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GI Pharm > Constipation, Diarrhea, Nausea/Vomiting > Flashcards

Constipation, Diarrhea, Nausea/Vomiting Flashcards

1
Q

methyl cellulose / psyllium MOA

A

dietary fiber and bulk forming laxative - hydrophilic muciloid that forms gelatinous mass when mixed with water

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2
Q

methyl cellulose / psyllium AE

A

allergic reactions, flatulence, borborygmi, intestinal obstruction

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3
Q

DDI of metamucil

A

inhibit coumarin absorption

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4
Q

DDI of citrucel (cellulose)

A

bind & impede drug absorption

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5
Q

uses for dietary fibers

A

both for constipation as a stool former and to treat IBS diarrhea by forming bulkier stool

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6
Q

AE for laxatives

A
  1. abuse

2. lag time leads to overdose and the following shit storm

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7
Q

lactulose MOA

A

not absorbed and produces osmotic laxative effect, fecal acidifier and TRAPS ammonia in ammonium form for excretion

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8
Q

stimulant laxatives (3)

A

bisacodyl (dulcolax)
senna
cascara sagrade extract

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9
Q

MOA of stimulant laxatives

A

mostly on LARGE bowel

  1. increase permeability of mucosa
  2. increas back diffusion of H20 & electrolytes
  3. propulsive contractility of colon
  4. stimulate prostaglandin synthesis
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10
Q

AE for bisacodyl (dulcolax)

A

excessive fluid loss, electrolyte loss, intestinal enterocyte damage

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11
Q

PK for bisacodyl (dulcolax)

A

prodrug - bacteria activated, is administered in enteric coated tab

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12
Q

AE for senna

A

abdominal pain, nephritis, melanotic pigmentation of colonic mucosa, abnormal urine coloration

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13
Q

PK for senna

A

natural derivative of senna/cascara - more gentle than the synthetics

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14
Q

castor oil MOA

A

rapid-acting and effective anionic surfactant - produces catharsis

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15
Q

castor oil AE

A

colic, dehydration, electrolyte imbalance - can induce uterine contraction in pregnancy

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16
Q

2 surfactant laxatives

A

castor oil & docusate sodium (colace)

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17
Q

docusate sodium (colace) MOA

A

anionic surfactant, weakly active, primarily used as stool softener, no effect on intestinal peristalsis

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18
Q

AE for docusate sodium (colace)

A

irritate mucosa and increase other drug absorption

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19
Q

CI for docusate sodium (colace)

A

not for use during abdominal pain, n/v

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20
Q

long term or short term use for docusate sodium (colace)

A

short term

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21
Q

lubiprostone MOA

A

activates intestinal Cl channels in a protein kinase-A independent fashion - increases intestinal fluid secretion & motility & alleviates symptoms of idiopathic constipation

22
Q

Tegaserod MOA

A

activation of 5-HT4 recetpors in GI tract - effective motility stimulant (also 5-HT2b antagonist)

23
Q

Tegaserod AE

A

5-HT2b antagonist activity has shown CV adverse effects

24
Q

opiate (1)

A

loperamide

25
Q

loperamide effects

A
  1. dec salivary, gastric, intestinal secretions
  2. dec motility of stomach & intestines
  3. inc muscle tone but dec cramps
  4. inc tone of sphincters
  5. inc contact time and reabsorption
26
Q

loperamide MOA

A

interacts with intestinal opioid receptors and binds to and inhibits calcium binding protein calmodulin

27
Q

anticholinergic for motion sickness

A

scopolamine

28
Q

MOA of scopolamine

A

blocks activation of muscarinic receptors and dec cochlear sensation of motion

29
Q

AE of scopolamine

A

sedation, extrapyramidal (drowsiness, dry mouth)

30
Q

scopolamine PK

A

patch placed behind ear before trip

31
Q

use for scopolamine

A

MS prophylaxis

32
Q

H1 antihistamines - antiemetics

A

cyclizine, meclizine, chlorpheniramine

33
Q

which are piperazine derivative H1 antihistamines

A

cyclizine and meclizine

34
Q

pharm effects of cyclizine and meclizine

A

significant anti-cholinergic effects

35
Q

AE for H1 antihistamines

A

sedation, anticholinergic

36
Q

which H1 antihistamine has the least sedative & GI AE

A

chlorpheniramine

37
Q

clinical use for cyclizine

A

OTC to counter MS

38
Q

clinical use for meclizine

A

vertigo and menier’s disease

39
Q

antidopaminergics (3) - antiemetics

A

chlorpromazine, droperidol, metoclopramide

40
Q

chlorpromazine MOA

A

blocks DA receptors in CTZ and centrally acting anticholinergic

41
Q

clinical utility for chlorpromazine

A

n/v, intractable hiccough

42
Q

droperidol MOA

A

blocks DA receptors in CTZ

43
Q

droperidol clinical utility

A

poor antipsychotic but highly useful antiemetic

44
Q

metoclopramide MOA

A

DA receptor antagonist that blocks chemotherapeutic induced activation of D2 receptors in CTZ - also stimulates gastric emptying

45
Q

metoclopramide clinical utility

A

prophylaxis prior to cancer chemo & prevention of post-op n/v

46
Q

serotonin antagonists

A

granisetron, dolasetron

47
Q

MOA of serotonin antagonists

A

5-HT antagonist blocks receptors in stomach/SI

  1. block signal to CTZ and to VC
  2. block 5-HT3 receptor in CTZ
48
Q

which serotonin antagonist has longest half life

A

dolasetron

49
Q

clinical utility for methylprednisolone

A

anti-emetic effect through prevention of prostaglandins - given with aforementioned entiemetics to increase their potency and reduce side effect profile

50
Q

aprepitant MOA

A

substance P/neurokinin 1 (NK1) antagonist - crosses BBB and inhibits central emesis

51
Q

PK of aprepitant

A

half life 9-13 hours, given orally

metabolism by CYP3A4

52
Q

lorazepam utility

A

effective for anticipatory vomiting because causes somnolence and amnesia

GI Pharm (6 decks)

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