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;
95 Cards in this Set
- Front
- Back
|
Acute diarrhea |
Sudden onset, lasts from 3 days to 2 weeks, self-limiting (eventually will go away) |
|
|
Chronic diarrhea |
Lasts for >3 weeks, associated with recurring passage of diarrheal stools, loss of appetite, nausea, vomiting, wt loss, chronic weakness, cramping |
|
|
Causes of acute diarrhea |
Bacterial Viral Drug induced Nutrition Protozoa |
|
|
Causes of chronic diarrhea |
Tumors DM Addison's disease Hyperthyroidism IBS AIDS |
|
|
Absorbents-mechanism of action |
Coat the walls of the GI tract; binds to the causative bacteria or toxin and expels it through the stool |
|
|
Examples of absorbent antidiarrheal drugs |
Bismuth subsalicylate (Pepto-Bismol) Kaopectate
-both OTC |
|
|
Do not give absorbent antidiarrheal drugs to who bc of Reyes Syndrome? |
Children/teens with flu or chicken pox |
|
|
Adverse effects of absorbent antidiarrheal drugs |
-increased bleeding time -constipation, dark stools, dark tongues -confusion, twitching -hearing loss, tinnitus (related to ASA) |
|
|
Causes of chronic diarrhea |
Tumors DM Addison's disease Hyperthyroidism IBS AIDS |
|
|
Absorbents-mechanism of action |
Coat the walls of the GI tract; binds to the causative bacteria or toxin and expels it through the stool |
|
|
Examples of absorbent antidiarrheal drugs |
Bismuth subsalicylate (Pepto-Bismol) Kaopectate
-both OTC |
|
|
Do not give absorbent antidiarrheal drugs to who bc of Reyes Syndrome? |
Children/teens with flu or chicken pox |
|
|
Adverse effects of absorbent antidiarrheal drugs |
-increased bleeding time -constipation, dark stools, dark tongues -confusion, twitching -hearing loss, tinnitus (related to ASA) |
|
|
What is the onset time for absorbent antidiarrheals? |
30 minutes |
|
|
Anticholinergic antidiarrheal-mechanism of action |
Slowdown intestinal muscle tone and peristalsis of G.I. tract. |
|
|
Examples of anticholinergic antidiarrheal |
Belladonna alkaloids (donated Rx) -administer via oral capsules or elixir (TID/QID) |
|
|
Causes of chronic diarrhea |
Tumors DM Addison's disease Hyperthyroidism IBS AIDS |
|
|
Absorbents-mechanism of action |
Coat the walls of the GI tract; binds to the causative bacteria or toxin and expels it through the stool |
|
|
Examples of absorbent antidiarrheal drugs |
Bismuth subsalicylate (Pepto-Bismol) Kaopectate
-both OTC |
|
|
Do not give absorbent antidiarrheal drugs to who bc of Reyes Syndrome? |
Children/teens with flu or chicken pox |
|
|
Adverse effects of absorbent antidiarrheal drugs |
-increased bleeding time -constipation, dark stools, dark tongues -confusion, twitching -hearing loss, tinnitus (related to ASA) |
|
|
What is the onset time for absorbent antidiarrheals? |
30 minutes |
|
|
Anticholinergic antidiarrheal-mechanism of action |
Slowdown intestinal muscle tone and peristalsis of G.I. tract. |
|
|
Examples of anticholinergic antidiarrheal |
Belladonna alkaloids (donated Rx) -administer via oral capsules or elixir (TID/QID) |
|
|
Adverse effects of Anticholinergic antidiarrheals? |
-dry mouth, urinary retention, hesitancy, impotence (dry mouth is most usual side effect concern) -headache, dizziness, confusion, anxiety, drowsiness -blurred vision, photophobia, increased intraocular pressure |
|
|
Opiate antidiarrheals-mechanism of action |
-Decreased bowel motility and relieve rectal spasms, -decreased transit time through with the bowel, allowing more time for water and electrolytes to be absorbed. -Reduce pain by relief of rectal spasms. |
|
|
Example of opiate antidiarrheals |
Lomotil Imodium
(Both slow peristalsis)
-used to treat ACUTE diarrhea. |
|
|
Opiate antidiarrheals-mechanism of action |
-Decreased bowel motility and relieve rectal spasms, -decreased transit time through with the bowel, allowing more time for water and electrolytes to be absorbed. -Reduce pain by relief of rectal spasms. |
|
|
Example of opiate antidiarrheals |
Lomotil Imodium
(Both slow peristalsis)
