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NAPLEX Prep > Constipation and Diarrhea > Flashcards

Constipation and Diarrhea Flashcards

1
Q

Conditions that cause constipation

A

IBS
Anal disorder
MS
CV events
Parkinsons
Pregnancy
Spinal cord tumors
Diabetes
Hypothyroidism

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2
Q

Non pharm for constipation

A

Increasing fluid intake
Physical activity
High fiber foods

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3
Q

Types of laxatives alone with examples

A

Bulk forming: Psyllium and fiber
Osmotic: PEG
Stimulants: Senna, bisacodyl
Stool softeners: Docusate
Lubricants: mineral oil

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4
Q

What is first line for constipation in pregnancy

A

Bulk forming
Fiber

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5
Q

Drugs that cause constipation

A

Antidiarrheals
Anticholinergiccs
Cation drugs
Colesevelam
Opioids
Clonidine
Verapamil

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6
Q

Recommend for iron-induced constipation

A

Stool softeners due to hard stool
Bulk forming

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7
Q

Recommended for opioid induced

A

Stimulants or osmotic

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8
Q

Fast relief laxatives

A

Adults: Bisacodyl or glycerin suppositories
Children: Glycerin suppository

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9
Q

Types of bulk forming

A

Psyllium
Calcium polycarbophil
Methylcellulose
Wheat dextrin

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10
Q

Psyllium

A

Metamucil

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11
Q

Calcium polycarbophil

A

FiberCon

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12
Q

Methylcellulose

A

Citrucel

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13
Q

Wheat dextrin

A

Benefiber

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14
Q

ADR of bulk-forming

A

Flatulence, bloating, cramps

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15
Q

Counseling of bulk forming laxatives

A

Adequate fluid are required or it can ↑ risk of fecal impaction

Separate calcium polycarbophil for other drugs that could bind

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16
Q

Types of osmotic laxatives

A

Magnesium hydroxde
PEG 3350
Glycerin
Lactulose
Sodium phosphate

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17
Q

Mag hydroxide

A

Milk of Magnesia

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18
Q

PEG3350

A

Miralax

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19
Q

Sodium phosphate

A

Fleet Enema

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20
Q

ADR of osmotic laxatives

A

Electrolyte imbalances, abdominal cramping

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21
Q

Indication of lactulose that is most common

A

Hepatic encephalopathy

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22
Q

Caution using magnesium laxatives?

A

Cation in renal impairment

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23
Q

Stimulant laxatives

A

Senna
Biacodyl

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24
Q

Bisacodyl

A

Dulcolax

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25
Q

ADR of stimulant laxatives

A

Abdominal cramping

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26
Q

Counseling of stimulant laxatives

A

Take at bedtime to induce bowel movement in the morning

Give 30 min after meal to induce peristalsis

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27
Q

Emollient laxatives

A

Docusate

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28
Q

Docusate

A

Colace

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29
Q

Indication for stool softners

A

When straining should be avoided or if stool is hard or dry

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30
Q

CI of mineral oil

A

<6 YO, pregnancy, bedridden, elderly, >1 wk, difficulty swallowingM

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31
Q

MOA of lubiprostone

A

Chloride channel activator → fluid secretion and peristalsis

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32
Q

MOA of linaclotide

A

guanylate cyclase C agonist that ↑ chloride and bicarb secretion into the lumen of the intestine → increasing speed of transit and reduced pain

