GI Disorder Flashcards

1
Q

Constipation more frequent in

A

Older adults

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2
Q

Diagnosis requires at least two of the following symptoms.

for const

A

Two or fewer bowel movements per week
Lumpy or hard stools at least 25% of time
Straining to pass stools at least 25% of time
Feeling of incomplete evacuation at least 25% of time

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3
Q

Const causes

A

lack of fluid intake
Lack of dietary fiber
Immobility

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4
Q

Tx of Const nutriotinoal

A

Prune/prune juice
Increase fluid
Increase activity
Increase fibre

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5
Q

Increased fiber includes

A

Whole wheat, bran, oats, fruits and vegetables.

Will increase gas production initially but the effect decreases with time.

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6
Q

Pharmacotherapy w/ laxatives

A

Laxatives are drugs that promote evacuation of bowel

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7
Q

Classes of laxatives

A

Bulk-forming (ie psyillium)

Stool softeners (ie docusate)

Stimulants

Osmotics

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8
Q

Builk forming laxatives

A

Bulk-forming (ie psyillium)
Fibre that absorbs water, forming bulkier stool that passes more easily
Must be taken with lots of water

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9
Q

Stool softeners

A

Docusate

Surfactant that lowers surface tension of stool allowing more water to enter stool
Often given when constipation poses a risk

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10
Q

Stimulants laxatives

A

Irritate bowel, promoting peristalsis What do you think this can cause?

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11
Q

Osmotic laxatives

A

Draw water into GI tract
Can cause dehydration

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12
Q

Psyllium Mucilloid

A

Bulk forming lax
Metamucil, Psyllium

Occasional constipation
Reduction of blood cholesterol with longer use

Mechanism of action
Absorbs water in bowel forming a bulky stool
Bulky stool stimulates defecation reflex

AE
- safest laxitive if taken as directed with water

Mild. cramping or D
If not taken with adequate water, can cause obstruction of the esophagus or intestines

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13
Q

When giving laxatives ensure

A

Closeby commode or
Clear path to BR

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14
Q

How often must pts have BM in hospital

A

Pt must have BM EVERY 3 days

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15
Q

Diarrhea is

A

Increased fluidity of feces when colon does not reabsorb enough water

Often secondary to another condition

i.e.
GI infection
Drugs (antibiotics, NSAIDs, orlistat, digoxin)
Inflammation of bowel
Foods
Diseases of SI and pancreas, leading to malabsorption of food

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16
Q

Prolonged diarrhea

A

Indication for pharmacotherapy
Symptom of underlying disease

Prolonged diarrhea can cause:
1 Fluid deficit
2 acid–base imbalances
3 electrolyte abnormalities

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17
Q

Tx focus when dealing with diarrhea

A

to eliminate primary cause of diarrhea and to manage symptoms through pharmacotherapy
If infection is primary cause, then antibiotics will be most effective treatment.

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18
Q

Oral solutions would you reccomend for diarrhea

A

Gatorade, pediolyte

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19
Q

Diet for diarrhea

A

Decrease fiber
Decrease milk products
Avoid fatty foods
Avoid coffee & tea

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20
Q

Pharmacotherapy of diarrhea

A

Opioids (Most common)
- Codeine
Loperamide
Non opioid
- Pepto-Bismol
Psyllium - absorbs water to form bulk

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21
Q

Atropine

A

Used for: Mod-severe diarrhe
MoA: Binds to mu opioid receptors in GI tract reducing peristalsis
- Atropine blocks ACh receptors to reduce peristalsis
Combined, this combo provides time for water to be abosrombed from LI

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22
Q

Loperamide (Immodium)

A

Loperamide is an anti-diarrheal agent that provides symptomatic relief

also increases rectal tone,reducing daily fecal volume, and increasing the viscosity and bulk density of feces .It also increases the tone of the anal sphincter, thereby reducing incontinence and urgency.

Onset: 1 hour, can last for 3 days

Does not mediate significant analgesic activity at therapeutic

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23
Q

Assessment before Immodium

A

Obtain a complete health history including allergies and drug history
Obtain vital signs, ECG and electrolytes why?
Obtain and evaluate stool culture why?
Assess for presence of dehydration why?

