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34 Cards in this Set
- Front
- Back
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Kaolin and Pectate: MOA
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Absorb fluid
Increase viscosity and bulk |
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Kaolin and Pectate: Advantages? Disadvantages?
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Few systemic effects
Large doses required May absorb some medicines |
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What is the name of the fiber supplement?
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Psyllium (Metamucil)
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Psyllium: MOA
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Absorb fluid
Bind bile acids |
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Psyllium: uses
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Chronic diarrhea
Diarrhea with incontinence Diarrhea predominant irritable bowel syndrome |
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What are the opiate-like antidiarrheals?
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Lomotil (diphenoxylate and atropine)
Imodium (loperamide) |
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What is the MOA of opiate-like antidiarrheals?
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Activation of gamma and delta opiate receptor activation, increasing segmenting contractions of the proximal colon
Decreases propulsive activity in distal colon and may increase secretion, gives time for fluid absorption |
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Opiate-like antidiarrheals: adverse effects?
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Toxic megacoloin in bad colitis
CNS effects of too much Constipation Distention, bloating, nausea, vomiting Atropine issues |
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What is pepto bismol?
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Bismuth subsalicylate
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Bismuth Subsalicylate: MOA? indications? adverse effects?
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Binds toxins?
Anti-inflammatory Traveler's diarrhea Black stool CNS bismuth toxicity (especially in renal failure) |
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Name the bile acid binders.
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Cholestyramine
Colestipol |
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Bile acid binders: effects
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Absorb excess bild acid (like for TI resection)
Nonspecific constipating effect |
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Bild acid binders: AEs?
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Bloating, excess constipation
Gritty, unpleasant texture Drug interactions |
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Octeotride: structure? effects?
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Octapeptide somatostatin analog
Decreases peristalsis and secretion |
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Octeotride: indications? administration
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AIDS diarrhea
Endocrine-secretory Peptide - must be given parenterally (SQ) |
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Constipation: risk factors?
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Increases with age
F>M Medications (bild acid binders, verapamil, diltiazem, opiates) |
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When do you not use opiates?
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With toxic megacolon
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Name the 2 common fiber agents.
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Psyllium
Carboxymethylcellulose (Citrucel) |
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Fiber: MOA
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Absorb water, add weight to stool
Speed transit Digested by bacteria |
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Fiber: AEs
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Bloating and flatulence
Diminishes with time Start low, go slow |
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Fiber: contraindications
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Bowel obstruction
Severely slow colon |
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Name the stimulant laxatives.
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Antrhaquinalones (most natural products)
Bisacodyl Castor oil (avoid) Docusate (use chronically) |
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Stimulant laxatives: MOA
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Cause intestinal fluid secretion
Impair absorption Stimulate motility |
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Stimulant laxatives: problems
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Cramps, discomfort
Tachyphylaxis (effects diminish) Injurious to colon? IBS patients see-saw Abuse with eating disorders |
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Lubiprostone: what is it? what does it do? what does it result in?
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Prostaglandin-like drug
Activates second messengers, resulting in chloride channel mediated secretion Produces a controlled secretory condition |
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MIneral oil: MOA
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Lubricates and prevents water absorption
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Why isn't mineral oil used?
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Aspiration can lead to lipoid pneumonia
Problems with elderly patients: reflux, reduced consciousness, do not give before sleep |
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What are the most common laxatives? What are the 2 types?
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Osmotic laxatives
Saline Nonabsorpbable |
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Name the saline type osmotic laxatives (4)
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Magnesium hydroxide
Magnesium citrate Sodium phosphate Polyethylene glycol |
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What are the nonabsorpable sugar oxmotic laxatives?
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Sorbitol - diet candies, meds
Lactulose |
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Osmotic laxatives: MOAs
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Hyperosmotic saline type: draw fluid into small intestine and increase motility
Isoosmotic saline-type: fluid load takes stool along Nonabsorbable sugars: bacterial degradation products stimulate colon, some osmotic load |
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Enema: MOA? special indications?
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Distension of rectum, lubricate and soften stool
Fecal impaction and concern about bowel obstruction - disimpact first |
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What are the types of enemas (5)?
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SMOG
Soap suds Tap water Saline Sodium phosphate |
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Enema: AEs?
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Phosphate chelates Calcium - be careful in renal patients
Repeated hypotonic enemas cause decreased Na Rectal trauma or perforation |
