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Pathopharm I > GI > Flashcards

GI Flashcards

1
Q

Constipation

A

Small, infrequent, or difficult BM

Fewer than 3 BMs/week

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2
Q

Constipation causes

A 
Diet (low in fiber)
Lack of exercise
Slowed peristalsis
Pathologic conditions causing constipation
Obstruction or diverticulitis
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3
Q

Impaction

A

Unrelieved constipation may lead to obstruction

Firm, immovable mass of stool obstructing lower GI tract

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4
Q

Impaction symptoms

A 
May have continuous oozing or diarrhea
Loss of appetite
N/V
Abdominal distention
Cramping and pain
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5
Q

Diarrhea

A

Increase in frequency and fluidity of bowel movements

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6
Q

Acute diarrhea causes

A

Infection, emotional stress, some medications

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7
Q

Acute diarrhea

A

Make sure liquid stool around an impaction is not misdiagnosed as acute diarrhea

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8
Q

Chronic diarrhea

A

Lasting more than 4 weeks

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9
Q

Chronic diarrhea causes

A

Chronic GI infection
Alterations in motility or integrity of GI tract
Malabsorption
Endocrine disorders

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10
Q

Episodic diarrhea

A

Food allergy or irritant (i.e. caffeine, enteral feeding)

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11
Q

Osmotic diarrhea

A

Caused by increasing amounts of osmotically active solutes
Typically related to magnesium sulfate or Epsom salt
Ingestion of magnesium sulfate causes sodium/water to enter colon
Common with tube feeding

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12
Q

Osmotic diarrhea

A

Magnesium sulfate

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13
Q

Secretory diarrhea

A

Caused by bacteria or toxin
Toxin can increase reabsorption of water in colon
Bacteria typically involved: Vibrio cholerae & Staphylococcus aureus

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14
Q

Exudative diarrhea

A

Active sites of inflammation in the bowel lumen that results in exudation of mucus, blood, and proteins which pulls water into the colon
Usually related to Cronhs or ulcerative colitis

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15
Q

Motility diarrhea

A

Related to decreased absorption in the small intestine/large amounts of fluid delivered to the colon
Example: dumping syndrome after gastrectomy or IBS

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16
Q

Problems caused by diarrhea

A

Skin breakdown
Fluid/Electrolyte imbalance
Nutritional concerns
More concerned for these complications in children and older adults

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17
Q

bismuth subsalicylate (Pepto-Bismol) class

A

Adsorbent anti-diarrheal

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18
Q

bismuth subsalicylate (Pepto-Bismol)

A

A form of aspirin

Activated charcoal

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19
Q

bismuth subsalicylate (Pepto-Bismol) MOA

A

Coats the walls of the GI tract and bind the causative agent for elimination through stool

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20
Q

bismuth subsalicylate (Pepto-Bismol) SE

A

Increased bleeding time (with warfarin)
Constipation
Dark stools and darkening of tongue

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21
Q

loperamide (Imodium), diphenoxylate with atropine (Lomotil) class

A

Antimotility anti-diarrheal

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22
Q

loperamide (Imodium) MOA

A

Inhibits peristalsis by reducing smooth muscle contractions of the GI tract
Inhibits intestinal secretion, decreasing stool water content
No anticholinergic effects

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23
Q

diphenoxylate with atropine (Lomotil) MOA

A

Inhibits GI motility

When taken in large dosages, atropine causes extreme anticholinergic effects (drying effects/reduce gastric secretions)

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24
Q

loperamide (Imodium), diphenoxylate with atropine (Lomotil)

A

Antimotility

Used alone or in combination with adsorbents and opiates

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25
Q

loperamide (Imodium), diphenoxylate with atropine (Lomotil) SEs (related to anticholinergic effects from atropine; wouldn’t have these with loperamide alone)

A

Urinary retention, headache, dizziness, anxiety, drowsiness, bradycardia, hypotension, dry skin, flushing

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26
Q

Probiotics

A

Obtained from bacterial cultures, most commonly lactobacillus organisms (Bacid, Culturelle) which make up normal flora

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27
Q

Lactobacillus organisms (Bacid, Culturelle)

A

These bacteria make up the majority of normal flora of gut; bacteria often destroyed by abx so probiotics good for patients with diarrhea from abx

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28
Q

Saccharomyces boulardii (Florastor)

A

Probiotic used to treat C-Diff

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29
Q

Probiotics MOA

A

Restore normal flora

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30
Q

Laxatives

A 
For treatment of constipation
One of the most misused medication; can lead to dependence
Treatment is Individualized:
Age
Severity
Contributing factors
31
Q

Laxatives groups

A 
Bulk-forming
Emollient
Hyperosmotic
Saline
Stimulant
32
Q

psyllium (Metamucil)

A

Bulk-forming laxative

33
Q

psyllium (Metamucil) MOA

A

Acts similar to dietary fiber
Absorbs water into the intestine, increasing bulk
Distends bowel to initiate reflex bowel activity and bowel movement

