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Pharm 154 > Diarr/IBS/Const > Flashcards

Diarr/IBS/Const Flashcards

1
Q

What is lubiprostone used for?

A

IBS-C more so. helps with opioid induced constipation

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2
Q

When does food poisoning usually start?

A

May start within hours, or begin days or weeks after, Has a broad range of effect

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3
Q

What is the only thing recommended for child VGE?

A

Fluids

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4
Q

What is critical for children treatment of TD?

A

Fluids

Imodium is MD only

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5
Q

How much PEG 3350 should a child be given?

A

1/2 capful, but its not for kids unless MD

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6
Q

What are the symptoms of IBS?

A

Pain/Spasms
Bloating
urgency
Constipation and diarrhea
Mucous in stool

> 6 months

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7
Q

For mild cases of Drug-induced diarrhea what can we use?

A

Imodium and Culturelle (Only if AB)

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8
Q

What is important with taking psylium

A

Take it with atleast a cup of water and

if you have diabetes watch for the flavoured agent

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9
Q

What is psyllium recommended for?

A

IBS-C

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10
Q

What are the stimulants Senokat dosing?

A

Extra strength= 1-2 tabs OD BID at night

Normal Strength = 2-4 tabs OD-BID at night

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11
Q

How much senna does one usually start with?

A

8mg then titrate up

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12
Q

Why is mineral oil not really indicated for constipation?

A

Can cause anal seepage

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13
Q

What is the treatment strategies for TD that has occured?

A

RX Ab usage if it reaches moderate

Loperamide alone

Pepto

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14
Q

How long does Phillips take to work?

A

Overnight
Saline constipation

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15
Q

What is docusate/Colace?

A

not entirely effective agent that takes 1-2 days to work

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16
Q

What are prevention strategies for travellers diarrhea?

A

RX antibiotics (onset)

Peptobismol

Dukoral vaccine

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17
Q

What is the Pepto dosing for prophylaxis?

A

2 tabs QID for 3 weeks max

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18
Q

What other things should be kept in mind when thinking of constipation?

A

Medication
Diabetes
Colon cancer
IBS
Depression

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19
Q

Most fermentable fibers are?

A

soluble

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20
Q

What should we watch for in pediatric diarrhea?

A

Watch for dehydration

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21
Q

Should we increase water in constipation?

A

no we get lots of water in food

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22
Q

What are common causes of child constipation?

A

Too busy to poop
Dietary issues
Toilet training issues

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23
Q

Common cause of diarrhea in pediatrics?

A

Viral gastroenteritis

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24
Q

What does loperamide do?

A

decrease diarrhea not much jelp with pain though

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25
Q

When does psylium become effective?

A

12-72 hours post taking it

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26
Q

How fast does Fleet work? (Enema)

A

2-5 minutes

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27
Q

How often does a formula fed babies have a BM?

A

2 a day

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28
Q

For cases of kids Diarrhea what can we use?

A

Imodium is off label, but Culturelle is only an option for AB-induced

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29
Q

What will fiber do?

A

Helps with BM habits

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30
Q

What is lubiprostone capsules used for?

A

IBS-C
Also Opioid medications

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31
Q

How can we prevent constipation in elderly?

A

Bulk forming agents, docusate, peg 3350

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32
Q

What are the TCAs that may help?

A

amitriptyline or desipramine at low doses

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33
Q

When should someone get help for constipation in terms of time?

A

Constipation lingers for 3 weeks or changes in bowel habit of more than 2 weeks

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34
Q

How can we stimulate paediatric BM?

A

MD
Rectal stimulation with Qtip and vaseline
Glycerin suppository

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35
Q

What is inulin/Prebiotic

A

It is a non thickening agent that can be added to food or fluid, similar to psylium

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36
Q

How long does mineral oil take to work?

A

6-8 hours, taken very enema works very quick though

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37
Q

What is Bismuth subsalicylate (BSS)

A

Not routinely recommended as they have different side effects

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38
Q

What if TD AB did not work?

A

Switch to pepto 1/2 QH dosing or loperamide

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39
Q

What is the onset of senna combo with docusate

A

Senna 6-8 hours, Docusate = 3 days

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40
Q

What are side effects of bisacodyl and senna?

