Gastrointestinal

Front 1

1. T or F, laxatives are used before GI surgery or before a radiologic exam.

2. An example of a laxative commonly used in the hospital in this way:

Back 1

1. True

2. Magnesium Citrate

Front 2

T or F, To correct constipation, increase exercise, fluid intake, and fiber

Back 2

True

Front 3

Hydrophillic Colloids (which is not for acute use) is what kind of fiber?

One example is:

Back 3

Indigestible fiber

Psyllium Seed (Metamucil)

Front 4

Metamucil would be used prophylactically for CHRONIC constipation, T or F?

Can this product also be used for diarrhea?

Back 4

True (& fiber is the ONLY one not habit forming)


Yes (diarreha is attracted to fiber/water, causing bulk)

Front 5

Saline Cathartics such as Epsom Salt, Milk of Magnesia, Magnesium Citrate, Miralax, Golytely can be used for ACUTE constipation.

Back 5

True

(Milk of Magnesia is most common in hospital; used at bedtime)

Front 6

Saline Cathartics work quickly---anywhere from 30 minutes to 3 hours?

Back 6

True

(Acute constipation or to prepare for an exam)

Front 7

Frequent use of Saline Cathartics will cause diarrhea, and can be habit forming?

Back 7

True

Front 8

The use of Saline Cathartics __________, which increases bulk, leading to motility/peristalsis.

Back 8

INCREASES osmotic pressure

True

(Also habit forming)

Front 9

This SALINE CATHARTIC is used before procedures:

1. Golytely
2. Magnesium Citrate
3. Epsom Salt

Back 9

2. Magnesium Citrate

(has flavor & carbonation, loaded with salt) palatable--chill it

Front 10

1. Can be used as a laxative or for feet:

Back 10

1. Epsom Salt

Front 11

Examples of "Surface Wetting Agents", or stool softeners are:

Back 11

Sulfosuccinate (Colace) or Sulfosuccinate (Surfak)

Colace & Surfak

Front 12

Stool softeners are:

1. habit forming
2. onset: 1 to 3 days
3. prevent straining/constipation
4. promotes mixture of water & fat to make soft

Back 12

All of the above

(used prophylactically only, not for acute symptoms)

Front 13

Mineral Oil is used as a LUBRICANT to line GI w/ oil so stool can slide through.

Onset: 6-8 hrs
For acute OR chronic constipation

Back 13

Yes, also habit forming

Front 14

1. Mineral Oil cannot be taken at bedtime because risk of:

2. Decreases absorption of

Back 14

1. Aspiration pneumonitis (can go to lungs)

2. Fat soluble medications (Blocks absorption of vitamins A, D, E, K) can't give at same time, won't be absorbed.

Front 15

Aspiration pneumonitis is a risk of what?

Back 15

Taking mineral oil at bedtime

(also, decreases absorption of fats & fat soluable medication)

Front 16

Directly irritates intestinal mucosa causing reflex reaction of peristalsis:

Examples include:

Back 16

STIMULANT CATHARTICS

Senna (Senokot)
Cascara, Castor Oil, Bisacodyl (Dulcolax)

Front 17

Most common STIMULANT CATHARTIC for acute constipation

Back 17

Dulcolax

(onset: 2-8 hrs)

Front 18

1. Uses for a Stimulant cathartic such as: Cascara, Senokot or Dulcolax for:

2. Habit forming

Back 18

1. Acute Constipation/Prior to GI exam

(side effects include cramping due to peristalsis)

2. True

Front 19

Diarrhea could be caused by:

1. Infection (toxin)
2. Increased peristalsis
3. Increased osmotically active substance in GI tract

Back 19

All of the above

Front 20

This antidiarrheal absorbs toxins in GI tract, but binds medication & vitamins (can't be administered at same time)

Back 20

Bismuth Salt (Peptobismol, Kaopectate)

(our one example)

Front 21

Bismuth Salt (or Bismuth subsalicylate) should be used with precaution when?

Back 21

1. Children w/ diarrhea
(virus & salicylates: Risk of Reyes Syndrome)

2. Allergic to salicilate or aspirin

Front 22

Can an adsorbant like peptobismol be used prophylactically? (ie: travelling, drinking water)

Back 22

Yes (have to take several times per day)

Front 23

Two reasons to use Lactobacillus Acidophillus:

(Yogurt can help too)

Back 23

1. Restore flora after broad spectrum antibiotics (may prevent super infection)

2. Restore flora after a bout of diarrhea

Front 24

Which drugs are H-2 receptor antagonists?

Tagamet
Zantac
Pepcid

Back 24

All of the above (are Histamine H-2 blockers )

Front 25

A disaccharide that is not absorbed and acts as a barrier on the ulcer allowing it to heal.