34
Q

psyllium (Metamucil)

A

Safe for long-term use

35
Q

psyllium (Metamucil) SEs

A

Impaction above strictures
Fluid/electrolyte imbalance
Gas formation
Esophageal blockage (must take bulk-forming with increased water to avoid esophageal obstruction)

36
Q

psyllium (Metamucil) systemic

A

No systemic effects; actions limited to GI

37
Q

psyllium (Metamucil)/bulk-forming laxatives contraindication

A

Contraindicated in patients with intestinal obstruction or fecal impaction

38
Q

docusate sodium (Colace)

A

Emollient laxative (stool softener)

39
Q

docusate sodium (Colace) MOA

A

Lubricates fecal material and intestinal walls, promotes fat absorption into fecal mass which softens stool, increases secretion of water by the intestine

Lubrication of fecal material and promoting fat absorption into fecal matter

40
Q

docusate sodium (Colace) indications

A

Prevent opioid-induced constipation; commonly used post-op

41
Q

docusate sodium (Colace)

A

Given PO

42
Q

mineral oil

A

Emollient laxative

43
Q

mineral oil MOA

A

lubricate intestines, prevents water from moving out of intestines

44
Q

mineral oil indication

A

fecal impactions

45
Q

mineral oil route

A

PO
PR (per rectum)
Enema

46
Q

docusate sodium (Colace), mineral oil

A

Emollient laxative

47
Q

docusate sodium (Colace), mineral oil SEs

A

Skin rashes

Decreased absorption of vitamins

48
Q

glycerin, lactulose and polyethylene glycol

A

Hyperosmotic laxatives

49
Q

glycerin, lactulose and polyethylene glycol MOA

A

INCREASES WATER CONTENT IN FECES

Promotes distention, peristalsis, and evacuation

50
Q

glycerin

A

Mild, commonly used in children, typically given as a suppository

51
Q

lactulose

A

Digested in the large intestine creating a hyperosmotic environment
Draws water into the colon
Helps reduce blood ammonia levels—commonly used in liver disease/hepatic encephalopathy

52
Q

polyethylene glycol

A

Commonly given before surgical/diagnostic bowel procedures (i.e., colonoscopy)
Very potent
Usually reconstituted in fluids

53
Q

glycerin, lactulose and polyethylene glycol/ hyperosmotic laxative indication

A

Evacuate bowels before diagnostics and surgical procedures

54
Q

glycerin, lactulose and polyethylene glycol

A

Hyperosmotic laxatives

55
Q

glycerin, lactulose and polyethylene glycol/ hyperosmotic laxatives SEs

A

Abdominal bloating
Rectal irritation
Electrolyte imbalances

56
Q

Magnesium salts, sodium salts

A

Saline laxatives

57
Q

Magnesium Salts (saline laxative)

A 
magnesium citrate (Citroma)
magnesium hydroxide (Phillips Milk of Magnesia)
magnesium sulfate (epsom salts)
58
Q

Magnesium Salts (saline laxative)

A

Available OTC

Can lead to hypermagnesemia so use cautiously in renal patients

59
Q

Sodium Salts (saline laxative)

A

Fleet enema

60
Q

Magnesium salts, sodium salts (saline laxatives) MOA

A

Increase osmotic pressure and draw water into colon; as water moves into the bowel, it increases the pressure in the bowel and increases peristalsis

61
Q

Magnesium salts, sodium salts (saline laxatives) SEs

A

Magnesium toxicity
Electrolyte imbalance
Cramping
Diarrhea

62
Q

bisacodyl (Ducolax), senna (Senokot)

A

Stimulant laxatives

63
Q

bisacodyl (Ducolax), senna (Senokot)/stimulant laxatives MOA

A

Induce intestinal peristalsis

64
Q

bisacodyl (Ducolax) route

A

PO and PR

65
Q

senna (Senokot) route

A

PO

66
Q

bisacodyl (Ducolax), senna (Senokot): stimulant laxatives

A

Class of laxatives MOST LIKELY to cause dependence

67
Q

bisacodyl (Ducolax), senna (Senokot)/ stimulant laxatives indications

A

Constipation or whole bowel evacuation; works on the entire GI tract

68
Q

bisacodyl (Ducolax), senna (Senokot): stimulant laxatives SEs

A

Nutrient malabsorption, gastric irritation, electrolyte imbalance

69
Q

Anti-diarrheals groups

A

Adsorbents
Antimotility (anticholinergics and opiates; opiates not commonly used due to CNS depression)
Probiotics

70
Q

Antimotility anti-diarrheals

A

Anticholinergics and opiates; opiates not commonly used due to CNS depression

71
Q

Anti-diarrheals route

A

All PO

72
Q

Magnesium hydroxide contraindication

A

Kidney dysfunction due to magnesium buildup

73
Q

Bulk forming laxative

A

Drug of choice for chronic constipation

Pathopharm I (10 decks)

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