A

minimally absorbed, but can lead to diarrhea, Stimulants

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41
Q

What does Saline do?

A

Draws water into the gut

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42
Q

What is the causes of constipation?

A

Disease states
Drug causes
Immobility
Fluids

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43
Q

What is very common treatment for pregnancy?

A

Docusate
Peg 3350
Psyllium

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44
Q

Is breastmilk a clear fluid?

A

yes

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45
Q

What is constella?

A

Moderate to severe treatment of IBS-C

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46
Q

What does the symptomatic treatment of diarrhea consist of?

A

Rehydration and proper diet

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47
Q

How does psylium induced obstruction occur?

A

by not taking the product with enough water

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48
Q

What does polycarbophil do?

A

It is a preventative agent for constipation that works in 12-72 hours

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49
Q

What food is a bulk-forming agent non food?

A

Soluble fibre

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50
Q

What is a key factor to consider with constipation

A

Is when someone has a significant decrease in frequency of bowel movements

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51
Q

What is the dosing of Peg 3350?

A

Capful (17g) then titrate every 2-3 days until mushy stool consistency

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52
Q

What do sufferers of IBS tend to over-react with?

A

Fructose, gluten

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53
Q

How do you take Senna when on T-3?

A

T3 late in day 8mg first night
T3 in AM 16mg first night

54
Q

What if TD and Pepto was not working?

A

Switch to antibiotic and loperamide

55
Q

What are red flags of constipation?

A

Stool texture change, blood, hemorhoids, weight loss, pain, narrower stools

56
Q

What is the normal BM activity?

A

wide range 2x per week to 3x per day

57
Q

What is the most common virus of gastroenteritis in children?

A

Rotaviruses

58
Q

What is psyllium used for?

A

IBS-C

59
Q

If dehydration is of concern what should we recommend?

A

Gastrolyte or pedialute

60
Q

Onset of senokat?

A

6-12 hours

61
Q

What does pepto help with?

A

Disagreeable foods

62
Q

What is the most common symptom of IBS?

A

Abdominal pain, less severe after a bowel movement

63
Q

What does a bowel obstruction usually lead to?

A

Constipation with very dramatic progression in symptoms

64
Q

What is psyllium?

A

Metamucil

65
Q

What is loperamide used for?

A

IBS-d

66
Q

What are Bentylol and Buscopan

A

Not first line agents of IBS, due to higher S/E profile

67
Q

What are the smooth muscle relaxants

A

Pinaverium
Trimebutine

68
Q

How common is a food allergy?

A

Less then 10% incidence decreases with age due to protein

69
Q

How long does lactulose syrup take to take effect?

A

1-2 days

70
Q

When do we refer for diarrhea?

A

<6 months
1/2 to 1 year = 1 day
1 to 3 2 days
>3 3 days

*Quicker if other symptoms like fever, blood or vomiting is occurent

71
Q

Which AB is good for the treatment of Travelers Diarrhea?

A

Rifaximin

72
Q

What is Culturelle Probiotics?

A

May help with AB associated diarrhea, but it has not ben shown/proven

73
Q

How is the Rotavirus vaccine given?

A

By mouth not by needle

74
Q

What in pinaverium

A

CC antagonists in the smooth intestine, used for both C/D

75
Q

What dose of magnesium is required for a laxative effect?

A

~250mg

76
Q

What is a normal BM for infants

A

1bm per each feed to 1 per week

77
Q

What often co-exists with IBS?

A

Anxiety or depression

78
Q

Is constipation a normal part of aging?

A

NO!

79
Q

What is the youngest age that we can recommend an enema?

A

2 yo

80
Q

What is not necessarily first line for pregnancy due to CI

A

MOM, Senna, Bisacodyl

81
Q

What is trimebutine?

A

Opiate receptor agonist 5HT3 antagonist

82
Q

What is Ibrela used for?

A

IBS-C

83
Q

What is the dose of psyllium (Metamucil)?

A

2-4 tablespoons daily with fluids

84
Q

What is the main decision made with antibiotic useage with TD?

A

Add loperamide to counteract the S/E of Diarrhea

85
Q

What is Kaopectate?

A

anti-diarrheal agents, safe but likely ineffective

86
Q

What is Stool softener?

