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Pharmacology HOSA > GI Drugs (Upper And Lower) > Flashcards

GI Drugs (Upper And Lower) Flashcards

1
Q

Antacids indications

A

hyperacidity caused by Heartburn, GERD, acid indigestion, sour stomach, peptic ulcer

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2
Q

Aluminum antacids side effects

A

Constipation , intestinal impaction, anorexia, weakness, tremors and bone pain

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3
Q

Calcium antacids side effects

A

Metabolic alkalosis, hypercalcemia, vomiting, confusion, headache, rebound hyperacidity, renal calculi, and neurological impairment

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4
Q

Sodium bicarbonate antacids side effects

A

systemic Alkalosis and rebound hyperacidity

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5
Q

Antacids considerations

A

Impair absorption of some other drugs

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6
Q

Histamine H2 antagonists ex

A

-tidine: cimetidine, famotidine, nizatidine, ranitidine,

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7
Q

Histamine H2 antagonists indications

A

Heartburn, acid indigestion, sour stomach, GERD, gastric or duodenal ulcer, gastric hypercecretory conditions, stress related ulcers, acute GI bleeding in critically ill patients,

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8
Q

Proton pump inhibitors indications

A

GERD, erosive esophagitis, prevent bleeding in patients using antiplatelet drugs, gastric and duodenal ulcers associated with h. pylori infections, pathologic hypersecretory conditions

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9
Q

Proton pump inhibitors considerations

A

Work better than H2 Agonists

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10
Q

Proton pump inhibitors ex

A

-prazole: omeprazole, lansoprazole, pantoprazole, rabeprazole, esomeprazole, dexlansoprazole,

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11
Q

Proton pump inhibitors administration

A

Take before eating

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12
Q

Sucralfate MOA

A

Pepsin inhibitor/mucosal protective drug

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13
Q

Sulfacrate indication

A

Used in the short term treatment of duodenal ulcers, preferred in pregnant women with GERD symptoms and for treatment of stress ulcers

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14
Q

Misoprostol indications

A

Decreases risk of NSAID induced gastric ulcer in high risk patients (elderly or critically ill)

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15
Q

Misoprostol consideration

A

Women MUST be on birth control

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16
Q

Antiemetic side effect

A

Drowsiness

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17
Q

Metoclopramide indication

A

Delayed gastric emptying and emesis

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18
Q

Metoclopramide MOA

A

Increases mobility of upper GI tract without increasing secretion production, and inhibits stimulation of the vomiting center in the brain

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19
Q

aminosalicylate interactions

A

reduced absorption of Digoxin, methotrexate increases risk of immunosuppression, hypoglycemics decrease blood glucose level, warfarin increases risk of bleeding

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20
Q

Olsalazine pregnancy cat

A

C

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21
Q

Diphenoxylate indications

A

Decrease peristalsis, and decrease lower GI motility, usually combined with atropine, and also used for diarrhea, and is chemically related to opioids

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22
Q

Diphenoxylate consideration

A

Can have sedative and euphoric effect, but it is NOT an analgesic, reduced abuse potential

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23
Q

Diphenoxylate interaction

A

Atropine

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24
Q

Loperamide MOA

A

Acts on wall of bowel to slow motility

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25
Q

Loperamide restriction

A

Not during pregnancy

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26
Q

Loperamide side effect

A

Dizzy/headache, sedation/euphoria, anorexia, constipation

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27
Q

Antidiarrheals restrictions

A

Not for people with bacterial diarrhea (e. Coli, salmonella, shigella) kids under 2, jaundice, pseudomembranous colitis, abdominal pain of unknown origin

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28
Q

Antidiarrheals precautions

A

Severe hepatic impairment, pregnancy (cat C),

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29
Q

Antidiarrheals interactions

A

Antihistamines

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30
Q

Antiflatulents ex

A

Simethicone, charcoal

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31
Q

Antiflatulents side effects

A

None

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32
Q

Charcoal uses

A

Prevention of nonspecific pruritud associated with kidney dialysis, and as an antidote in poisoning

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33
Q

Laxatives indication

A

Prevent occasional constipation

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34
Q

Lactulose indications

A

Hypersmotic agent, ammonia toxicity

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35
Q

Magnesium considerations

A

Caution with renal impairment

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36
Q

Aminosalicylates ex

A

Sulfasalazine (MUST maintain high fluid intake)

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37
Q

Aminosalicylates indications

A

Ulcerative colitis, crohn disease, and other inflammatory diseases

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38
Q

Aminosalicylates side effects

A

Abdominal pain, nausea, diarrhea, headache, dizziness, weakness, fever, and low sperm count

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39
Q

Aminosalicylates interactions

A

Cardiotonics, hypoglycemics, anticoagulants

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40
Q

Stimulant laxatives ex

A

Senna, or bisacodyl, cascara sagrada, sennosides, bisacodyl

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41
Q

Stimulant laxatives side effects

A

Brown urine, dark Colon mucosa

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42
Q

Docusate indications

A

Stool softener (relieve constipation)