-used to treat ACUTE diarrhea. |
|
|
Opiate antidiarrheals adverse effects |
-drowsiness, sedation, dizziness, lethargy, urinary retention -respiratory depression when used with higher doses
DO NOT USE IN KIDS UNDER 2!! |
|
|
Intestinal flora modifiers |
Probiotics or bacterial replacement drugs |
|
|
Lactobacillus organisms work by: |
-replacing the balance of normal flora lost with antibiotic therapy -found in butter milk and yogurt |
|
|
Food treatments of diarrhea? |
-Probiotics – yogurt, can be found in OTC pill/tablet form -BRAT diet-bananas, rice, applesauce, (dry)toast/tea -ABC diet-apples, bananas, carrots |
|
|
Red flags when treating diarrhea: |
-Abdominal pain right sided especially could indicate appendicitis -fever, nausea, vomiting, constipation -abdomen is firm or distended -suspected C-diff
***Do not give antidiarrheals or laxatives to patients with suspected C diff*** |
|
|
Toxic megacolon |
Clinical term for an acute toxic colitis with dilatation of the colon which can either be total or segmental. |
|
|
Evidence or symptoms of toxic megacolon |
-radiographic evidence of colonic dilatation – classic finding is more than 6 cm in the transverse colon -any 3 of the following-fever >101.5°F, tachycardia >120 beats/min, leukocytosis, or anemia. -any 1 of the following – dehydration, altered mental status, electrolyte abnormality, or hypotension. |
|
|
Constipation |
Abnormally frequent and difficult passage of species through the lower G.I. tract |
|
|
Causes of constipation |
-Poor diet – lack of fruits and vegetables or bulk in diet -Poor oral intake of fluids, lack of exercise -blockage, tumor, ileus -Side effects of medications |
|
|
Risk factors for |
-gender – females 2:1 -depression and psychological disorders -over 65 years of age -Low or no fiber diet -less exercise, lower education levels, lower socioeconomic status, minority race |
|
|
Constipation |
Abnormally frequent and difficult passage of species through the lower G.I. tract |
|
|
polyethylene glycol-electrolyte solution |
Brand names – GoLYTELY, MiraLAX, and others
Usual dosage – 4 L of oral solution at a rate of 240 mL every 10 minutes
Usual indications-stimulates bowel evacuation prior to G.I. examination (example colonoscopy, sigmoidoscopy) |
|
|
Causes of constipation |
-Poor diet – lack of fruits and vegetables or bulk in diet -Poor oral intake of fluids, lack of exercise -blockage, tumor, ileus -Side effects of medications |
|
|
Risk factors for |
-gender – females 2:1 -depression and psychological disorders -over 65 years of age -Low or no fiber diet -less exercise, lower education levels, lower socioeconomic status, minority race |
|
|
Laxatives mechanism of action |
Bulk forming, emollient, hyperosmolar, Saline, stimulant. |
|
|
Bulk stimulant laxatives |
Rapid acting, aggressive laxatives that cause the fecal matter to increase in bulk. Increase the motility of the G.I. tract by increasing the fluid in the intestinal contents, which enlarges bulk, stimulates local strict receptors, in activates local activity |
|
|
lactulose |
Brand name-Chronulac
Usual dosage-15-30 mL PO
Usual indications-short-term treatment of constipation, alternative choice for patients with cardiovascular disorders |
|
|
magnesium citrate |
Brand name- Citrate of Magnesia
Usual dosage-1 glassful, 1/2 glass for peds pts
Usual indication-stimulates bowel evacuation before G.I. diagnostic tests and examinations |
|
|
magnesium sulfate |
Brand name – Epsom salts
Usual dosage – 10–25 mg PO
Usual indications – very potent laxative used for total, rapid evacuation of the G.I. tract, for treatment of G.I. poisoning |
|
|
magnesium |
Brand name – Epsom salts
Usual dosage – 10–25 mg PO
Usual indications – very potent laxative used for total, rapid evacuation of the G.I. tract, for treatment of G.I. poisoning |
|
|
polycarbophil |
Brand name – FiberCon
Usual dosage – 1 g PO 1 to 4 times per day as needed; do not exceed 6 g per day for adults or 3 g per day for children
