(Gastrointestinal) Treatment Of Lower Gi Disorders

Front 1

This chronic condition leads to dehydration and electrolyte imbalance. It ma be a symptom of another disease or caused by chronic inflammation, over-stimulation-or emotional disturbances.

Back 1

Diarrhea

Front 2

Aluminum silicate clay. Protects mucosa from irritation

Back 2

Kaolin

Front 3

Extract of citrus acid that acts as a demulcent on irritated bowel lining.

Back 3

Pectin

Front 4

Absorbents are ineffective at treating which type of diarrhea:

Back 4

Acute infectious diarrhea

Front 5

This absorbent coats walls of the GI tract, absorbs bacteria, and can be used In cases of drug overdose.

Back 5

Charcoal

Front 6

Side effects of bismuth subsalicylate Pepto-Bismol)

Back 6

Constipation
Blackens tongue and stool

Front 7

What is the chemical name for Peptol-Bismol? Which class of drugs is it in?

Back 7

Bismuth Subsalicylate - Local acting adsorbent

Front 8

In which group of patients should you be cautious with using Bismuth Subsalicylate? Why?

Back 8

Be careful in children since it can cause Reye's Syndrome

Front 9

Four systemically acting antidiarrheals:

Back 9

Opiates
Diphenoxylate
Loperamide
Anticholinergics

Front 10

How do opiates work to treat diarrhea?

Back 10

Reduce acute intestinal hyper-motility and spasm

Front 11

Paragoric constituents (4):

Back 11

4% opium tincture, benzoic acid, camphor, anise

Front 12

___________ and _________ inhibit release of Ach from enteric nervous system through presynaptic opioid receptors.

Back 12

Diphenoxylate and Loperamide

Front 13

This drug is a weak analog of meperidine with less abuse potential than codeine:

Back 13

Diphenoxylate (lomotil)

Front 14

The anti-diarrheal drug Lomotil conains not only Diphenoxylate, but this other compound. Why?

Back 14

Also contains atropine. Atropine dries mucous membranes which lowers the abuse potential of diphenoxylate (which is an opioid).

Front 15

How does the availability of loperamide (Imodium) compare with Diphenoxylate (Lomotil)?

Back 15

Loperamide is available without prescription, unlike diphenoxylate.

Front 16

Loperamide or dipenoxylate are contra indicated in patients with ___________ because it can lead to toxic megacolon.

Back 16

Severe Ulcerative Colitis

Front 17

Who do anticholinergics reduce diarrhea?

Back 17

Antispasmodics

Front 18

Lactobacillus acidophilus is used to treat uncomplicated diarrhea caused by ________

Back 18

antibiotics

Front 19

Name a food product that contains lactobacillus acidophilus:

Back 19

Un-pasteurized yogurt

Front 20

How does lactobacillus acidophilus work?

Back 20

Produces lactic acid which creates an unfavorable environment for pathological flora

Front 21

Laxatives or Cathartics?

Alters hydration of stool, producing soft, formed stool

Back 21

Laxatives

Front 22

Laxatives or Cathartics?

Increase motor activity of intestine.

Back 22

Cathartics

Front 23

5 indications for laxatives:

Back 23

Prep for GI X-ray procedures
Prep for some surgeries
Following ingestion of some poisons
Following treatment with some anthelmintics to flush out remaining parasites
To avoid straining for stool

Front 24

Two contra-indications for use of laxatives:

Back 24

Appendicitis and undiagnosed abdominal pain

Front 25

This cathartic is hydrolyzed by pancreatic lipases to ricinoleic acid which is a local irritant to the intestine

Back 25

Castor oil

Front 26

Laxatives or Cathartics?

Ex-lax

Back 26

Cathartics

Front 27

This drug acts similarly to phenophthalein (the original ingredient in Ex-Lax). It is more likely to cause side effects than bulk laxatives

Back 27

Bisocodyl

Front 28

these are natural products like SENNA (used in Ex-Lax) or emodin alkaloids which are absorbed in the small intestine and excreted in the colon causing stimulation of peristalsis.

Back 28

Antraquinones

Front 29

(T/F) Antraquinones may cause acute colonic distention

Back 29

False (or at least the notes don't say that)

They cause chronic colonic distention

Front 30

Two types of saline cathartics:

Back 30

Salts
Isosmotic electroylate solutions containing polythyleneglycol

Front 31

These are the safest laxatives available with few serious side effects:

Back 31

Bulk laxatives

These form gels in the large intestine, causing distention which stimulates intestinal peristaltic activity

Front 32

Pancreatic enzyme replacements are used to treat _________ which is a condition that evolves when lipase output is 10% below normal

Back 32

Steatorrhea

Front 33

This supplement will help pancreatic enzyme replacement be more effective, as it causes a decrease in gastric acidity

Back 33

Cimetidine

Front 34

How does Chenodiol help dissolve bile stones?

Back 34

Inhibits HMG-CoA reductase which is the rate-limiting enzyme in the conversion of bile salts to cholesterol. Causes increased excretion of bile salts and decreased secretion of cholesterol

Front 35

What limits the use of chenodiol?

Back 35

Does-related diarrhea and increased cholesterol

Front 36

How does Ursodiol help dissolve bile stones?

Back 36

Causes transport of cholesterol in a liquid crystal form. Does not impact bile acid synthesis

Front 37

Both chenodiol and ursodiol are most effective in dissolving which type of stones?

Back 37

Small floating stones

They also enhance benefits of shock wave lithotripsy

Front 38

Drug of choice for severely ill patients with ulcerative colitis:

Back 38

Glococorticoids

Front 39

This is the generic name for drugs that contain 5-aminosalicylic acid

Back 39

Mesalamine

Front 40

How do mesalmines and sulfasalazine work?

Back 40

Bacteria cleave the compounds which liberates salicylate. Salicylate blocks cyclo-oxygenase - inhibiting PG production

Front 41

What should you use in a patient with ulcerative colitis who is unresponsive to corticosteroids?

Back 41

Immunosuppressive drugs:

Cyclosprine
Azathioprine

Front 42

Treatment of toxic megacolon:

Back 42

All the normal treatments for colitis (Glucocorticoids, sulfasalazine, or mesalamine and immunosuppressive drugs) plus a broad spectrum antibiotic to avoid bacteremia from perforated colon.

Front 43

What should be used with extreme caution in a patient with toxic megacolon?

Back 43

Antidarrheals

Front 44

Treatments for Crohn's Disease (6):

Back 44

Salfasalazine, glucocorticoids, metronidazole, immunosuppressives with purine antimetabolites, methotrexate, Anti-TNF

Front 45

Mechanism of methotrexate

Back 45

Inhibits dihydrofolate reductase

Front 46

What is infliximab?

Back 46

Anti-TNF-alpha therapy. Used in Crohn's disease

Front 47

This is often considered a functional disorder because no structural, biochemical, or infectious etiology has been found.

Back 47

Irritable Bowel Syndrome

Front 48

This nerve receptor antagonist slows movement through the colon. It was withdrawn from the market but re-introduced after popular demand

Back 48

Lotronex

Front 49

This drug is used to treat constipation-IBS in women who are over 18.

Back 49

Lubiprostone (Amitiza)