo MI
AE namewangle glaucoma scannessBBB
 upperGl motility

1 D2 Dopamine ReceptorAntagonist 7 Osmotic Laxatives

Metoclopramide Magnesium Hydroxide Lactulose

MOA blockP2mediatedinhibition of nninntinemnn
gastroesophagealperistalsisandreduction
of Lespressure RapperG1motility
Agastricemptying
gg
mongAfecalfluidPcolonic
t ig
promoteNH diffusion

Tx impairedgastricemptyingupperonbleedemesis catusebrain
purgation can
Metals Liver Excretion kidneys highdoses damage
APR parkinsonism
polyethylene glycolelectrolytesolution
smalldose Miralax
2 motilin ReceptorAgonists Macrolides
Moa drawwaterintointestine
erythromycin azithromycin PfecalfluidPcolonic
MOAdirectstimofmotilinreceptoronGl peristalsis
smoothmuscle
Tx ptswhofail Dateuppgeld
gastropanesis 8 chloridechannelActivator
shortterm Lubiprostone
moa activatestypes a channelsonsmallintestine
stooltintestinal
epithelialcellsMsecretionsoften
3 Bulk Forming Laxatives motilityshonentransittimeincolon
cellulose
psylium methyl Tx andopioidinducedconstipation
idiopathic
toppygenic
MOA indigestibleplantfibers astoolvolume
Abowelmovement fermentedby 9 GC
bacteria dstoolwater CAFÉ'atotide
Pt straintopoopforconstipatedpts
need Moa Gc creceptorsactivated Rcamp r intestinalmotility
drinklotsoffluidstoprevent mayalsorelievepainpainsensinghemeactivityt
intestinal blockade
IBSC
Clkidselderlypts a Cl ptsyoungerthan6 mechanical Gl obstruction
4 Stool softeners
10NHE3 Inhibitornapgdi HydrogenExchangers
Docusate MineralOil ym
MOA lubricates E3inhibitoristhe SIandcolonwhatabsorption
MOANH
Motigggglipids
penetratefeces stool Posmoticsecretionofwateringut shonenstoolconsistency
d IBSC
Cl ptsyoungerthan6 mechanical Gl obstruction
ADR
Severelipidpneumonitis
Fatmalabsorption
youngkids tgiverectally polyethylene glycol sodiumPicosulfate
notorally manage solution based preparation
tablets
5 stimulants MOA likeosmoticlaxative
Senna bisacodyl dose Miralax
uses small
MOA unknown Tx acutechronicconstipation treatpreventchronic
constipation
mmmm mmmm
methyl
naltrexone naloxegol
MOA Blockuneceptor mediated Glmotiityinhibition
 Treatment Plans

HPyloricaused Pepticulcers yo inhibitors all punno1 bonemarrowsuppression

Tripleinppp
YEA if used with 6 MP
ppltelarithromyein
amoxicillin
2forptswithpenicillinallergy
ppl em PPIt clanthromyein
metronidazole
3 forptswithClanthromycin
metr nidazole
ppl
resistance amoxicillin
trifabutin
QuadrupleTherapy
1 Bismuth bismuthsub
salicylatet
metronidazole tetracycline Ppl
21clavithromyan clarithromycint
amoxicillint metronidazole Ppl

PLAB
1 henoprazantamoxacillintelavithromycin triple
2 vonoprazan tamoxicillindual
 Groupings

CI Alcohol Nephnetoxic CI Antacids

1 HaReceptorAntagonists Grothe 1 5 ASA
4 tidines butserious

CYP3A4 inhibitors inducers prodrugs Nasophangngitis

1 PLAB 1 PPI 1 redolizumab biologics
2 Budesonide corticosteroid 2 6 Mercaptopurine alustekinumab biologics
immunomodulator
4RolapitantNkantagonist
6 Tenepanov metabolized byCYP3Ad Traveller'sDiarrhea Don'ttakewithin2
ForAIDSPH 1 Loperamide opioidagonist Hours of otherDrugs
1 octnotide syntheticsomatostatin a pygmy gyqp.gg pygmy
txtordiawnea peptoBismoll peptomismoll
2 cholestyramine Absorbent

causeMalabsorptionsyndromes
castvitB12non hemeinenMq2t
1 Ppls prazoles
2 Aprepitant NKantagonist
popproteininducersinhibitors
1RolapitantNkantagonist
cancrossBBB
1 Doxylaminetpyridoxine Haantagonist
1 metociopramide D2antagonist
HeartDisease
1Ppl MI
2 MagnesiumHydroxide stoolsoftener
3 Lactulose stoolsoftener
chemoinducedvomiting
stgineistidexatifiation 1 sevens sat3antagonist
2 metociopramide D2antagonist
acutecasesLabour
www.mmmm.my
givewithdexamethasone
delayed arms day
pexamemasoneyonogeneid
CI w AnticholinergicDrugs
1 Dicycloamine alreadyanticholinergic
2 Hyosycamine alreadyanticholinergic
3 Nabilone synthetic cannabinoid
CIw Parkinson's 4 scopolamine mareceptorantagonist
5 Doxylaminetpyridoxine Haantagonist