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33
Q

MOA of PAMORAs

A

Act on mu-opiod receptors in GI tract decreasing constipation

34
Q

Indication for lubiprostone

A

CIC, IBS-C, OIC

35
Q

Indication for linaclotide

A

CIC, IBS-C

36
Q

Indication for alvimopan

A

Surgery to ↓ risk of post-op ileus

37
Q

Lubiprostone

38
Q

Linaclotide

39
Q

Alvimopan

40
Q

Methylnatrexone

41
Q

Naloxegol

42
Q

ADR of Amitiza

A

Nausea
Methadone decreases effect

43
Q

ADR of Linzess

44
Q

What is the max dose od ALvimopan

45
Q

CI of Entereg

A

Potent risk of MI with long term use

Therapeutic dose of opioid for >7 days

46
Q

Drugs for OIC

A

Methylnatrexone
Naloxegol
Naldemedine

47
Q

What is Prucalopride

A

Indicated for CIC

Serotonin 5-HT4 Receptor agonist

48
Q

ADR of prucalopride

A

Suicidal ideations, diarrhea

49
Q

Common indication for bowel prep

A

Colonoscopy

50
Q

Bowel irrigation products

A

PEG solution
Sodium phosphates
Sodium sulfate, potassium sulfate, and mag sulfate

51
Q

PEG solution

A

GoLytely, Colyte

52
Q

Sodium phosphates

53
Q

Contents of Supper Bowel Prep Kit

A

Sodium sulfate, potassium sulfate, and magnesium sulfate

54
Q

BBW of bowel preps

A

Osmoprep: nephropathy

55
Q

CI of OsmoPrep

A

Acute phosphate nephropathy, gastric bypass o stapling surgery

56
Q

Counseling on bowel prep

A
  1. Start the evening before colonoscopy and the morning of
  2. Clear liquid diet must be started the day prior
  3. Do not consume solid or semi-solids with red or blue/purple food coloring
57
Q

Non pharm for diarrhea

A

Fluid and electrolyte replacement
ORS

58
Q

ORS products

A

Pedialyte
Gatorade
Enfamil Enfalyte

59
Q

Short term diarrheals

A

Bismuth subsalicylate
Loperamide

60
Q

Antimotility drugs

A

Loperamide
Diphenoxylate

61
Q

Bismuth subsylate

A

Pep Bismol

62
Q

Loperamide

A

Imodium AD

63
Q

Diphenoxylate/atropine

64
Q

Schedule of Lomotil

65
Q

CI of pesto bismol

A

Salicycylate allergy, GI ulcer and bleed

66
Q

Warning and ADR of Pepto

A

Avoid in children recovering from flu, chicken pox, or viral infection due to Reyes syndrome

ADR: black tongue and stool, salicylate toxicity, nausea

67
Q

Signs of salicylate toxicity

68
Q

Dosing of loperamide

A

4 mg PO after the first loose stool, then 2 mg after each subsequent loose stool

Max OTC: 8 mg/day
Max Rx: 16 mg/day

69
Q

BBW of loperamide

A

Cardiac arrest and sudden death with doses higher than recommended: don’t exceed

Avoid in <2YO

70
Q

CI of Imodium

A

Acute dysentry
Pseudomembranous colitis
Bacterial enterocolitis

71
Q

ADR of Imodium

A

Constipation

72
Q

Counseling of Imodium

A

Limited in blister packs due to caution with overdose

Don’t use >48 hrs

73
Q

CI of Lomotil

A

Risk of respiratory and CNS depression in children (avoid <2YO or <6Yo for tabs)

Pseudomembranous colitis

74
Q

Counseling of Lomotil

A

Liquid formulation indicated <13YO

75
Q

The importance of API in Lomotil

A

Diphenoxylate inhibits excessive GI motility and propulsion

Atropine discorages abuse

76
Q

ADR of atropine

A

Anticholinergic: constipation, dry mouth, sedation, tachycardia, flushing, urinary retention, blurred vision

77
Q

When should you discontinue Lomotil

A

Improvement seen in 48 hr

DC at 10 days

78
Q

MOA of Dicyclomine

A

Antispasmodic

79
Q

Dicyclomine

80
Q

Warning and ADR of Bentyl

A

Anticholinergic: caution in >65YO
Toxic megacolon or paralytic ileus

ADR: DZ, dry mouth, nausea, blurred vision

81
Q

What is eluxadoline

A

peripherally-acting mixed mu-opioid agonist

82
Q

CI of eluxadoline

A

Pts without gallbladder, pancreatitis, sphincter of Oddi dysfunction

NAPLEX Prep (14 decks)

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