GI Drugs Flashcards
Is constipation more common in younger or older adults?
Older
Can constipation be a symptom of an underlying disease?
Yes
What are 4 possible symptoms of constipation in which 2 are required to be diagnosed with constipation?
- two or less bowel movements per week
- lumpy or hard stools at least 25% of the time
- straining to pass stools at least 25% of the time
- feeling of incomplete evacuation at least 25% of the time
What are some causes of constipation?
- lack of exercise
- insufficient diet, lack of dietary fibre
- lack of fluid intake
- drugs that reduce GI motility
What can severe constipation lead to?
Fecal impaction and complete bowel obstruction
What are some non-pharmacological approaches to treat constipation?
- regular exercise
- eating a sufficient amount of food to meet the requirements of the body
- healthy diet including insoluble dietary fibre
- adequate hydration
What are laxatives?
Drugs that promote the evacuation of bowel.
How many classes of laxatives are there?
4
What are the 4 classes of laxatives?
- Bulk forming
- Stool softeners
- Stimulants
- Osmotics
How do bulk-forming laxatives work?
They have fibre that absorbs water, forming bulkier stool that passes more easily.
What must be taken with bulk-forming laxatives?
Lots of water
Name a bulk forming laxative:
Metamucil
How do stool softeners work?
They are made up of surfactants that lower the surface tension of stool allowing more water to enter the stool.
Name a stool softener:
Colace
How do stimulants work?
They cause the intestinal muscles to rhythmically contract to help stimulate a bowel movement.
Name a stimulant:
Ducolax (Senokot)
How do osmotic laxatives work?
They draw water into the GI tract
Name a osmotic laxative:
Magnesium hydroxide
What are the therapeutic uses of Metamucil?
- occasional constipation
- reduction of blood cholesterol w longer use (LDL)
What are the adverse effects of Metamucil?
Mild cramping and diarrhea
Which laxative is the safest?
Bulk-forming
What are the serious effects of Metamucil if not taken with adequate water?
Obstruction of esophagus or intestines
What is Diarrhea?
Increased fluidity of feces when the colon does not reabsorb enough water.
Is diarrhea often secondary to another condition?
Yes
What can cause diarrhea?
- GI infections
- drugs (antibiotics, NSAIDs, and digoxin)
- inflammation of the bowel
- foods
- disease of the small intestine and pancreas, leading to malabsorption of food
What can prolonged diarrhea cause?
- fluid imbalance
- pH imbalance
- electrolyte imbalance
What 2 types of drugs can be used to treat diarrhea?
- opioids
2. non-opioids
Are opioids or non-opioids more effective at treating diarrhea?
Opioids
How do opioids work?
They decrease GI motility via muscarinic receptors, providing more time for water reabsorption.
Name an opioid:
Atropine (Lomotil)
Name an over the counter opioid:
Imodium
Name a non-opioid:
Pepto-Bismol
Why should you take Lomotil?
Moderate to severe diarrhea
What are the adverse effects of Lomotil?
- dizziness
- lethargy
- drowsiness
- anticholinergic effects
What is nausea?
An unpleasant feeling of need to vomit accompanied by weakness, diaphoresis, dizziness, and hyperproduction of saliva.
What is vomiting?
The stomach content are forced upward into the mouth.
What is another name for vomiting?
Emesis
What are some causes of nausea and vomiting?
- motion sickness
- drugs, toxins
- GI infection
- stress, pain
- pregnancy
What are some complications from chronic vomiting?
- dehydration
- electrolyte imbalances
- significant weight loss
What classes of drugs can be used to treat nausea and vomiting?
- Anticholinergics
- Antihistamines
- Serotonin receptor antagonists
Name an anticholinergic used to treat nausea due to motion sickness:
Scopolamine
Name an antihistamine used to treat nausea due to motion sickness:
Gravol
Name a serotonin receptor antagonist used to treat chemotherapy induced nausea and vomiting:
Ondansetron
Name a anti-psychotic medication used to treat severe nausea and vomiting:
Stemetil
What is an adverse effect of Stemetil?
Extrapyramidal effects
What are some extrapyramidal effects?
- anxiety
- slurred speech
- akinesia (not moving)
- dystonic reactions (involuntary)
- tremor
What is pancreatitis?
When the digestive enzymes remain in the pancreas rater than being released into the duodenum.
What is acute pancreatitis associated with in males and females?
Males: alcoholism
Females: gallstones
Is acute pancreatitis more common in young, middle, or older aged adults?
Middle aged adults
What is chronic pancreatitis associated with?
Alcoholism
What causes pancreatitis?
- alcoholism
- infections
- genetic (cystic fibrosis)
What are some signs and symptoms of pancreatitis?
- left upper quadrant pain when eating
- nausea and vomiting when eating
What type of drug can treat pancreatitis?
Pancreatic enzymes
Name a pancreatic enzyme drug:
Pancreatin/Pancrease
How does Pancrease work?
It facilitates digestion by turning:
- lipids into fatty acids
- starches into dextrin and sugars
- proteins into peptides
What are some of the adverse effects of Pancrease?
- GI symptoms
Acid secretion in the stomach is increased by:
- gastrin receptors
- histamine 2 receptors
- PNS (acetylcholine receptors)
Acid secretion in the stomach is decreased by?
Prostaglandin receptors
What type of cells produce mucous which protects the lining of the stomach?
Goblet cells
What is peptic ulcer disease (PUD)?
Erosion of the mucosal lining of the stomach and/or the duodenum
What causes peptic ulcer disease?
- H. pyloric infection
- chronic use of NSAIDs (reduce the production of prostaglandins)
Are gastric ulcers or duodenal ulcers more common?
Duodenal ulcers
What causes peptic ulcer disease?
Stress, mediated by the sympathetic nervous system which leads to vasoconstriction of blood vessels to the stomach and therefore causes reduced secretion of mucous and bicarbonate ions
What is Gastroesophageal Reflux Disease (GERD)?
A chronic condition characterized by persistent heartburn due to weakening of the lower esophageal sphincter.
What are some symptoms of GERD?
- heartburn
- chest pain
- nausea
- belching
What type of drugs can be used to treat PUD and GERD?
- Drugs that reduce acid secretion (H2 receptor antagonists, ppi’s, prostaglandins)
- Drugs that neutralize acid (antacids)
- Antibiotics (Amoxicillin and tetracycline)
Name a H2 receptor antagonist used to treat PUD and GERD:
Zantac
What are some adverse effects of Zantac?
- neutropenia (fewer neutrophils) and thrombocytopenia (low platelet)
- confusion
- loss of libido in men
Name a proton pump inhibitor used to treat PUD and GERD:
Losec
When should Losec be taken?
30 mins before meals
How long can you take Losec for?
4-8 weeks (short term only)
What are some of the adverse effects of Losec?
- headache
- nausea
- diarrhea
- rash
- abdominal pain
- blood conditions
- fatigue
- weakness
What are antacids composed of and what do they do to stomach acid?
Carbonate, hydroxide, and bicarbonate compounds that neutralize the stomach acid
