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Gastro > Drugs for diarrhea > Flashcards

Drugs for diarrhea Flashcards

1
Q

Types of acute diarrhea drugs (4)

A
  1. opioid agonist
  2. intestinal adsorbents
  3. colloidal bismuth compounds
  4. lyophilizate
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2
Q

opioid agonist examples

A

LOPERAMIDE, diphenoxylate (+ atropine)

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3
Q

opioid agonist MOA

A
  • act in enteric NS (mu + delta receptors) -> increase colonic transit time
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4
Q

opioid agonist adverse effects

A
  • addiction for diphenoxylate

*loperamide does not cross BBB

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5
Q

why is diphenoxylate formulated with atropine

A
  • discourage overdose by causing adverse effects (dry mouth etc)
  • aid in antidiarrheal effect (parasympathetic slows GI motility)
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6
Q

first line for symptomatic control of diarrhea with unknown cause

A

LOPERAMIDE

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7
Q

intestinal adsorbents examples

A

DIOSMECTITE (Mg, Al silicate clay), kaolin (Mg Al silicate clay)

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8
Q

intestinal adsorbents MOA

A
  • absorb bacteria, toxin, fluid -> decrease stool liquidity and number
  • use in acute diarrhea (not chronic)
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9
Q

intestinal adsorbents adverse effects

A
  • constipation
  • can bind to other meds: DO NOT take within 2 HOURS of other medication
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10
Q

colloidal bismuth compounds examples

A

BISMUTH subcitrate, bismuth subsalicylate

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11
Q

bismuth compound MOA

A
  • Bismuth has an antimicrobial effect and binds enterotoxins, which has benefit for treating traveller’s diarrhoea

Specifically bismuth subsalicylate:
Rapid dissociation in stomach allowing absorption of salicylate -> salicylate inhibits intestinal prostaglandin production and chloride secretion -> reduces stool frequency and liquidity in acute infectious diarrhoea

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12
Q

bismuth compound adverse effects

A
  • prolong use cause bismuth toxicity (encephalopath(
  • avoid in RENAL INSUFFICIENCY
  • salicylate toxicity at high doses of bismuth subsalicylate
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13
Q

Lyophilizate of killed
Lactobacillus acidophilus example

A

LACTEOL FORT

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14
Q

lacteol fort MOA

A

– heat-inactivated Lactobacillus acidophilus
– Adheres onto the surface of intestinal cells and normalizes intestinal flora by competitive exclusion
– interfere with the intestinal adherence of other micro- organisms -> over colonization of these organisms is prevented

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15
Q

lacteol fort indication

A

traveler’s diarrhea

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16
Q

lacteol fort adverse effects

A
  • little risk of adverse effects
  • MAINTAIN HYDRATION
  • contraindicated in LACTOSE INTOLERANT
17
Q

drugs for chronic diarrhea (2)

A
  1. bile salt binding resins
  2. somatostatin-like peptides
18
Q

bile salt binding resins example

A

cholestyramine

19
Q

bile salt binding resin MOA

A
  • Bile salts normally absorbed in the terminal ileum
    – Disease of the ileum (e.g., Crohn’s disease) or surgical resection leads to malabsorption of bile salts resulting in colonic secretory diarrhoea (osmotic laxative-like effect of bile salt in colon)
    – Bile salt-binding resins bind to bile salts alleviating diarrhoea caused by excess fecal bile salts
20
Q

cholestyramine indication

A

diarrhea from diseases of ileum (Crohn’s disease) or surgical resection

21
Q

cholestyramine adverse effects

A
  • bloating, flatulence, constipation
  • binds to other drugs, DO NOT give within 2 HOURS of other oral drugs
22
Q

somatostatin-like peptides examples

A

OCTREOTIDE (subcutaneous/ IV)

23
Q

octreotide MOA

A

– Mimics somatostatin hormone released in the GI tract, pancreas and hypothalamus in the brain

physiological effects including:
- Inhibition of release of various transmitters and hormones (e.g., gastrin, VIP, 5-HT)
- Reduces intestinal and pancreatic secretions
- Slows gastrointestinal motility and inhibits gallbladder contraction

24
Q

somatostatin like peptides adverse effects

A
  • impaired pancreatic secretion cause STEATORRHEA -> fat soluble vitamin deficiency
  • nausea, abdo pain
  • GALLSTONES (50% of pts)
  • prolonged treatment cause HYPOTHYROIDISM
  • bradycardia
25
Q

somatostatin like peptides indications

A

secretory diarrhea caused by GI and neuroendocrine tumours (eg carcinoid tumour and vasoactive intestinal peptide-secreting (VIP)
tumour)

26
Q

charcoal uses

A

emergency treatment of certain types of poisoning, binds to enterotoxins & prevent INFECTIOUS DIARRHEA

27
Q

charcoal adverse effects

A
  • nausea/ vomiting
  • aspiration -> cause bronchiolitis, ARDS
  • interfere with absorption of nutrients -> do not use for LONG TERM

Gastro (20 decks)

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