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RESP & GIT Pharmacology > Diarrhea And Constipation > Flashcards

Diarrhea And Constipation Flashcards

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1
Q

Drugs altering motility

A

Anti-spasmodics - decrease smooth muscle tone
Laxatives - accelerate passage
Anti-diarrhoeal drugs - decrease motiity
Pro-kinetics - increase motility of smooth muscle

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2
Q

Dicyclomine

A

Antimuscarinic

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3
Q

Hyoscine butyl-bromide

A

Anti-muscarinic

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4
Q

Mebeverine

A

Anti-muscarinic

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5
Q

Propantheline

A

Anti-muscarinic

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6
Q

Falvoxate

A

Antimuscarinic

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7
Q

Clidinium bromide

A

Anti-muscarinic

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8
Q

Anti-muscarinics indications

A

Used as anti-spasmodics

  • intestinal
  • biliary
  • genitourinary
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9
Q

Diarrhea mechanisms

A
  1. Increased osmotic load - water retention in lumen
  2. Excessive secretion of electrolytes
  3. Exudation of protein and fluid from mucosa
  4. Altered motility - rapid transit and decreased fluid absorption (inflammatory/infectious)
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10
Q

Diarrhea Mx

A
  1. Prevent dehydration
  2. Anti-infective - curative
  3. Spasmolytic or other antidiarrhoeal (symptomatic)
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11
Q

Loperamide

A

Anti-motility agent

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12
Q

Diphenoxylate

A

Antimotility agent

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13
Q

Codeine

A

Anti-motility agent

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14
Q

Anti-motility agents

A

-opioid derivatives - inhibits Ach release - decreased peristalsis and increased sphincter tone

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15
Q

Anti-motility agent indications

A

Traveller’s diarrhea

Adjunct in chronic diarrheal disease

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16
Q

Anti motility agent SE

A
  • minimal
  • some BBB crossing
  • low incidence of addiction

Avoid in suspected inflammatory diarrhea

  • prolonged fever with shigella
  • toxic megacolon in pts w. C. difficile (>6cm dilation of transverse colon)
17
Q

Bismuth subsalicylate

A
  • decreases fluid secretion

- travellers diarrhoea, episodic diarrhea, acute gastroenteritis, H. Pylori eradication

18
Q

Adsorbents

A
  • adsorbs intestinal toxins and microorganisms
  • coats intestinal mucosa
  • interferes with abrorbtion of other drugs
19
Q

Cholestiramine

A

Adsorbent - Bile acid sequestrant

20
Q

Kaolin and Pectin

A

Adsorbent

21
Q

Methylcellulose

A

Adsorbent (fermented fibre)

22
Q

Aluminium hydroxide

A

Adsorbent

23
Q

Probiotics indications

A
  • acute diarrhea
  • antibiotic associated diarrhea
  • infectious diarrhea
24
Q

Dietary fibre

A

Laxative - bulk forming
Unfermented fibre attracts H2O and increases stool bulk - distends intestine increasing peristalsis
(fermented fibre attracts stool water - used in diarrhea)

  • hydrophilic colloids
  • indigestible parts of fruit and veg
  • psyllium seeds, bran, ispaghula
25
Q

Osmotic active agents

A

Saline laxatives: magnesium citrate - non-absorbable salts

Electrolyte solution laxatives
-polyehtylene glycol

Nondigestible sugars & alcohols

  • lactulose - semi-synthetic sugar cannot be hydrolized by intestinal enzymes
  • increases osmotic pressure, increase fluid, increase lumen pressure, stimulate evacuation
26
Q

Docusate sodium/calcium/potassium

A

Laxative - stool wetting agent

  • lowers surface tension of stools - allow mixing
  • may take days
27
Q

Mineral oil

A

Indigestible

-causes anal leakage and lipid pneumonitis NB

28
Q

Senna

A

Stimulant laxative

-induce limited low grade inflammation

29
Q

Bisacodyl

A

Stimulant laxative

-induce limited low grade inflammation

30
Q

Castor oil

A
  • irritant laxative

- stimulates uterine contractions in pregnant

31
Q

Pro-kinetic agents

A
  • increase intensity of contractions in small intestine without rhythm disruption
  • good in diabetics with gastroparesis
32
Q

Dopamine receptor antagonists

A

Suppress Ach release
-inhibits motility, reduces LOS tone, reduce intragastric pressure

  • metoclopramide
  • domperidone
33
Q

Cisapride

A

5HT4 agonist - prokinetic agent

-ventricular arrhythmia

34
Q

Macrolide

A

Pro-kinetic agent

Only used in diabetics with gastroparesis

RESP & GIT Pharmacology (4 decks)

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