Final Exam - Diarrhea + Constipation Flashcards
___ liters of fluid enters proximal small intestine every day
9
if small intestine water absorptive capacity is exceeded, _____ overloads the colon, resulting in diarrhea
chyme
acute diarrhea is usually caused by ?
infection
what is the most common foodborne cause of diarrhea and vomiting?
norovirus
______ diarrhea is characterized by a change in active ion transport
a. exudative
b. secretory
c. osmotic
d. altered intestinal transit
b. secretory
_____ diarrhea is caused when poorly absorbed substances are retained in intestinal fluids, and results in influx of water and electrolytes into the lumen
a. exudative
b. secretory
c. osmotic
d. altered intestinal transit
c. osmotic
most common bacteria in the US
salmonella
what is tenesmus?
straining and painful stooling
what does the BRAT diet stand for?
bananas
rice
applesauce
toast
_____ _____ may be considered for any traveler to prevent traveler’s diarrhea
bismuth subsalicylate
when antibiotic prophylaxis is indicated, _____ is recommended for traveler’s diarrhea prevention
rifaximin
true or false: antibiotics are recommended for mild traveler’s diarrhea treatment?
false
(not recommended; loperamide or bismuth subsalicylate)
antimotility drugs mech of action
activate the mu opioid receptors in bowel to reduce peristalsis and inc segmentation
what is the purpose of atropine in Lomotil (diphenoxylate/atropine)?
the side effects of atropine are a deterrent for abusing it
true or false: loperamide has CV risks
true
psyllium, polycarbophil, attapulgite, and kaloin-pectin mixture are examples of
a. antimotility agents
b. absorbents
c. antisecretory agents
b. absorbents
absorbents mech of action
adsorb nutrients, toxins, drugs and digestive juices
what is the GI transit time from mouth to anus?
36 hours
(30-40 is the range)
acute constipation is less than ____ bowel movements/week
a. 2
b. 3
c. 5
d. 7
b. 3
chronic constipation requires symptoms lasting > ____ weeks
6
true or false: diabetes, Parkinson’s, CNS injury, and MS can slow down GI motility
true
bulk laxatives mech of action
forms emollient gels which retain water, swells, and stimulates bowel movement
true or false: Citrucel should be mixed with hot water
false
(cold water)
docusate mech of action
decreases fecal surface tension; stool softener
(does nothing for peristalsis)
mineral oil mech of action
lubricates lumen of colon
mech of action of saline laxatives (milk of magnesia, Mg citrate)
draws fluid into colon which stimulates motility
hyperosmotic agents are excellent for ____ constipation
a. acute
b. chronic
b. chronic
true or false: fluoroquinolones are recommended for prophylaxis of traveler’s diarrhea
false
(not recommended)
antibiotic treatment should be used in ____ traveler’s diarrhea
a. mild
b. moderate
c. severe
c. severe
antibiotic treatment is not recommended in ____ traveler’s diarrhea
a. mild
b. moderate
c. severe
a. mild
MOA of stimulant laxatives
Locally stimulates enteric nerves which stimulates contractions and mobility; also increases fluid and Na
secretion into the lumen
glycerin suppositories
a. hyperosmotic agent
b. stimulant laxative
a. hyperosmotic agent
bisacodyl suppositories
a. hyperosmotic agent
b. stimulant laxative
b. stimulant laxative
lubiprostone is a _____ channel activator
chloride
lubiprostone (Amitiza) is indicated for what two conditions?
CIC (chronic idopathic constipation in adults)
IBS-C
linaclotide (Linzess) and plecanatide (Trulance) MOA
guanylate cyclase-C receptor activator
metoclopramide and prucalopride are ______ agents
prokinetics
patients on opioids should avoid which laxatives?
bulk laxatives
methylnaltrexone (Relistor) and naloxegol (Movantik) MOA
mu opioid receptor antagonist
when to take naloxegol (Movantik)
1 hr prior to 1st meal or 2 hours after meal