A

added to other laxatives and preventative measures

87
Q

What is peppermint Oil for?

A

Broadly used for both IBS-C and IBS-D

88
Q

What is loperamide?

A

Imodium

89
Q

What is the pepto dosing for treatment?

A

2 tabs Q 1/2 hours up to 8 doses

90
Q

Is pepto-bismol used for drug-induced diarrhea?

A

No, since it is not indicated

91
Q

What is Senna?

A

It provides relief of acute constipation with 6-12 hours

92
Q

What are the BMs of IBS-C on bristol stool chart

A

1-2

93
Q

What are the smooth muscle relaxants used for?

A

IBS-D or IBS-C

94
Q

How long does stimulants take to work?

A

6-12 hours

95
Q

What is the dosage of Dulcolax?

A

Suppository, Once a day
Oral = 1-2 tabs daily

96
Q

Why should loperamide be avoided in severe diarrhea?

A

Since our body might be wanting to empty pathogens

97
Q

What are glycerin suppositories especially good in?

A

infants and young children because it causes a bowel evac within 30 minutes

98
Q

What are dietary ways of managing IBS?

A

Fiber
Reducing fatty foods
Avoid offending foods

99
Q

What type of fibre should we add?

A

Soluble and insoluble fibre slowly

5g a day

100
Q

Does miralax help with IBS-C?

A

It improves symptoms of constipation, but it does nothing to help with the spasms associated with IBS

101
Q

What is the common side effects of lactulose syrup?

A

gas/bloating

102
Q

What can food allergies cause?

A

Rash GI symptoms, anaphylaxis

103
Q

Common causes of pediatrics constipation

A

Starting solid food
Low fluids

104
Q

What is a key component of constipation?

A

Straining

105
Q

What are the BMs of IBS-D on bristol stool chart?

A

6-7

106
Q

What is eluxadoline used for?

A

IBS-D Expensive though

107
Q

What are Antidepressants (TCAs) used for?

A

IBS-D and pain

108
Q

What is the three types IBS?

A

IBSC
IBSD
IBS Mixed

109
Q

What is Ovol?

A

This is an anti-flatulent agent, will not work for IBS

110
Q

What are osmotic laxatives use carefully in?

A

Those with chonic renal or congestive heart failure

111
Q

What are stimulants?

A

Phenolphthalein (ExLax)

112
Q

How many BM do breastfed babies have?

A

once every 7-10 days

113
Q

What does peppermint oil do?

A

Can help with spasms, bloating, gas

114
Q

Should Pepto be used in kids?

A

no

115
Q

What usually causes diarrhea from food?

A

Usually something in the food is an irritant or natural laxative

116
Q

What is PEG 3350?

A

Miralax or Restoralax

117
Q

What is the MOA of stimulants?

A

irritant to gut linings

118
Q

What is the rate of microlax enemas

A

5ml dose evacuation in 5-20 minutes

Used in nursing home commonly

119
Q

What is Peg 3350 used?

A

Preventative therapy.

120
Q

How often do people with IBS avoid certain foods?

A

all the time

121
Q

What is Colyte

A

Pre-colonoscopy
drink 240ml every 10 minutes to 4L

BM in 1 hour

122
Q

What age is Imodium CI in?

A

<2, but under 12 is not recommended

123
Q

What is the dosing of loperamide?

A

2-4mg up to QID

124
Q

What is rifaximin used for?

A

IBS-D

125
Q

What can SSRI be used?

A

IBS-C and depression, may help reduce pain

126
Q

Onset of dulcolax (Docusate)

A

Supp = 15-60 minutes
Oral= 6-12 hours

127
Q

What is immodium not good for?

A

Prophylaxis treatment of TD

128
Q

Where is sorbitol located?

A

In prunes/plums and it has an instant laxative effect

129
Q

What are the three options of Drug-Induced diarrhea?

A

Withdrawal
Continue
Adjust dose

130
Q

What is IBgard?

A

Concentrated peppermint oil

131
Q

What could be switched temporarily to help reduce infant diarrhea?

A

Lactose free infant formula

132
Q

What can high doses of imodium do?

A

Withdrawal symptoms of opiates, but ventricular arrhythmias can occur

Pharm 154 (16 decks)

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