VELEZ COLLEGE

College of Occupational and Physical Therapy

Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

NAME: SEAN JERALD B. SOLANA SCORE: /233

STUDENT ID NO.: 20-80907 COURSE & SECTION: BSPT 3 -C DATE: 04/17/23

OBJECTIVES:

By the end of this activity, the student must be able to:

1. Distinguish the general mechanisms in which drugs can affect the functions of the
gastrointestinal system.
2. Determine the indications, contraindications, mechanisms of action, pharmacokinetics, and
side effects of major drug classifications of:
2.1.Drugs that Control Gastric Acidity and Secretion
2.2.Antidiarrheal Agents
2.3.Laxatives and Cathartics
2.4.Miscellaneous Gastrointestinal Drugs
3. Discuss how each drug class in this topic affect the physical therapy management (scheduling
of treatment, monitoring and documentation procedures, applications and/or modifications,
and referral to other medical professionals) of:
3.1.General physical therapy patients and clients
3.2.Patients with acute, subacute, or chronic pain with varying pain intensities
3.3.Patients with Gastrointestinal Irritation, Dyspepsia, Increased Intragastric pH, Peptic
Ulcer, Gastroesophageal Reflux Disorder, Gastrointestinal Hypermotility and Hypomotility,
Nausea and Vomiting, Indigestion, Stress Ulceration Syndrome, Prolonged Bed Rest
Post-operatively and due to SCI

GENERAL INSTRUCTIONS: Read the questions and instructions carefully. Answers should be
placed in the corresponding space provided. Cite all the sources that were used to complete this
worksheet using the AMA format. A dedicated space for sources can be found at the end of this
worksheet.

I. Fill in the Blanks: Supply the missing word/s in each item. Answers must be completely
written out. Incorrect spelling and the use of abbreviations will be marked wrong. (233 points)

1. Drugs Used to Control Gastric Activity and Secretion (91 points)

Drug Examples Indication Mechanism of Side Effects Rehabilitation

Action Concerns

Antacids 1. Aluminum Stomach upset, Antacids Most common May cause

hydroxide heartburn and contain base side effect is electrolyte
2. Magnesium acid such as constipation imbalances
hydroxide indigestion carbonate or and diarrhea when used in
3. Calcium
hydroxide high doses and
carbonate
4. Sodium combined with cause an
carbonate aluminum,

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

5. Magnesium magnesium, increase in

Trisilicate sodium, or urinary pH
calcium. The
base combines
with excess
hydrogen ions
(H+) in the
stomach to
increase
intragastric pH.
antacids
containing
aluminium may
provide
additional
protection of
the gastric
mucosa by
inhibiting
Helicobacter
pylori infection
and by
enhancing the
production of
prostaglandins,
proteins, and
growth factors
that defend the
stomach lining
from gastric
acids
H2 Receptor 1. Cimetidine Acid reflux and Histamine Side effects Sudden
Blockers 2. Famotidine gastroesophage stimulates include withdrawal
3. Nizatidine al reflux specific headache, may result in
4. Ranitidine disease receptors on dizziness and increased acid
5.
stomach mild GI secretion
parietal cells to problems such
increase gastric as nausea,
acid secretion. diarrhea and
H2 antagonists, constipation
or blockers,
selectively bind
to H2 receptors

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

without
activating these
receptors.
These drugs
prevent the
histamine-
activated
release of
gastric acid
under basal
conditions and
during
stimulation by
food, and they
can help
decrease
damage from
gastric acid
caused by
NSAIDs and
other factors
that increase
acid secretion
Proton Pump 1. Esophagitis, Inhibit the H+ , Potential Increased
Inhibitors Dexlansoprazol peptic ulcer K+ -ATPase problems secretion of
e disease, non- enzyme that is include an gastric rebound
2. erosive reflux ultimately increased risk and gastric
Esomeprazole
responsible for of certain polyps
3.
Lansoprazole secreting acid infections
4. Omeprazole from gastric (Clostridium
5. parietal cells difficile,
Pantoprazole into the lumen pneumonia),
of the stomach. decreased
Otherwise absorption of
known as certain
proton pump nutrients
inhibitors have (vitamin B,
antibacterial magnesium,
effects against iron), and
H. pylori kidney
infection and problems such
that they may as interstitial
have some anti- nephritis

