Elimination Flashcards

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1
Q

What is the main function of the small intestines? Large intestine?

A

SI: Absorption of nutrients
LI: Reabsorption of water

- Vit B + K synthesis

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2
Q

Describe the positive feedback of HCl.

A

Gastrin secreted by G-cells….

> > Production of HCl acid (by parietal cells)&raquo_space; Proton pump releases HCl (mediated by H, K, ATPase)

> > Histamine&raquo_space; binds to H2 receptors (stim. by parietal cells)&raquo_space; Increases HCl production

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3
Q

Foveolar or Goblet cells secrete ______.

A

Mucous, HCO3

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4
Q

Anatacid

A

Neutralizes existing avid by increasing stomach pH without decreasing HCl production.

  • Sx relief only
  • Unscheduled

**2 hours post/pre other PO meds

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5
Q

What 2 drug classes does Magnesium hydroxide (Milk of Magnesia) belong to?

A
  1. Antacid
    S/e: diarrhea
  2. Saline/Osmotic laxative
    - Best for pre-procedure
    - 1-3 hours (fast onset)
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6
Q

Bismuth Subsalicylate
(Pepto-Bismol)
- 3 drug classes

A
  1. Antacid
  2. Anti-infective
  3. Anti-diarrheal
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7
Q

How do PPIs differ from H2-receptors?

A

PPI has higher efficacy + longer t1/2.

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8
Q

Ranitdine (Zantac)

A

Selectively inhibits H2-receptor to decrease HCl production (H2-receptor blocker)

*Doesn’t cross BBB = no drowsiness

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9
Q

Complications of diarrhea

A
  • Electrolyte imbalance
  • Dehydration
  • Malabsorption
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10
Q

Opioids

  • S/e
  • Contraindications?
A

Antidiarrheal

S/e: CNS depression
Contraindication: pregnancy, drug abuse

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11
Q

Lomotil (dyphenosylate)

A

Atropine (Antidiarrheal)

Low dose: OTC
High dose: Rx

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12
Q

Imodium (Loperamide HCl)

- Meperidine + atropine

A

Atropine (Antidiarrheal)

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13
Q

Metamucil

A

Bulk forming laxative

  • Must take w/ water
  • Onset: 1-2 days
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14
Q

Lactulose

A

Saline + Osmotic laxative

  • Best for pre-procedure
  • Fast onset: 1-3 hrs
  • Contraindication: lactose intolerance
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15
Q

GoLytely

A

Saline + Osmotic laxative

  • Best for pre-procedure
  • Fast onset: 1-3 hrs
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16
Q

Ducolax; Senna; Castor oil

A

Stimulant laxative
**Not first choice for constipation + pre-surgery

S/e: N+V, cramping

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17
Q

Colace (Docusate sodium)

When is it mainly used?

A

Softener (laxative)

  • *Mainly used for post-MI + surgery
  • Decreases straining
18
Q

Mineral oil; Glycerine

A

Laxatives

  • Lubrication
  • Supplementary tx
19
Q

Cathartics Enema

A

A pre-procedural bowel preparation that expands the bowel for fast evacuation

  • Have pt lie on their LS
20
Q

Gasex

A

Tx: bloating

21
Q
Gravol (dimenhydrinate + cholortheophyline) 
Ginger gravol (OD s/e??)
A

H1 antagonist

Ginger gravol OD:

  • Bleeding
  • CNS depression
22
Q

Tx for motion/morning sickness; Nausea

A

Reduces vestibular excitation.

  1. H1 antagonists
  2. Antimuscarinic anticolinergics
23
Q

Tx for drug-induced pain; Chemo/visceral pain

A

5HT3 (serotonin) antagonists

24
Q

Tx for GI pain

A

Phenothiazines (D2-receptor antagonism) - stimulates GI motility

25
Q

Tx for Chemo/Chronic disease

A

Cannabinoids (CB 1, CB 2 agonism) - binds to receptor that stimulates GABA

26
Q

Dramamine (Meclizine)

A

H1 antagonist

27
Q

Diclectin (doxylamine + pyridoxine hydrochloride)

A

H1 antagonist

**For pregnant women

28
Q

Scopolamine (Hyoscine)

A

Antimuscarinic anticholinergic

  • Has some affinity to H1-receptors
29
Q

Ondansetron (Zofran)

- What is its drug schedule?

A

5HT3 antagonism

- Rx only!

30
Q

Metoclopramide
(Maxeran, Reglan)

  • s/e?
  • Drug schedule?
A

Phenothiazines (D2-receptor antagonism)

s/e: sedation
- Rx only

31
Q

Prochlorperzine (Stemetil)

  • s/e?
  • Drug schedule?
A

Phenothiazines (D2-receptor antagonism)

s/e: sedation
- Rx only

32
Q

Dronabinol (Marinol); Cesamet/Nabilone;

Cannabis

A

Cannaboids

33
Q

Traveler’s Diarrhea

  • Tx and PK?
A

Diarrheal condition usually caused by bacteria.

Tx: Ciprofloxacin

  • 70% bioavailability
  • Directly binds to bacteria in GI
  • t1/2 = 4 hours
34
Q

C. difficle

  • Type of infection?
  • Clinical presentations?
  • Tx?
A

Destroys intestinal lining by releasing Toxin A (enterotoxin) and Toxin B (cytotoxin).

  • HAI (esp. in elderly)

Presentations:

  • *Bloody diarrhea w/ pus
  • Fever
  • Ab. pain

Tx:
1st line: FLAGYL (Metronidazole)
2nd line: VANCOMYCIN

35
Q

Tenesmus

A

The feeling of incomplete defecation

36
Q

Dysentery

A

Bloody diarrhea

37
Q

IBS

  • Triggers?
A

Inflammatory Bowel Syndrome - CNS dysregulation of normal motility

Triggers: stress, menstruation, diet, food intolerances

S+S:
- Ab pain, discomfort, cramping, bloating, diarrhea/constipation

38
Q

Fecal impaction

A

A procedure that removes a mass of stool.

If not removed , can cause partial/complete bowel obstruction

39
Q

Hirschsprung Disease

A

Congenital disease that causes issues w/ peristalsis in GI.

  • D/t parasympathetic ganglion n. cells (responsible for bowel mvt) in the wall of colon not developing before birth
40
Q

Paralytic ileus

A

“Pseudo-obstruction” - Impaired bowel motor activity w/o physical obstruction.

  • Often d/t surgery
41
Q

What are factors that affect constipation?

A
  1. Diet

2. Perstalsis