24
Q

Interventions for pts recieving antidiarrheal therapy

A

Monitor for anticholinergic effects including dry mouth
Initiate safety measures to reduce risk of falls

25
Q

Vomiting controlled by

A

Controlled by the vomiting center of the brain that receives signals from digestive tract, inner ear, chemoreceptor trigger zone, cortex

26
Q

Complications from chronic vomitingq

A

Dehydration
Electrolytes
WT loss
Metabolic alk

27
Q

When foods and fluids cannot be tolerated, start with

A

Warm fluids, gatorade, bland fluid

28
Q

Complentary alternative therapy for NV

A

Acupuncture
Herbs like ginger and peppermint
Breathing exercises

29
Q

Pharm therapty of NV KNOW THIS

A

Anticholinergics
Antihistamines

30
Q

Scopolamine

A

Anticholinergics
Often given as a patch or SQ
Nausea due to Motion sickness or Post OP
AE-Dry mouth, Sleepines, Urinary retention, Agitation, Dilated pupils

31
Q

Antihistimanines (Gravol)

A

Nausea due to motion sickness
Cause significant drowsiness
AE- Drowsiness. Dizziness, Blurred vision,Dry mouth, nose, and throat, Constipation

32
Q

Serotonin Receptor antiagonists

A

Ondansetron - zofran

Chemotherapy-induced nausea and vomiting
AE- Blurred vision, bradycardia, anxiety, agitation, shivering

33
Q

Phenothiazines

A

D2 receptor antagonists; ie prochlorperazine)

Antineoplastic therapy
- NV

34
Q

Cannabinoids (Marinol-dronabinol)

A

Antineoplastic therapy
Stimulate appetite (CAN be a benefit)
AE- seizures, tachycardia, mood changes

35
Q

Corticosteroids

A

Antineoplastic therapy (Cancer tx)
Post-surgical nausea and vomiting

36
Q

Haldol

A

classified as an antipsychotic but also helps control nausea and vomiting by blocking dopamine receptors in the brain.

1st Line therapy for preventing post op vomiting

Can be given PO
AE: Anxiety, tiredness, neuroleptic malignant sundrome (Life threatening)

37
Q

Metoclopramide (Maxeran)

38
Q

In both Crohn’s and ulcerative colitis, malnutrition can result. Why do you think this is?

A

Crohns - Affects the small intestine

39
Q

First response to IBD exacerbation

40
Q

Pharmacotherapy of IBD (1 of 2)

A

5 ASA
Corticosteriods
Immunosuppressants

41
Q

IBS Tx

42
Q

Pancreatis

A

Digestive enzymes remain in the pancreas rather than being released into duodenum

Acute pancreatitis
More common in middle-aged adults
Associated with gallstones in females, alcoholism in males
Chronic pancreatitis
Associated with alcoholism

43
Q

Causes of pancreatitis

A

Alcoholism
Infections
Genetic (cystic fibrosis)

44
Q

Pancrelipase

A

Use: Replacement therapy for patients with insufficient pancreatic exocrine secretions

Panceatisi

MoA- Facilitates digestion

lipids into glycerol and fatty acids
starches into dextrin and sugars
proteins into peptides

45
Q

Protevyion from acid secretion in stomach

A

Goblet cells produce mucous which protects the lining of the stomach

Pancreas secretes bicarbonate ions into duodenum to neutralize acid to protect mucosa

46
Q

Most peptic ulcer dx caused by

47
Q

Duodenum ulcers relieved by

48
Q

Gastric ulcers

A

More common in those over 60, not relieved by food

49
Q

GERD

A

Chronic condition

50
Q

Nutritional therapy for GERD

A

Consume small meals and consume liquids bw meals

Limit foods or substances increasing gastric acid (Coffee and alcohol)

(Choclate fried food)

Avoid lying down after eating or eating right before bed. Meals should be consumed at least 3 hours before bed.

Avoid wearing tight garments or bending over.
Avoid cigarette smoking which relaxes the sphincter.
Avoid using NSAIDS. Which can damage esophageal mucosa.

51
Q

Ranitidine (Zantac)

A

Uses:
Duodenal ulcers, gastric ulcers
Hypersecretory conditions (ie ZES)
Heartburn, GERD
Used off-label to counter medications that promote development of peptic ulcers

MoA:
Blocks H2 receptors on the parietal cells in the stomach to decrease acid production
Administered once daily

52
Q

AE of Ranitidine

A

Adverse effects
Uncommon and transient
Serious adverse effects, reduction in;
1 Platlets
2 RBC
3 WBC

53
Q

Proton Pump Inhibitors

A

PPIs block the enzyme (H+/K+ pump )on parietal cells, reducing acid secretion in the therapy of PUD and GERD

Should be taken about 30 minutes before meals

54
Q

Omeprazole

A

PPI

Uses: By prescription, approved for short-term, 4- to 8-week therapy of active peptic ulcers
OTC, indicated for relief of heartburn

MoA: Reduces acid secretion in stomach by irreversibly binding to the H+/K+ pump

AE: Headache, nausea, diarrhea, rash, abdominal pain

SHOWN to cause cancer long term (In animals)

55
Q

Main downside of taking antacids

A

Can reduce absorptionof OTHER Drugsthat require acidic environment

Neutralize the stomach acid

56
Q

Adverse effects of hydroxide

A

Constipation
At high doses, aluminum products bind with phosphate in GI tract, and long-term use can result in phosphate depletion