Bowel Disorder Drugs Flashcards

1
Q

What are the two different types of diarrhea? What 2 things does it cause you to lose?

A

Acute
Chronic

Water
Electrolytes

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2
Q

What can cause diarrhea(6)?

A
Microbes
Osmotics
Drugs
Tumors
Hyperthyroid
IBS-D
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3
Q

How do microbes cause diarrhea?

A

They increase inflammation which increases gut motility

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4
Q

What is an example of an osmotic that causes diarrhea? What pulls water into lumen?

A

Lactose intolerance

Disaccharide pulls water w/ it

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5
Q

What drugs cause diarrhea?

A

Cholinergics

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6
Q

What type of lifestyle actions can cause diarrhea?

A

Drinking contaminated water (poor dietary habits)

Emotional stress

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7
Q

What are the 3 drug classes that Tx simple diarrhea?

A

Adsorbents/bulk forming agents
Anticholinergics
Opioid derivatives

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8
Q

What is the MOA of adsorbents?

A

Adsorbent forms complex w/ water and irritating bacteria to get pooped out

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9
Q

What are adsorbents indicated for?

A

Diarrhea

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10
Q

What is bismuth subsalicylate(Pepto-Bismol)? Is it used to directly Tx or prophylactically? What 2 things does it do to bacteria?

A

Adsorbent

Prophylactically for travelers

  1. prevents bacteria attachment
  2. lysis of bacteria
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11
Q

What are the 3 drug classes that are considered antimotility drugs?

A

Anticholinergics
5HT3 antagonists
Opioids

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12
Q

What neurotransmitters increase gut motility?

A

ACh

5HT

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13
Q

What is paregoric(opium tincture)? Indication?

A

Opiate

Diarrhea

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14
Q

What is 3 others words for tincture?

A

Alcohol
Elixir
Spirit

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15
Q

What is the MOA of opioids for Tx diarrhea?

A

Activated Mu receptors in large intestine which decreases peristalsis

Activates delta receptors in the large intestine which decreases secretions

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16
Q

What is loperamide(Immodium A-D)? Indication? OTC or Rx?

A

Opioid derivative

Diarrhea

OTC

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17
Q

What is diphenoxylate/atropine(Lonox,Lomotil)? What types of drugs are each of them? Indication? OTC or Rx?

A

Opioid derivative

Atropine-Anticholinergic
Diphenoxylate-opioid

Travelers diarrhea

Rx

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18
Q

What is a high dose of 5HT-3 antagonist used for? Low dose?

A

Tx diarrhea

Tx N/V

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19
Q

What is alosetron(Lotronex)? Route? Indication, specifically what gender? ADR?

A

5HT-3 antagonist

Oral

IBS-D especially in women

Ischemic colitis
Constipation

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20
Q

Why does 5HT-3 cause ischemic colitis?

A

Because it decreases the blood supply to the GI

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21
Q

What is a cathartic?

A

Strong laxative

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22
Q

What are laxatives/cathartics indicated for?

A

Constipation
Parasite infection
Cleanse before surgery or exam
Prevent straining

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23
Q

What can straining when going to the bathroom possibly cause?

A

MI
hernia
Hemorrhoids

24
Q

What 6 drugs can cause constipation?

A
Analgesics
Anticholinergics
Al3+ antacids
Ca2+ antacids
Opioids
CCB
25
Q

What lifestyle habits can cause constipation?

A

Holding you poop in
Low water
Low fiber
Lack of exercise

26
Q

What conditions can cause constipation?

A
Hypothyroidism 
Pregnancy
Hyperglycemia 
MS
PD
27
Q

What condition can be caused if a pt has little fiber?

A

Diverticulitis

28
Q

What are 4 good sources of fiber?

A

Fruits
Veggies
Unprocessed grains
Metamucil

29
Q

What are the different drug classes to Tx constipation?

A
Stimulants
Swelling agents/bulk
Osmotic (saline) laxative
Emollients/softeners
chloride channel activators
Peripheral Mu-opioid antagonists
30
Q

MOA of stimulant laxatives?

A

Irritates the mucosal lining which causes the lining to increase histamine release which causes contraction to increase gut motility

31
Q

What is senna(Senekot)?

A

Stimulant laxative

32
Q

What is bisacodyl(Dulcolax)?

A

Stimulant laxative

33
Q

What is the MOA of a swelling agent/bulk forming laxative?

A

Soaks up water which puts pressure on wall of bowel to increase gut motility

34
Q

What is methylcellulose(Citrucel)?

A

Swelling agent/bulk forming laxative

35
Q

What is psyllium(Metamucil)?

A

Swelling agent/ bulk forming laxative

36
Q

What is the MOA of an Osmotic(saline) laxative?

A

Draws water into lumen of intestine

37
Q

What is lactulose(Enulose)? How does it attract water?

A

Osmotic(saline) laxative

Sugar and sodium attracts the water

38
Q

What is magnesium hydroxide(Milk Of Magnesium)?

A

Osmotic(saline) laxative

39
Q

What is magnesium citrate?

A

Osmotic(saline) laxative

40
Q

What is sodium phosphate(fleet enema)?

A

Osmotic(saline) laxative

41
Q

What is PEG(Golytely, Nulytely, Miralax)? What is the solution made up of? Indication?

A

Osmotic(saline) laxative

Non-absorbable sodium

Bowel cleanse for colonoscopy

42
Q

What is lactulose? What does it get rid of and how? Indication?

A

Osmotic(saline) laxative

Gets rid of NH3 by lowering the pH of the colon contents

Hepatic encephalopathy

43
Q

What is the 2 MOA of Emollients/softeners?

A

Allows water to penetrate fecal mass

Lubricates passage through rectum

44
Q

What is Docusate calcium(Surfak)?

A

Emollients/softeners

45
Q

What is Docusate sodium(Colace)?

A

Emollients/softeners

46
Q

What is the MOA of chloride channel activators? Indication?

A

Activates Cl transporters so Cl- can enter lumen for water to follow

IBS-C
Chronic idiopathic constipation

47
Q

What is lubiprostone(Amitiza)?

A

Chloride channel activator

48
Q

What is linaclotide(Linzess)?

A

Chloride channel activators

49
Q

What is the MOA of Mu-antagonist drugs?

A

Blocks Mu receptors to increase peristalsis

50
Q

What is methylnaltrexone bromide(Relistor)? Indication? Route and time? Effect on CNS?

A

Mu-antagonist

Opioid induced constipation
SC Q daily (QD)

No effect on CNS

51
Q

What is Alvimopan(Enterig)? Route? Indication?

A

Mu-antagonist

oral

Postoperative ileus

52
Q

What is cathartic colon? What must a pt used to go to the bathroom?

A

Loss of bowel tone

Must use cathartic to cause bowel movement

53
Q

What Sx should a pt stop taking a laxative or cathartic?

A

N/V

Abdominal pain

54
Q

What should be used as an alternative to laxative?

A

High fiber diet

Increased fluids

55
Q

What can cause dependency on laxatives and decreased bowel tone?

A

Long term use of laxatives

56
Q

What should bisacodyl be given with? What does bisacodyl interact with?

A

Water

Milk
Antacids
Juices