Laxatives And Antidiarrheals

Front 1

Name the dietary fiber and related bulk-forming laxatives

Back 1

Bran
Psyllium (plantago) preps
Methylcellulose

Front 2

Name the saline and osmotic laxatives

Back 2

Magnesium salts
Lactulose

Front 3

Name the Stimulant laxatives

Back 3

Phenolphthalein
Cascara sagrada, Senna
Castor oil

Front 4

Name the opioid antidiarrheals

Back 4

morphine
codeine sulfate

Front 5

Name the adsorbent antidiarrheals

Back 5

kaolin
pectin
kaopectate

Front 6

Name the protective antidiarrheals

Back 6

bismuth subcarbonate

Front 7

Name the opioid derivative antidiarrheals

Back 7

diphenoxylate HCl
loperamide

Front 8

How long does it take for bran/psyllium preps/methylcellulose to take effect (dietary fiber/bulk-forming laxatives)

Back 8

3 days for effect and latency (softening of feces)

Front 9

How long does it take for magnesium salts/lactulose (saline and osmotic laxatives) to take effect

Back 9

lactulose- takes 3 days
magnesium salts- takes 1-3 hours

Front 10

how do magnesium salts/lactulose (saline and osmotic laxatives) work?

Back 10

they are incompletely absorbed, retain water in the intestinal loop, which increase in liquid volume of the feces making them watery

Front 11

how do Phenolphthalein/cascara sagrada/senna/castor oil work? (stimulant laxatives)

Back 11

inhibit Na/K ATPase
irritant on mucosa itself
decreases electrolytes/water net absorption which increases motility

Front 12

Which stimulant laxatives cause mucosal injury?

Back 12

phenolphthalein
castor oil

Front 13

which laxative may interfere with absorption of fat soluble vitamins (ADEK), Ca, P and takes 3 days for effect?

Back 13

mineral oil

Front 14

Which antidiarrheals affect the Mu receptors?

Back 14

the opioids (morphine and codeine sulfate

Front 15

What effect does morphine and codeine sulfate have?

Back 15

decrease peristaltic propulsive movements, increase tone of intestinal muscle, constricts sphincters, increases pendular movement

Front 16

Which antidiarrheals absorb compounds from the solution, thus binding potential intestinal toxins?

Back 16

kaolin, pectin, kaopectate (absorbents)

Front 17

Which antidiarrheals create a protective coating because of their consistency and do not cause constant irritation in the GI tract?

Back 17

bismuth subcarbonate

Front 18

Which antidiarrheal has a muscarinic receptor antagonist action?

Back 18

atropine

Front 19

Which antidiarrheal causes euphoria at large doses and is often combined with atropine?

Back 19

diphenoxylate HCl

Front 20

which antidiarrheal is available OTC?

Back 20

loperamide

Front 21

What is a laxative that is a chloride channel activator (stimulates type 2 chloride channel in small intestine)

Back 21

Lubiprostone

Front 22

Which laxatives are mu opioid receptor antagonists?

Back 22

methylnaltrexone bromide
alvimopan

Front 23

Which laxative is used for patients receiving paliative care for advanced illness (hae no effect on analgesic effects in the CNS)

Back 23

methylnaltrexone

Front 24

Which laxative is used to shorten the period of postoperative ileus after a bowel resection?

Back 24

Alvimopan

Front 25

What are antidiarrheals that are opioid agonists?

Back 25

loperamide
diphenoxylate

Front 26

what is a colliodal bismuth compound (antidiarrheal agent)

Back 26

bismuth subsalicylate (pepto bismol)

Front 27

what is the mechanism of colloidal bismuth compounds? (bismuth subsalicylate)

Back 27

bismuth has direct antimicrobial effects and binds enterotoxins, salicylate inhibits intestinal prostaglandin and chloride secretion reducing stool liquidity in infectious diarrhea

Front 28

Which antidiarrheal should you NOT use in renal insufficiency?

Back 28

bismuth subsalicylate

Front 29

What kind of laxative is methylnaltrexone bromide
alvimopan
methylnaltrexone?

Back 29

opioid receptor antagonist

Front 30

What kind of laxative is lubiprostone?

Back 30

chloride channel activator

Front 31

What kind of laxative is magnesium hydroxide?

Back 31

osmotic laxative

Front 32

magnesium hydroxide/sodium phosphate/sorbitol/lactulose are examples of what?

Back 32

osmotic laxatives

Front 33

aloe/senna/cascara/bisacodyl/castor oil are examples of what?

Back 33

stimulant laxatives

Front 34

which laxatives are mu opioid antagonists?

Back 34

methylnaltrexone bromide
alvimopan

Front 35

which laxative is for use with chronic constipation and irritable bowel syndrome with constipation?

Back 35

lubiprostone

Front 36

how do opioid agonist anti-diarrheals work?

Back 36

inhibit presynaptic cholinergic nerves in submucosal and myenteric plexus, this leads to increased colonic transit time and fecal water absorption

Front 37

Which drugs reduce intestinal fluid secretion and slow gastrointestinal motility?

Back 37

somatostatin
octreotide

Front 38

Which drug is used in treatment of AIDS or vagotomy or diarrhea caused by short bowel syndrome?

Back 38

octreotide

Front 39

What is the treatment for mild traveler's diarrhea?
What is the treatment for severe traveler's diarrhea?

Back 39

mild- loperamide
severe- ciprofloxacin, levofloxacin, norfloxacin, ofloxacin

Front 40

What is the treatment of irritable bowel syndrome, predominant symptom diarrhea?
Predominant symptom constipation?

Back 40

diarrhea- antidiarrheals, esp loperamide
constipation- fiber supplements, milk of magnesia

Front 41

What is the treatment for chronic abdominal pain?

Back 41

low dose tricyclic antidepressants- amitriptyline or desipramine

Front 42

What is the treatment for inflammatory bowel disease?

Back 42

prednisone, prednisolone, budesonide, azathioprine, 6-mercaptopurine, methotrexate, anti-TNF antibodies