Back 25

Sucralfate (Carafate)

Front 26

Ulcers can be caused by:

1. stress (physiologic not psychologic)
2. Alcoholism
3. Idopathic (prone to ulcers)
4. Drug-induced (aspirin, corticosteroids)

Back 26

True
(including bacteria induced Heliobacter pylori)

Front 27

Almost all patients in the ICU will be given prophylactic medications for ulcers when on: corticosteroids

Back 27

True

Front 28

Goal of Antacids is to buffer the stomach pH between ______

Back 28

4 and 5

Front 29

Exceeding pH of 5 leads to

Best time to administer antacid:

Back 29

Rebound Acidity (Autonomic Nervous System kicks in)

1 and 3 hours post meal. (nocturnal acid makes rebound hard)

Front 30

Best neutralizing antacid, but it may be too good, raising pH to 5, getting rebound acidity

Back 30

Sodium Bicarbonate (Rolaids)

Front 31

1. A very weak, constipating antacid:

2. Good Antacid, may cause diarrhea

Back 31

1. Aluminum Hydroxide (Alternagel)
2. Magnesium Hydroxide

That's why it's combined: Magnesium Hydroxide/Aluminum Hydroxide (Maalox, Mylanta)

Front 32

1. Histamine 2 Blockers (H-2 antagonists) blocks H2 receptor in____

2. Promotes healing in______weeks

Back 32

1) stomach (blocks secretion of acid)

2) 6-8 weeks

Front 33

Examples of H-2 blockers drugs (blocks acid produced by parietal cells)

Back 33

Tagamet, Zantac & Pepcid

(blocks release of acid)

Front 34

Histamine 2 blockers (such as: Tagamet, Zantac & Pecid) can be used prophylactically for ulcer therapy and will prevent nocturnal acid.

Back 34

True

Prone to ulcers: idopathic, medication prone to ulcers, (H2 blocker would be better than antacids)

Front 35

Major breakthrough for gastro esophageal reflux disease (GERD), or heartburn. PREVENTS acid secretion.

Can it also help with ulcers?

Back 35

Proton Pump Inhibitors

Yes, by preventing proton release so ulcer can heal (6-8 weeks)

Front 36

The following drugs are__________used for ulcer therapy:

1. Esomeprazole
2. Lansoprazole
3. Dexlansoprazole

Back 36

ALL
PROTON PUMP INHIBITORS
(breakthrough drug)

"-prazole"

Front 37

Ideal time to administer a Proton Pump Inhibitor:

(ie: Esomeprazol, Lansoprazole, Omeprazole)

Back 37

"-prazol"

30 minutes before a meal (dosed once a day)

Front 38

Our body cannot absorb this ulcer drug which is a double sugar; it becomes gelatinous & is attracted to ulcers .

(forms a barrier & allowing it to heal in 6-8 weeks)

Back 38

Sucralfate

Can't be used prophylactically because there's no ulcer to be attracted to.

Front 39

Can sulcrulfate be used prophylcatically for ulcers?

Back 39

No.

You need an ulcer to begin with.

Front 40

Can fiber be used for diarrhea?

Back 40

Yes, for bulk

Front 41

Diarrhea could be caused by:

Increased peristalsis, or,

Increased osmotically active substance in GI tract.

Back 41

Both. Including Bacteria

Front 42

Histamine 2 blockers (such as: Tagamet, Zantac & Pecid) can prevent nocturnal acid.

Back 42

True

Front 43

Major breakthrough drug for gastro esophageal reflux disease (GERD)

(ie: Esomeprazol, Lansoprazole, Omeprazole)

Back 43

Proton Pump Imhibitor

Front 44

If 'prone' to ulcers, H2 blocker (such as Zantac, Pepcid & Tagamet) would be 'better' than antacids. T or F?

Back 44

True. Blocks secretion of acid produced by parietal cells) Also, works for nocturnal acid.

Front 45

Name an adsorbant antidiarrheal

Back 45

Bismuth Salt (Peptobismol, Kaopectate)

Front 46

Psyllium Seed is an indigestible fiber.

Name the common name for this hydrophillic Colloid

Back 46

Metamucil (laxative)

Front 47

If 'prone' to ulcers, you would use:

1. Cimetidine (Tagamet)
2. Lansoprazole (Prevacid)
3. Sodium Bicarbonate (Rolaids)

Back 47

H2 Blocker

(Not #2 proton pump inhibitor or #3 Antacid)

Front 48

If 'prone' to ulcers, you would use:

1. Proton Pump Inhibitor
2. Histamine H-2 Blocker
3. Antacid

Back 48

Histamine H-2 Blocker
(like zantac, tagamet, or pepcid)

Front 49

When would a Proton Pump Inhibitor be used?

1. Gerd (acid reflux)
2. Ulcers
3. In combination w/ antibiotics for heliobacterpylori (causes ulcers)

An example of a drug is:

Back 49

"-prazole"
Esomeprazole. Lansoprazole, Omeprazole,