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43
Q

Sucralfate indication

A

Protect coating for stomach lining

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44
Q

Gastric stasis

A

Failure of the body to remove stomach contents normally

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45
Q

Gastroesophageal reflux disease (GERD)

A

Reflux or backup of gastric acid contentos into the esophagus

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46
Q

Hydrochloric acid

A

Stomach acid that aids in digestion

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47
Q

Hypersecretory

A

Characterized by excessive secretion of a substance

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48
Q

Upper GI system includes

A

Mouth, esophagus and stomach

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49
Q

Proton pump inhibitors use

A

Treatment of helicobacter pylori infection in people with duodenal ulcers

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50
Q

Antacids MOA

A

Neutralize of reduce the acidity of the stomach and duodenal contents by increasing the pH of the stomach acid

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51
Q

Antacids ex

A

Aluminum, magaldrate, magnesium

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52
Q

Aluminum carbonate use

A

Hyperphosphatemia, or as an adjunct to a low phosphate diet to prevent formation of phosphate based urinary stones

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53
Q

Calcium use

A

Calcium deficiencies, such as menopausal osteoporosis

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54
Q

Magnesium uses

A

Magnesium deficiencies, magnesium depletion from malnutrition, restricted diet, or alcoholism

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55
Q

Magnesium antacids side effects

A

Severe diarrhea, dehydration, hypermagnesemia

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56
Q

Antacids contraindications

A

Severe abdominal pain of unknown cause, lactation

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57
Q

Sodium antacids contraindications

A

Cardiovascular problems, and people on sodium restricted diets

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58
Q

Calcium antacids contraindications

A

Renal calculi, hypercalcemia

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59
Q

Aluminum antacids precautions

A

Gastric outlet obstruction, or upper GI bleeding , decreased kidney function,

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60
Q

Antacids pregnancy cat

A

C, caution

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61
Q

Calcium antacids precautions

A

Respiratory insufficiency, renal impairment, cardiac disease

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62
Q

Magnesium antacids precautions

A

Decreased kidney function

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63
Q

Antacids interactions

A

Decreased absorption and decreased effect of digoxin, isoniazid, phenytoin, and chlorpromazine, decreased effectiveness of tetracycline, decrease anti inflammatory properties of corticosteroids, salicylates are excreted faster in the urine

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64
Q

Histamine H2 antagonists MOA

A

Inhibit the action of histamine at H2 receptor cells of the stomach, reducing the secretion of gastric acid, (selective only in stomach, so don’t cause the reactions of general body H2 receptors)

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65
Q

Histamine H2 antagonists side effects nature

A

Mild and very rare

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66
Q

Histamine H2 antagonists side effects

A

Dizziness, somnolence, headache, confusion, hallucinations, diarrhea, reversible impotence

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67
Q

Histamine H2 antagonists precautions

A

Renal or hepatic impairment, severely ill, elderly, debilitated patients, pregnancy (cat B), and lactation

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68
Q

Nizatidine pregnancy cat

A

C

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69
Q

Histamine H2 antagonists interactions

A

Antacids, and metoclopramide decrease absorption of H2 antagonists, carmustine decreases white blood cell count, opioid analgesics increase risk of respiratory depression, oral anticoagulants increase risk for bleeding, and increased serum digoxin levels

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70
Q

Proton pump inhibitors MOA

A

Suppress gastric acid secretions by inhibition of the hydrogen-potassium adenosine triphospatase (ATPase) enzyme system of the gastric parietal cells

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71
Q

Combination therapy for H. pylori in people with duodenal ulcers

A

One PPI + 2 anti-invectives, bismuth + 2 anti-invectives ,

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72
Q

Proton pump inhibitors side effects

A

Headache, nausea, diarrhea, abdominal pain

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73
Q

Proton pump inhibitors precautions

A

Elderly, hepatic impairment, prolonged treatment can reduce ability to absorb vitamin B12, causing anemia

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74
Q

Proton pump inhibitors contraindications

A

Pregnancy (cat B), lactation

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75
Q

Omeprazole pregnancy cat

A

C

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76
Q

Proton pump inhibitors menopausal women considerations

A

Increase in features in hip, wrist, and spine in people taking high PPI doses and undergoing osteoporosis treatment with biophosphonates

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77
Q

Proton pump inhibitors interactions

A

Sulfacrate decreases proton pump inhibitor absorption, decreased absorption of ketoconazole and ampicillin, oral anticoagulants increase risk of bleeding, increased absorption of digoxin, risk for toxic level of anti seizure drugs (benzodiazepines and phenytoin), biophosphonates increase risk of fracture