Usual indications – short-term treatment of constipation, mild laxative |
|
|
psyllium |
Brand name – Metamucil
Usual dosage – 1 teaspoon or packet in cold water, 1 to 3 times per day; 1/2 packet for children
Usual indications – mild laxative, short-term treatment of constipation |
|
|
Emollient or lubricant laxatives |
Stool softener-used to prevent constipation. Used to lubricate fecal material and intestinal walls. |
|
|
docusate (emollient laxative) |
brand-name – Colace
Usual dosage – 50–240 mg PO
Usual and indications – prophylaxis for patients who should not strain – such as after surgery, MI, or obstetrical delivery |
|
|
glycerin |
Brand name – Sani-supp
Usual dosage- 4 mL of liquid suppository
Usual indications – short-term treatment of constipation |
|
|
mineral oil |
Brand name – Agoral plain
Usual dosage – 5 to 45 mL PO
Usual indications – short-term treatment of constipation |
|
|
Emollient or lubricant laxatives |
Stool softener-used to prevent constipation. Used to lubricate fecal material and intestinal walls. |
|
|
docusate (emollient laxative) |
brand-name – Colace
Usual dosage – 50–240 mg PO
Usual and indications – prophylaxis for patients who should not strain – such as after surgery, MI, or obstetrical delivery |
|
|
glycerin |
Brand name – Sani-supp
Usual dosage- 4 mL of liquid suppository
Usual indications – short-term treatment of constipation |
|
|
mineral oil |
Brand name – Agoral plain
Usual dosage – 5 to 45 mL PO
Usual indications – short-term treatment of constipation |
|
|
T/F
Emollients are safe for long term constant use-will not cause laxative dependence. |
True |
|
|
Hyperosmolar laxative |
Increase fecal water content, draws water into the bowels.
Result – bowel distention, increased peristalsis, and evacuation |
|
|
Indications for hyperosmotic laxatives |
Used for bowel prep before surgery or for diagnostic testing such as colonoscopy.
Can work within 12 hours |
|
|
Hyperosmolar laxative |
Increase fecal water content, draws water into the bowels.
Result – bowel distention, increased peristalsis, and evacuation |
|
|
Indications for hyperosmotic laxatives |
Used for bowel prep before surgery or for diagnostic testing such as colonoscopy.
Can work within 12 hours |
|
|
Examples of hyperosmotic laxatives: |
-Lactulose -Kristalose -Miralax OTC -Milk of Magnesia -fleet enema-phosphate of soda |
|
|
Chemical stimulant laxatives |
Directly stimulate the nerve plexus in the intestinal wall, causing increased movement in the stimulation of local reflexes. |
|
|
bisacodyl |
Brand name – Dulcolax
Usual dosage- 10 to 15 mg PO or 2.5 g in water via enema
Usual indications –emptying of the G.I. tract before some surgeries or diagnostic tests, prevention of constipation and straining after G.I. surgery, myocardial infarction, obstetrical delivery, short-term treatment of constipation |
|
|
castor oil |
Brand name – Neoloid
Usual dosage – 15 to 30 mL PO
Usual indications – emptying of the G.I. tract for diagnostic testing, short-term treatment of constipation
***special consideration – avoid frequent use to prevent constipation from G.I. tract exhaustion when there's no stimulus to movement. |
|
|
senna |
Brand name-Senokot
Usual dosage – 1 to 8 tablets per day at bedtime or 10 to 25 mL of syrup
Usual indications short-term treatment of constipation, treatment of encopresis, OTC |
|
|
methylnaltrexone |
NEW laxative
Brand name-Relistor
Approved in 2008 for the treatment of opioid induced constipation in patients with advanced disease who are receiving palliative care and are no longer responsive to traditional laxatives.
Given by daily subQ injection, reaches peak levels in 1/2 hour and is eliminated primarily unchanged in the urine. The drug half life is about eight hours. |
|
|
methylnaltrexone |
NEW laxative
Brand name-Relistor
Approved in 2008 for the treatment of opioid induced constipation in patients with advanced disease who are receiving palliative care and are no longer responsive to traditional laxatives.
