Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
56 Cards in this Set
- Front
- Back
|
What is loperamide?
|
phenylpiperidine analgesic analog, delayogen
|
|
|
How is loperamide excreted?
|
stool
|
|
|
What is loperamide's MOA?
|
increases segment contractions in proximal colon, decreases propulsive spike activity in distal colon
|
|
|
What are the adverse effects of loperamide?
|
constipation, distension, bloating, nausea, vomiting
CNS depression, drowsy, dizzy, toxic megacolon |
|
|
What are the contraindications of loperamide?
|
avoid in toxic patietn, dysentery, severe ulcerative coloitis
|
|
|
What kind of drug is diphenoxylate and atropine?
|
opiod, anticholinergic, delayogen
|
|
|
how id diphenoxylate excreted?
|
fecally
|
|
|
Why is atropine included in diphenoxylate and atropine?
|
to discourage opiate abuse
|
|
|
What are the side effects of diphenoxylate and atropine?
|
toxic megacolon, CNS depression, constipation
|
|
|
What happens with peds patients and diphenoxylate/atropine?
|
can become toxic from atropine and respiratory depresison from diphenoxylate
|
|
|
How should you give loperamide?
|
after every BM
|
|
|
What is the MOA of bismuth subsalicylate?
|
binds bacterial toxins, nonspecific anti-inflammatory effect
|
|
|
Why do you give bismuth salicylate?
|
traveller's diarrhea
|
|
|
What are the adverse effects of bismuth salicylate?
|
black stools, bismuth toxicity with enteritis
|
|
|
Who should not get bismuth subsalicylate?
|
renal failure, enteritis
|
|
|
What is bismuth toxicity?
|
seizures, encephalopathy
|
|
|
In what diseases do you use cholestyramine?
|
cholecystectomy, terminal ileal resection or disease
|
|
|
What is the MOA of cholestyramine?
|
anion exchange resin, binds bile acids
|
|
|
What are the adverse effects of cholestyramine?
|
bloating, constipation, binds other drugs
|
|
|
What is octreotide?
|
somatostatin analog, anti-secretory agent
|
|
|
What is octreotide's MOA?
|
hyperpolarizes gut neurons, decreases ACh release, slows peristalsis, prevents release of secretion-inducing NTs
|
|
|
Why would you give octreotide?
|
severe refractory secretory diarrhea, endocrine tumor-related diarrhea
|
|
|
What are the adverse effects of octreotide?
|
gallbladder stasis, inhibition of pancreatic secretion, injection site irritation
|
|
|
What is psyllium?
|
fiber, bulk forming agents
|
|
|
Why do you use psyllium?
|
more gritty, but also less expensive
|
|
|
What is psyllium's MOA?
|
adds weight and bulk to the stool by absorbing water, speeds transit through colon, digested by bacteria
|
|
|
What are psyllium's adverse effects?
|
bloating, flatulence
|
|
|
What are the adverse effects of psyllium?
|
obstruction of the bowel, severely slow colon
|
|
|
what is Bisacodyl's MOA?
|
stimulates enteric nerves to cause colonic mass movement, increases fluid/NaCl secretion
|
|
|
What are the adverse effects of Bisacodyl?
|
cramps
|
|
|
What is castor oil's MOA?
|
hydrolyzed to ricinoleic acid, stimulates fluid and water secretion, increases intestinal permeability
|
|
|
What should you do with castor oil?
|
avoid it! causes cramping
|
|
|
What is Docusate's MOA?
|
anionic surfactant, does not need accelerated colon transit, mild contact laxatives that increase NaCl secretion via cAMP
|
|
|
What's good about docusate?
|
softer bm in 3-5 days, safter, milder, long-term
|
|
|
What is mineral oil's MOA?
|
penetrates and lubricates feces, prevents H2O reabsorption
|
|
|
How is mineral oil absorbed?
|
somewhat orally, not at all if in enema
|
|
|
Why would you give mineral oil?
|
fecal impaction, post-MI to avoid straining/vagal stimulus, post-surgical or post partum
|
|
|
What are the adverse effects of mineral oil?
|
aspiration causes lipoid pneumonia, anal leakage with irritation, malabsorption of fat soluble vitamins, chronic intestinal hypomotility
|
|
|
What is the MOA of magnesium salts?
|
poorly absorbed ions, hold H2O in the lumen and stimulate peristalsis
|
|
|
What are the adverse effects of magnesium salts?
|
hypermagensemia with renal failure, cramping/pain with magnesium citrate
|
|
|
What is polyethylene glycol?
|
balanced salt solution, causes mass fluid passage through GI tract, little absorbed without glucose or slow drinking
|
|
|
Why do you give polyethylene glycol?
|
prepare for colonoscopy, fecal impaction, severe chronic constipation
|
|
|
What is the MOA of sodium phosphate?
|
osmotic purge
|
|
|
What are the adverse effects of sodium phosphate?
|
hyperphosphatemia and hypocalcemia with renal insufficiency
|
|
|
What is lactulose?
|
galactose-fructose
|
|
|
What are the adverse effects of lactulose?
|
gas/gloat/distention
|
|
|
Why would you use lactulose?
|
treatment of hepatic encephalopathy, acidifies colon, traps ammonia and amines in colon for excretion
|
|
|
What are the adverse effects of enemas?
|
phosphate can be absorbed and cause hypocalcemia in patients iwth renal failure
repeated water/soap suds enemas can cause hyponatremia |
|
|
What are the indications for enema use?
|
intermittent constipation, fecal impaction, bowel obstruction is a concern/oral laxatives are constrained
|
|
|
What do you give for acute infectious diarrhea with a fever and systemic illness??
|
nothing, bismuth subsalicylate, antibiotics
|
|
|
What do you give for acute mild infectious diarrhea?
|
bismuth subsalicylate, loperamine, diphenoxylate-atropine
|
|
|
What do you give for chronic diarrhea?
|
fiber, loperamide
|
|
|
What do you give for episodic constipation?
|
bisacodyl, docusate
MOM, magnesium citrate, lactulose |
|
|
What do you give for fecal impaction?
|
enema
polyethylene glycol, mineral oil |
|
|
What do you give for chronic mild constipation?
|
fiber, osmotic salts or enema
|
|
|
What do you give for chronic severe constipation?
|
low fiber, daily osmotic agent: MOM, mag citrate, sodium phosphate, polyethylene glycol, misoprostol
|
