GI Stimulant

Indication: diabetic gastric delayed emptying, GERD, IV used for prevention of N/V due to chemotherapy, surgery, and post surgery

MOA: GI uses: sensitizes GI tissues to effects of acetycholine leading to an increase in peristalis, N/V antidopaminergic agent

drug induced parkinsons can occur

Indication: nocturnal heartburn due to GERD not responding to antacids or acid secretion reduction agents

MOA: enhances the release of acetylcholine at the myenteric plexus 98% plasma protein bound, many serious drug interactions

Available only as a compassionate use  program drug

Warning: serious cardiac arrhythmias (QT elongation)

Indication: post-operative ileus following large/small bowel resection

MOA: acting as a peripheral only mu-receptor opioid antagonst, it prevents the narcotic induced decrease in GI motility

Does not cross BBB

Indication: restoration of bowel function in patients with late stage, advanced illness who receive opioids on a continuous basis for pain relief

MOA: SQ injection: blocks mu-opiod receptors in GI cells thus allowing the bowels to continue to function normally

Doesn't cross BBB

Indication: an opiod antagonist for the treatment of opioid induced constipation in adult patients with chronic non-cancer pain

MOA: a PEGylated derivative of naloxone, at the recommended dose levels, naloxegol functino as a peripherally-acting mu- opiod receptor antagonist in tissues such as the gastrointestinal tract, theraby decreasing the constipating effects of opiods

Ex: pain pump due to shingles

substrate for the _glycoprotein transporter

Indicaiton: an opioid antagonist indicated for the treatment of opiod induced constipation in adult patients with chronic non-cancer pain

MOA: Naldemedine is a derivative of naltrexone to which a side chain has been added that increases the molecular weight and the polar surface area, thereby reducing its ability to cross the BBB

CYP3A4 inducers and inhibitors. P-gp inhibitor