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GI Test > Diarrhea, Abdominal Pain, and Constipation Pharm > Flashcards

Diarrhea, Abdominal Pain, and Constipation Pharm Flashcards

1
Q

What is loperamide?

A
  • Chemically related to opioids but does not exhibit analgesic/opiate like effects or appear to produce physical dependence
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2
Q

What is the MOA of loperamide?

A
  • Interferes with peristalsis
  • Direct action on circular and longitudinal muscles of intestinal wall, slowing motility
  • Slowed motility allows for fluid/electrolyte reabsorption and increasing bulk/density of feces
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3
Q

What is diphenoxylate?

A
  • Synthetic opiate agonist
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4
Q

What is added to diphenoxylate? Why?

A
  • Small quantity of atropine to discourage abuse/over doseage
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5
Q

What is the MOA of diphenoxylate?

A
  • Believed to exert effect locally and centrally on GI smooth muscle cell
  • Inhibits GI motility and slows excess GI propulsion
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6
Q

What is the MOA of eluxadoline?

A
  • Agonist at opioid mu and kappa receptors in GI

- Antagonist at delta opioid receptor in GI (stomach, pancreas, biliary secretions decreased)

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7
Q

What is the indication for eluxadoline?

A
  • IBS-D
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8
Q

What is the MOA of alosetron?

A
  • Selectively blocks GI based 5-HT receptors

- Antagonism modulates regulation of visceral pain, colonic transit, and GI secretions

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9
Q

What is the indication of alosetron?

A
  • Chronic, severe IBS-D not responsive to other conventional therapies (women)
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10
Q

What is crofelemer?

A
  • Derived from dark red sap of Croton lechleri tree
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11
Q

What is the MOA of crofelemer?

A
  • Inhibits chloride ion secretion by blocking cAMP-stimulated CFTR and calcium activated chloride channels
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12
Q

What is the indication for crofelemer?

A
  • Non-infectious diarrhea in HIV/AIDS
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13
Q

What are the two antimuscarinics used for abdominal pain?

A
  • Hyoscyamine

- Dicyclomine

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14
Q

What is the MOA of antimuscarinics?

A
  • Competitively inhibit autonomic, postganglionic cholinergic receptors
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15
Q

What is the indication of antimuscarinics?

A
  • Abdominal pain/spasms
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16
Q

What is the MOA for methylnaltrexone, naloxegol, and alvimopan?

A
  • Peripheral mu-opioid receptor antagonists
17
Q

What are the indications for methylnaltrexone, naloxegol, and alvimopan?

A
  • Opioid induced constipation
  • Alvimopan- only for accelerating time to GI recovery following bowel resection surgery with primary anastomosis (prevention of postoperative ileus)
18
Q

What is the MOA of linaclotide?

A
  • Selective guanylate cyclase agonist
19
Q

What are the indications of linaclotide?

A
  • IBS-C

- Chronic idiopathic constipation

20
Q

What is the MOA of lubiprostone?

A
  • PGE-1 derivative
  • Increases intestinal fluid secretion by activating GI specific chloride channels in luminal cells of intestinal epithelium
21
Q

What are the indications of lubiprostone?

A
  • IBS-C (women)
  • CIC
  • OIC
22
Q

How do bulk forming/hydrophilic colloidal agents work?

A
  • Work to increase bulk-volumes and water content, thereby increasing GI motility
  • Fiber can also support colonic bacteria, fermentation, and digestion
23
Q

What is the efficacy of bulk forming agents?

A
  • 2-4 days
24
Q

What are stool softeners?

A
  • Surfactant or emollient laxatives
  • Docusate salts
  • Mineral oil
25
Q

What is the MOA of stool softeners?

A
  • Anionic surfactants –> softens and lubricates feces
  • Increases fluid secretion into GI tract
  • Decreases fluid reabsorption from GI tract
26
Q

What is the efficacy of stool softeners?

A
  • 1-3 days

- Minimal laxative effect, softening mainly

27
Q

What are some stimulants?

A
  • Senna
  • BIsacodyl
  • Castor oil
  • Glycerin
  • Sodium picosulfate
28
Q

What is the MOA of stimulants?

A
  • Irritant to enterocytes, GI smooth muscle leading to inflammation
  • Promotes water/electrolyte accumulation in GI
29
Q

How is glycerin different?

A
  • Is a tri-hydroxyl alcohol and functions as an irritant, an osmotic, and lubricant agent
30
Q

What is the efficacy of stimulants?

A
  • Usually seen in 12-36 hours
31
Q

What are some saline agents used as laxitives?

A
  • Magnesium salts

- Sodium phosphate

32
Q

What is the MOA of saline agents?

A
  • Magnesium/phosphate ions poorly absorbed
  • Hyperosmolar solutions
  • Osmotically retain water in GI tract
33
Q

What are some osmotic agents used as laxitives?

A
  • Lactulose
  • Magnesium citrate
  • Sorbitol
  • Polyethylene glycol
34
Q

What is the MOA of osmotic agents?

A
  • Osmotically attract and retain increased water in colon increasing moisture, softness, and volume/bulk
35
Q

What is the efficacy of osmotic agents?

A
  • 1-2 days
36
Q

What is lactulose given for?

A
  • Severe liver disease patients (hyperammonemia)

GI Test (10 decks)

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