Given by daily subQ injection, reaches peak levels in 1/2 hour and is eliminated primarily unchanged in the urine. The drug half life is about eight hours. |
|
|
Amitiza(lubiprostone) |
**NEW laxative
Mobility enhancer, activates chloride 2 channels drawing fluid
Approved for chronic constipation, take BID for long term use, works well in elderly |
|
|
methylnaltrexone |
NEW laxative
Brand name-Relistor
Approved in 2008 for the treatment of opioid induced constipation in patients with advanced disease who are receiving palliative care and are no longer responsive to traditional laxatives.
Given by daily subQ injection, reaches peak levels in 1/2 hour and is eliminated primarily unchanged in the urine. The drug half life is about eight hours. |
|
|
Amitiza(lubiprostone) |
**NEW laxative
Mobility enhancer, activates chloride 2 channels drawing fluid
Approved for chronic constipation, take BID for long term use, works well in elderly |
|
|
Negative outcomes of |
Impaction, hemorrhoids, obstruction, fecal seating, bowel perforation, rectal ulcers, ileus. |
|
|
methylnaltrexone |
NEW laxative
Brand name-Relistor
Approved in 2008 for the treatment of opioid induced constipation in patients with advanced disease who are receiving palliative care and are no longer responsive to traditional laxatives.
Given by daily subQ injection, reaches peak levels in 1/2 hour and is eliminated primarily unchanged in the urine. The drug half life is about eight hours. |
|
|
Amitiza(lubiprostone) |
**NEW laxative
Mobility enhancer, activates chloride 2 channels drawing fluid
Approved for chronic constipation, take BID for long term use, works well in elderly |
|
|
Negative outcomes of |
Impaction, hemorrhoids, obstruction, fecal seating, bowel perforation, rectal ulcers, ileus. |
|
|
Medications or food that may cause constipation |
Antihistamines, iron supplements, alcohol, dairy products or calcium supps, chocolate |
|
|
Antiemetic agent mechanisms of action |
Work by reducing the hyperactivity of the vomiting reflex in one of two ways: -locally, to decrease the local response to stimuli that are being sent to the medulla to induce vomiting or -centrally to block the chemoreceptor trigger zone or suppress the vomiting center directly. |
|
|
Local acting antiemetics may be: |
Antacids, local anesthetics, absorbents, protective drugs that coat the G.I. mucosa, or drugs that prevent distention and stretch stimulation of the G.I. tract. |
|
|
Centrally acting antiemetics may be: |
Phenothiazines, nonphenothiazines, anti-cholinergic/antihistamines, serotonin receptor blockers, substance P/neurokinin 1 receptor antagonist |
|
|
Scopolamine indications |
Used for motion sickness, secretion reduction before surgery, nausea/vomiting. |
|
|
Available forms of scopolamine |
IM injections, oral, transdermal patches, ocular forms |
|
|
Contraindication for scopolamine antiemetic |
Patients with glaucoma |
|
|
Side effects of anti-emetics |
Drowsiness, dry mouth, drying of secretions, constipation, may cause psychotic issues |
|
|
Antihistamine anti-emetics include: |
Benadryl OTC, Antivert RX, Dramamine OTC |
|
|
Indications for antihistamine antiemetics |
Motion sickness, nonproductive cough, allergy symptoms, sedation |
|
|
Scopolamine indications |
Used for motion sickness, secretion reduction before surgery, nausea/vomiting. |
|
|
Available forms of scopolamine |
IM injections, oral, transdermal patches, ocular forms |
|
|
Contraindication for scopolamine antiemetic |
Patients with glaucoma |
|
|
Side effects of anti-emetics |
Drowsiness, dry mouth, drying of secretions, constipation, may cause psychotic issues |
|
|
Antihistamine anti-emetics include: |
Benadryl OTC, Antivert RX, Dramamine OTC |
|
|
Indications for antihistamine antiemetics |
Motion sickness, nonproductive cough, allergy symptoms, sedation |
|
|
Adverse affects of antihistamine antiemetics |
May have cumulative effect, Drive house, constipation, confusion (especially in the elderly), urinary retention, drowsiness.
**NEVER GIVE TO CHILDREN |