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

inflammatory
properties that
help decrease
gastric
irritation.
Others 1. Anticholiner Gastric acidity 1. Cholinergic 1. Cause Increased risk
gics and mucosal stimulation many side in drug toxicity
2. Metoclopra breakdown of the gut effects, therefore
mide via vagal such as dry worsens side
3. Prostagland
efferent mouth, effects and
ins
4. Sucralfate fibers constipatio condition
produces a n, urinary
general retention,
increase in and
GI motility confusion.
and 2. Restlessnes
secretion. s,
Drugs that drowsiness,
block the and fatigue
effects of are fairly
acetylcholi common in
ne on taking
stomach metoclopra
parietal mide
cells will 3. Prostagland
decrease in analogs
the release may be
of gastric effective
acid. only at
2. Metoclopra doses that
mide cause other
stimulates GI effects,
motility in such as
the upper diarrhea.
GI tract 4. Sucralfate
(prokinetic is well
effect), thus tolerated,
decreasing although
the risk of constipatio
gastric acid n may
moving occur in
backward some
patients.

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

into the
esophagus.
3. Prostagland
ins such as
PGE2 and
PGI2
inhibit
gastric
secretion
and help
protect the
stomach
mucosa by
stimulating
gastric
mucus
secretion.
4. Sucralfate
is a
disaccharid
e that exerts
a
cytoprotecti
ve effect on
the stomach
mucosa.7
And it may
form a
protective
gel within
the stomach
that adheres
to ulcers
and shields
them from
the contents
of the
stomach.

2. Antidiarrheals (62 points)

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

Opioid 1. Diarrhea and These drugs The primary Addiction

Derivatives Diphenoxylate stomach upset produce a side effects potential
2. Loperamide general with opioid problem to
3. Opium decrease in GI derivatives are opiods
tincture
motility, and nausea,
4. Paregoric
5. Difenoxin they may also abdominal
reduce fluid discomfort,
loss by constipation,
increasing the and other GI
absorption of disturbances.
salt and water Drowsiness,
or by fatigue, and
decreasing dizziness is
fluid and also included.
electrolyte
excretion from
the GI tract.
Bismuth 1. Kaopectate Diarrhea, This drug may This drug is Salicylate
Salicylates 2. Pepto- heatburn, stimulate water relatively free intoxication
Bismol stomach upset and electrolyte from serious
3. Kaopectate absorption side effects.
Extra Strength
from the lower
4. Maalox Total
Relief GI tract, thus
5. Pepto- decreasing
Bismol fecal fluid loss.
Maximum
Strength Bismuth
salicylate also
decreases
gastric acid
secretion and
exerts antacid
effects, hence
its use in
stomach upset
and minor
gastric
irritation

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

Others 1. Clinicians Diarrhea 1. Clonidine Includes Hypertension,

2. Octreotide stimulate constipation, bradycardia,
3. Cholestyra alpha-2 nausea, and drug
mine, receptors in vomiting, intoxication
Colestipol,
the GI tract, bladder pain,
Colesevale
m thereby headache
decreasing
secretion,
increasing
absorption,
and
normalizing
GI
movement.
2. Octreotide
is a
complex
drug that
mimics the
effects of
endogenous
ly produced
somatostati
n. It inhibits
the
secretion of
serotonin
and other
peptides
that
stimulate
GI
function,
and it is
especially
useful in
treating
diarrhea
caused by
tumors that
secrete
these
substances

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

into the GI
tract.
3. These are
drugs that
sequester
and bind
bile acids
within the
GI tract and
can be
useful in
treating
diarrhea
caused by
excess bile
acid
secretion.

3. Laxatives (40 points)

Classification Examples Indication Mechanism of Side Effects Rehabilitation

Action Concerns

Bulk-forming 1. Irritable Bowel These agents Disturbances in Fluid and

Methylcellulose Syndrome absorb water the GI system, electrolyte
2. (IBS), and swell such as nausea abnormalities
Polycarbophil constipation, within the and cramps, which can
and prevention lower GI tract. may occur with become life-
of acute The increased laxative use. threatening if
constipation size of the renal and
water-laden cardiovascular
laxative function is
stretches the compromised.
bowel, thus
stimulating
intestinal
movement
(peristalsis)
Stimulant 1. Bisacodyl Irritable Bowel May activate Serious lower Fluid and
2. Castor oil Syndrome peristalsis by a GI irritation, electrolyte
(IBS), direct irritant spastic colitis abnormalities

