Anitdiarrhels & Laxatives

Question 1

What is diarrhea?

Answer 1

The abnormal passage of stools with increased frequency, fluidity, and weight or with increased water excretion.

Question 2

Diarrhea is classified as _____ or more ______ or ______ stools per _____?

Answer 2

Diarrhea is classified as 3 or more loose or liquid stools per day

Question 3

Acute diarrhea lasts for?

Answer 3

3 days - 2 weeks

Question 4

Chronic diarrhea lasts for?

Answer 4

3-4 weeks

Question 5

What are some causes of acute diarrhea?

Answer 5

Bacteria, viruses, drugs, nutritional factors, Protozoa

Question 6

What are some causes of chronic diarrhea?

Answer 6

Tumours, diabetes, Addision’s disease, hyperthyroidism, IBS, AIDS

Question 7

What are the goals of treating diarrhea?

Answer 7

1. Stopping the frequency of stool
2. Alleviating abdominal cramps
3. Replenishing fluids and electrolytes
4. Preventing weight loss and nutritional deficits from malabsorption

Question 8

What are the classes of antidiarrheals?

Answer 8

1. Absorbents
2. Anti-motility drugs (anticholinergics and opiates)
3. Probiotics

Question 9

What is the MOA of absorbents?

Answer 9

Coat the walls of the GI tract. Bind to the causative bacteria or toxin, which is then eliminated through the stool

Question 10

Are are examples of absorbents?

Answer 10

bismuth subsalicylate (Pepto-Bismol)

Question 11

What class does bismuth subsalicylate belong to?

Answer 11

Absorbents

Question 12

What are the subclasses of anitimotility drugs?

Answer 12

Anticholinergics and opiates

Question 13

What is the MOA of anticholinergics?

Answer 13

Decrease intestinal muscle tone and peristalsis of the GI tract. This slows the movement of fecal matter through the GI tract. They also have a drying effect, and reduce gastric secretions. Used in combination with absorbents and opiates.

Question 14

What is an example of an anticholinergic drug?

Answer 14

belladonna alkaloids
*Note: these are NOT used in Canada

Question 15

What is the MOA of opiates?

Answer 15

They decrease bowel motility which increases the time it takes for the fecal matter to travel through the bowel, allowing time for more water and electrolytes to be absorbed. They also help to reduce pain caused by rectal spasms.

Question 16

What are examples of opiates?

Answer 16

codeine phosphate
loperamide hydrochloride
diphenoxylate hydrochloride with atropine sulphate

Question 17

What is the MOA of probiotics?

Answer 17

They supply missing bacteria to the GI tract and suppress the growth of diarrhea-causing bacteria

Question 18

What is an example of probiotics?

Answer 18

Lactobacillus acidophilus

Question 19

What is the indication of absorbents?

Answer 19

Milder causes of diarrhea

Question 20

What is the indication of antimotility drugs?

Answer 20

More severe cases of diarrhea

Question 21

What is the indication for probiotics?

Answer 21

Antibiotic-induced diarrhea

Question 22

What are some adverse effects of absorbents?

Answer 22

• Increased bleeding time
• Constipation, dark stools
• Confusion
• Tinnitus
• Metallic taste
• Blue gums or black tongue

Question 23

What are some adverse effects of anticholinergics?

Answer 23

• Urinary retention, sexual dysfunction
• Headache, dizziness, confusion, anxiety, drowsiness
• Dry skin, flushing
• Blurred vision
• Hypotension, bradycardia or tachycardia

Question 24

What are some adverse effects of opiates?

Answer 24

• Drowsiness, dizziness, lethargy
• Nausea, vomiting, constipation
• Respiratory depression
• Hypotension
• Urinary retention
• Flushing

Question 25

If a child or teenager has chicken pox or influenza what should you not give them? Why?

Answer 25

bismuth subsalicylate because of the risk of Reye’s syndrome (swelling of the liver and brain)