Bowel Disorder Drugs Flashcards
What are the two different types of diarrhea? What 2 things does it cause you to lose?
Acute
Chronic
Water
Electrolytes
What can cause diarrhea(6)?
Microbes Osmotics Drugs Tumors Hyperthyroid IBS-D
How do microbes cause diarrhea?
They increase inflammation which increases gut motility
What is an example of an osmotic that causes diarrhea? What pulls water into lumen?
Lactose intolerance
Disaccharide pulls water w/ it
What drugs cause diarrhea?
Cholinergics
What type of lifestyle actions can cause diarrhea?
Drinking contaminated water (poor dietary habits)
Emotional stress
What are the 3 drug classes that Tx simple diarrhea?
Adsorbents/bulk forming agents
Anticholinergics
Opioid derivatives
What is the MOA of adsorbents?
Adsorbent forms complex w/ water and irritating bacteria to get pooped out
What are adsorbents indicated for?
Diarrhea
What is bismuth subsalicylate(Pepto-Bismol)? Is it used to directly Tx or prophylactically? What 2 things does it do to bacteria?
Adsorbent
Prophylactically for travelers
- prevents bacteria attachment
- lysis of bacteria
What are the 3 drug classes that are considered antimotility drugs?
Anticholinergics
5HT3 antagonists
Opioids
What neurotransmitters increase gut motility?
ACh
5HT
What is paregoric(opium tincture)? Indication?
Opiate
Diarrhea
What is 3 others words for tincture?
Alcohol
Elixir
Spirit
What is the MOA of opioids for Tx diarrhea?
Activated Mu receptors in large intestine which decreases peristalsis
Activates delta receptors in the large intestine which decreases secretions
What is loperamide(Immodium A-D)? Indication? OTC or Rx?
Opioid derivative
Diarrhea
OTC
What is diphenoxylate/atropine(Lonox,Lomotil)? What types of drugs are each of them? Indication? OTC or Rx?
Opioid derivative
Atropine-Anticholinergic
Diphenoxylate-opioid
Travelers diarrhea
Rx
What is a high dose of 5HT-3 antagonist used for? Low dose?
Tx diarrhea
Tx N/V
What is alosetron(Lotronex)? Route? Indication, specifically what gender? ADR?
5HT-3 antagonist
Oral
IBS-D especially in women
Ischemic colitis
Constipation
Why does 5HT-3 cause ischemic colitis?
Because it decreases the blood supply to the GI
What is a cathartic?
Strong laxative
What are laxatives/cathartics indicated for?
Constipation
Parasite infection
Cleanse before surgery or exam
Prevent straining
What can straining when going to the bathroom possibly cause?
MI
hernia
Hemorrhoids
What 6 drugs can cause constipation?
Analgesics Anticholinergics Al3+ antacids Ca2+ antacids Opioids CCB
What lifestyle habits can cause constipation?
Holding you poop in
Low water
Low fiber
Lack of exercise
What conditions can cause constipation?
Hypothyroidism Pregnancy Hyperglycemia MS PD
What condition can be caused if a pt has little fiber?
Diverticulitis
What are 4 good sources of fiber?
Fruits
Veggies
Unprocessed grains
Metamucil
What are the different drug classes to Tx constipation?
Stimulants Swelling agents/bulk Osmotic (saline) laxative Emollients/softeners chloride channel activators Peripheral Mu-opioid antagonists
MOA of stimulant laxatives?
Irritates the mucosal lining which causes the lining to increase histamine release which causes contraction to increase gut motility
What is senna(Senekot)?
Stimulant laxative
What is bisacodyl(Dulcolax)?
Stimulant laxative
What is the MOA of a swelling agent/bulk forming laxative?
Soaks up water which puts pressure on wall of bowel to increase gut motility
What is methylcellulose(Citrucel)?
Swelling agent/bulk forming laxative
What is psyllium(Metamucil)?
Swelling agent/ bulk forming laxative
What is the MOA of an Osmotic(saline) laxative?
Draws water into lumen of intestine
What is lactulose(Enulose)? How does it attract water?
Osmotic(saline) laxative
Sugar and sodium attracts the water
What is magnesium hydroxide(Milk Of Magnesium)?
Osmotic(saline) laxative
What is magnesium citrate?
Osmotic(saline) laxative
What is sodium phosphate(fleet enema)?
Osmotic(saline) laxative
What is PEG(Golytely, Nulytely, Miralax)? What is the solution made up of? Indication?
Osmotic(saline) laxative
Non-absorbable sodium
Bowel cleanse for colonoscopy
What is lactulose? What does it get rid of and how? Indication?
Osmotic(saline) laxative
Gets rid of NH3 by lowering the pH of the colon contents
Hepatic encephalopathy
What is the 2 MOA of Emollients/softeners?
Allows water to penetrate fecal mass
Lubricates passage through rectum
What is Docusate calcium(Surfak)?
Emollients/softeners
What is Docusate sodium(Colace)?
Emollients/softeners
What is the MOA of chloride channel activators? Indication?
Activates Cl transporters so Cl- can enter lumen for water to follow
IBS-C
Chronic idiopathic constipation
What is lubiprostone(Amitiza)?
Chloride channel activator
What is linaclotide(Linzess)?
Chloride channel activators
What is the MOA of Mu-antagonist drugs?
Blocks Mu receptors to increase peristalsis
What is methylnaltrexone bromide(Relistor)? Indication? Route and time? Effect on CNS?
Mu-antagonist
Opioid induced constipation
SC Q daily (QD)
No effect on CNS
What is Alvimopan(Enterig)? Route? Indication?
Mu-antagonist
oral
Postoperative ileus
What is cathartic colon? What must a pt used to go to the bathroom?
Loss of bowel tone
Must use cathartic to cause bowel movement
What Sx should a pt stop taking a laxative or cathartic?
N/V
Abdominal pain
What should be used as an alternative to laxative?
High fiber diet
Increased fluids
What can cause dependency on laxatives and decreased bowel tone?
Long term use of laxatives
What should bisacodyl be given with? What does bisacodyl interact with?
Water
Milk
Antacids
Juices