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Classification Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

constipation, effect on the which can

and prevention intestinal become life-
of acute mucosa or by threatening if
constipation stimulating the renal and
nerve plexus cardiovascular
within the gut function is
wall. compromised.
Hyperosmotic 1. Glycerin Irritable Bowel Administration Serious lower Fluid and
2. Lactulose Syndrome of osmotically GI irritation, electrolyte
(IBS), active spastic colitis abnormalities
constipation, substances which can
and prevention produces a become life-
of acute gradient that threatening if
constipation draws water renal and
into the bowel cardiovascular
and small function is
intestine. This compromised.
gradient
increases stool
fluid content
and stimulates
peristalsis.
Lubricants 1. Docusate Irritable Bowel Agents like Serious lower Fluid and
and Stool 2. Mineral oil Syndrome mineral oil and GI irritation, electrolyte
Softeners (IBS), docusate spastic colitis abnormalities
constipation, facilitate the which can
and prevention entry of water become life-
of acute into the fecal threatening if
constipation mass, thus renal and
softening the cardiovascular
stool and function is
permitting compromised.
easier
defecation.
These agents
may also exert
a laxative
effect because
of the increased
pressure in the
bowel
secondary to

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 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Classification Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

the increased
stool size.

4. Miscellaneous GI Drugs (40 points)

Drug Examples Indication Mechanism of Side Effects Rehabilitation

Action Concerns

Emetics 1. Treatment for Emetics induce Dizziness, Critically ill

Apomorphine food poisoning vomiting. They prolonged patients will
2. Ipecac are frequently vomiting, suffer some
administered to stomach upset degree of
help empty the stress-related
stomach of damage to the
poisons or stomach
ingested toxins. mucosa, and
Stimulating the will most likely
medullary be ion
emetic center, prolonged bed
and ipecac also rest and
exerts a direct continuous
emetic effect constipation
on the stomach.
Anti-emetics 1. Motion Block specific Vomiting, Critically ill
Dimenhydrinat sickness, CNS dopamine headache, patients will
e gastrointestinal (D2) and fatigue, dry suffer some
2. Scopolamine motility serotonin (5- mouth degree of
disorder, HT3) receptors, stress-related
vertigo cannabinoids, damage to the
and several stomach
other drugs that mucosa, and
act at various will most likely
sites in the be ion
CNS to prolonged bed
suppress rest and
nausea and continuous
vomiting. constipation
Digestants 1. Pepsin Insufficient The primary Abdominal Critically ill
2. Hydrochloric release of digestant cramps, nausea, patients will
acid digestive preparations diarrhea suffer some

10 of 12
 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

enzymes contain degree of

secondary to pancreatic stress-related
cystic fibrosis enzymes or bile damage to the
salts. stomach
Pancreatic mucosa, and
enzymes such will most likely
as amylase, be ion
trypsin, and prolonged bed
lipase are rest and
responsible for continuous
digestion of constipation
carbohydrates,
proteins, and
lipids,
respectively.
These enzymes
are normally
synthesized in
the pancreas
and secreted
into the
duodenum via
the pancreatic
duct. Bile salts
are synthesized
in the liver,
stored in the
gallbladder,
and released
into the
duodenum via
the common
bile duct. Bile
salts serve to
emulsify lipids
in the intestinal
tract and are
important in
lipid digestion
and absorption.
Cholelitholytic 1. Ursodiol Gallstones Decrease the Bladder pain, Do not appear
Agents 2. Chenodiol cholesterol tachycardia, effective in the
content of bile sever nausea, treatment of

11 of 12
 VELEZ COLLEGE
College of Occupational and Physical Therapy
Department of Physical Therapy
2nd Semester, S.Y. 2022-2023
PHARMA – Pharmacology in Rehabilitation

Worksheet 8: Gastrointestinal Drugs

Drug Examples Indication Mechanism of Side Effects Rehabilitation
Action Concerns

and may help stomach pain, calcified

dissolve painful and gallstones
gallstones that bloody
are urination
supersaturated
with
cholesterol

References:
• Bismuth Subsalicylate: Generic, Uses, Side Effects, Dosages, Interactions, Warnings.
(2021, September 2). RxList.
https://www.rxlist.com/consumer_bismuth_subsalicylate_kaopectate/drugs-
condition.html
• Ciccone, C.D. (2016). Pharmacology in rehabilitation (5th ed.). Philadelphia: F.A. Davis
Co.

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