Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/40

Click to flip

40 Cards in this Set

  • Front
  • Back
definition of diarrhea
excessive water in stool
>200ml/day
mechanisms for diarrhea
increased osmotic load
secretion of electrolytes/water into lumen
exudation of protein & fluid from mucosa (Crohn's)
altered motility
indications to treat diarrhea
infant, elderly, children at risk
cardiac & renal function
intraluminal treatment for diarrhea
fiber (pts w/fermentation of colonic bacteria)
cholestyramine (bile/Crohn's)
Bismuth
SE's from treating diarrhea
possible systemic or super infection & toxic megacolon
actions of bismuth
anti-inflammatory, anti-microbial, beneficial motility, releive cramping

mechanism unknown

salicylic acid absorbed
Antimotility/Antisecretory treatment of diarrhea
Opioids
Alpha 2 agonist
Octreotide
MOA of Loperimide
opioid
Mu receptors inhibit ACh rls
decrease myenteric reflex
(slows motility)
Use for Loperimide
diarrhea
NOT inflammatory bowel dz (b/c toxic megacolon)
Effects of Loperimide
slows motility
increases anal sphincter tone
doesn't penetrate CNS
(no respiratory depression)
MOA Clonidine for diarrhea
Alpha 2 agonist
lowers tone on myenteric & submucosal
Effects of Clonidine
stim absorption
inhib secretion
Significant SE's
(hypotension, depression, fatigue)
Uses of Clonidine in diarrhea
Diabetic neuropathy
(b/c increased # & sensitivity of enterics)
Opiate WD (can't use Loperimide if being treated for WD)
definition of constipation
<3 stools per week
SE's of constipation
rectal prolapse, ulcers, UTI
2 types constipation treatment
laxative
cathartics
1st treatment for constipation
increase fiber, water, physical activity
ID other meds contributing
psychosocial/emotional
SEs with laxatives
excess loss water & electrolytes
secondary aldosteronism (w/vol depletion)
steatorrhea
excretion of Ca in stool
osteomalacia of vertebral
Classes of constipation agents
luminally active
non-specific irritants or stims
prokinetics
Luminally active agents for constipation
hydrophylic colloids
osmotically active
prokinetic
Hydrophylic colloids (2 examples)
Psyllium (Metamucil)
Polycarbophil (Fibercon)
action of hydrophylic colloids
bring water into gut
types of fiber
fermenting (decrease stool water & increase stool volume)
non-fermenting (increase water & bulk)
osmotically active luminal treatment of constipation
magnesium phosphate(epsom salts)
sodium phosphate (Fleet)
contraindications for osmotically active luminal agents
renal insufficency, cardiac dz, electrolyte abnormalities
Types of prokinetics for constipation
cholinergics
serotonin

(not very effective yet)
5HT3 affect on GI motility
inhibits peristalsis
5HT4 affecto on GI motility
stimulates peristalsis
MOA of Metoclopramide for constipation
(Reglan)
stimulates 5HT4, antag 5HT3

good for GERD- increase motility (& ctx sphincter)
MOA of Cisapride for constipation
(Propulsid)
5HT4 agonist
increase LES pressure
withdrawn b/c Vtach & Vfib
serotonin for GI
mostly for GERD
limited effect for lower GI
Cholinergics for constipation
Bethanacol
Neostigmine
5HTs for GI
Metoclopramide
Cisapride
MOA of bethanacol
M3 agonist
only gives cramps & stasis
SE's big
MOA of Neostigmine
Cholinesterase Inhibitor
Use for Neostigmine
pseudoobstruction & paralytic ileus (following surgery)
SE's for Neostigmine
paralyze skeletal muscle
(e.g. diaphragm)
MOA of Tegaserod Maleate
(Zelnorm)
5HT4 agonist
IBS with constipation
contraindications of Tegaserod Maleate
(zelnorm)
for IBS
WITHOUT
diarrhea
previous obstruction or adhesion
SE's Tegaserod Maleate
ischemic colitis
dehydration
hypotention