GI- diarrhea and constipation crap Flashcards
1
Q
Metoclopramide
A
- D2 receptor antagonist- enhances motility and tone of SM in the upper GI tract and esophageal sphincter
- uses:
- antiemetic- acts on CTZ in CNS
- dec. gastric hypomotility and associated nausea and vomiting - SE:
- cramping and diarrhea
- at high doses: extrapyramidal sx, and exacterbation of parkinsons disease, depression, anxiety - CI:
- pregnancy
2
Q
Bethanechol
A
- muscarinic agonist that inc GI motility and tone
- uses
- tx postop ileus
- inc lower esophageal sphincter tone
- DOES NOT get into CNS - no CNS SE - SE
- muscarinic issues: cramping, diarrhea, salivation, sweating, etc.
-
3
Q
Anti-spasmotics, or Anti-cholinergic agents in GI
A
- Glycopyrrolate, and dicyclomine
- used as GI anti-spasmotics , dec intestinal overactivity and reduce cramping and spasms,
SE: sedation, dry mouth, constipation
4
Q
Alosetron
A
- Blocks 5-HT3 receptors (regulate visceral pain, colonic transit, and GI secretion)
- USES:
- tx women w/severe diarrhea predominant IBS that has failed with other treatments (pt and dr have to sign risk-benefit agreement) - SE:
- constipation
- GI obstruction, GI perforation, impaction, toxic megacolon, secondary ischemic colitis, death - CI
- ischemia or uc, constipation,
- anything seriously wrong with the GI- don’t take, also with vascular issues of the GI
5
Q
TCA
A
- tx IBS because of the anti-cholinergic effects to dec. spasticity and improve chronic pain
6
Q
Ondansetron (“–setron)
A
- anti-emetic- selectively blocks 5HT3 receptors in teh CTZ and in the GI tract
- uses
- tx vomitinn in chemotherapy, and with vagal stimulation pathologies (GI distenstion, gastroenteritis)
- NOT effective for vomiting due to motion sickness- not sedating
7
Q
Procholorperazine, and promethazine
A
- Phenothiazines, and Buytrophenones- block Dopamine, muscarinic, and histamine receptors - anti-emetic
TX: post op nausea and vomiting, cause significant sedation
8
Q
Cannabinoids
A
- Dronabinol, Nabilone
- anti-emetic, mech unknown
- combined w/procholorperazine or promethazine to inc effectiveness off both
9
Q
Bisacodyl
A
- laxative
2. act on the bowel to inhibit absorption of water and may sitmulate peristalsis
10
Q
Castor oil
A
- laxative
- requires presence of bile- dont use when biliary obstruction
- used to prepare bowel for diagnostic procedures
CI: pregnacy- can stimulate the uterus
11
Q
mineral oil
A
stool softener
- it can dec. absorption of fat soluble vitamins
- if inhaled: lipoid pneumonia
12
Q
Ducosate Sodium
A
stool softener
- emulsifying agent that allows water to penetrate the colonic contents and soften them
13
Q
Glycerin
A
Stool softener
- suppository, lubricates the distal end of the bowel- irritation from glycerin can stimulate peristalsis
14
Q
Lubiprostone
A
- laxative, Prostaglandin E1 derivative- inc. intestinal fluid secretion by activation chloride channels in the luminal cells of the intestingal epithelium
- uses
- soften stools and inc. intestinal motility, promoting spontaneous bowel movements
- reduces sx chronic constipation - does not alter electrolytes, does not produce tolerance, well tolerated
15
Q
Alvimopan, methylnaltrexone
A
- Laxative - mu antagonist that acts selectively on the GI tract
- Uses
- antagonize opioid induced inhibition of the gastric motility and ileus when opioids are used to tx pain - SE:
- constipation, flatulence
- anemia, dyspepsia, hypokalemia, back pain, and urinary retention - ci
- severe hepatic impairment, end stage renal disease, or in pts undergoing surgery for correction of complete bowel obstruction