78
Q

Omeprazole interactions

A

Clarithromycin risks an increase in plasma levels in both drugs

79
Q

Cholinergic blocking drugs for GI disorders ex

A

Propantheline, and glycopyrrolate, these have been largely replaced by H2 antagonists

80
Q

Sucralfate side effects

A

Constipation

81
Q

Sucralfate interactions

A

Similar interactions to PPIs

82
Q

Misoprostol MOA

A

Inhibits production of gastric acid and has mucosal protective properties

83
Q

Misoprostol Sadie effects

A

Headache, nausea, diarrhea, abdominal pain

84
Q

Misoprostol interactions

A

Antacids decrease misoprostol effects

85
Q

GI stimulants uses

A

GERD, gastric stasis in diabetic people, people with nausea and vomiting associated with chemo, and in the immediate postoperative period

86
Q

Metoclopramide side effects nature

A

Usually mild, but higher doses or prolonged administration can exacerbate them

87
Q

Metoclopramide side effects

A

Restlessness, drowsiness, dizziness, extrapyramidal effects (tremor, involuntary limb movements, muscle rigidity), facial grimacing and depression

88
Q

GI stimulant contraindications

A

GI obstruction, gastric perforation or hemorrhage, or pheochromocytoma, Parkinson, seizure disorder, people taking drugs likely to cause extrapyramidal symptoms

89
Q

GI stimulants precautions

A

Diabetes and cardiovascular disease, pregnancy (cat B), lactation

90
Q

Metoclopramide pregnancy cat

91
Q

GI stimulant interactions

A

Decreased absorption of cimetidine decreased absorption of digoxin, MAOIs increase risk of hypertensive episode

92
Q

Metoclopramide interactions

A

Cholinergic blocking drugs and opioid analgesics decrease metoclopramide effectiveness, and decreased levels of levodopa and metoclopramide with levodopa

93
Q

Antiemetic drugs uses

A

Inhibiting the CTZ and dopamine and acetylcholine

94
Q

Motion sickness drugs ex

A

Dimenhydrinate, diphenhydramine, meclizine, scopolamine

95
Q

5-HT3 receptor antagonists MOA

A

Target serotonin receptors both at the CTZ and peripherally at the nerve endings in the stomach (reduces non-GI adverse effects)

96
Q

Antiemetic use

A

Before surgery to prevent vomiting during surgery, immediately after surgery when patient is recovering from anesthesia, while administering antineoplastics, during radiation therapy where the GI tract is the treatment field, and during pregnancy for hyperemesis, bacterial and viral infections and adverse drug reactions

97
Q

Antiemetic contraindications

A

Severe CNS depression

98
Q

5-HT3 receptors antagonists contraindications

A

Heart block, prolonged QT intervals, pregnancy, lactation, uncomplicated vomiting in young children

99
Q

Prochlorperazine contraindications

A

Bone marrow depression, blood dyscrasias, Parkinson’s disease, or severe liver or cardiovascular disease

100
Q

How to treat severe nausea and vomiting

A

NOT using only antiemetic drugs (cause should be investigated)

101
Q

Severe nausea and vomiting being treated with antiemetics considerations

A

Antiemetics can hide signs of brain tumor/injury, appendicitis, intestinal obstruction, drug toxicity

102
Q

Cholinergic blocking antiemetics precautions

A

Glaucoma, obstructive disease of the GI or genitourinary system, renal or hepatic dysfunction, and in older men with possible prostatic hypertrophy

103
Q

Promethazine precautions

A

Hypertension, sleep apnea, epilepsy

104
Q

5-HT3 receptor antagonists precautions

A

Cardiac conduction problems, or electrolyte imbalances

105
Q

5-HT3 receptor antagonists uses

A

Hyperemesis

106
Q

Antiemetics pregnancy cat

107
Q

5-HT3 receptor antagonists pregnancy cat

108
Q

Pregnancy cat C antiemetic drugs

A

Perphenazine, prochlorperazine, promethazine, scopolamine, chlorpromazine

109
Q

Antiemetics interactions

A

CNS depressants increase risk of sedation, antihistamines increase anticholinergic side effects, antacids decrease absorption of antiemetics,

110
Q

5-HT3 receptor antagonists interactions

A

Rifampin decreases 5-HT3 effectiveness

111
Q

Prochlorperazine interactions

A

Lithium increases risk of extrapyramidal effects

112
Q

Emetic use

A

Induced vomiting, used when people accidentally ingest a poison or drug overdose, but not all are treated with emetics

113
Q

Emetics MOA

A

Local irritation of the stomach and by stimulation of the vomiting center in the medulla

114
Q

Metoclopramide consideration

A

Tardive dyskinesia can occur with long term use (12+ weeks)

115
Q

Antacids ex

A

Aluminum carbonate, aluminum hydroxide, calcium carbonate, magnesia, magnesium oxide, sodium bicarbonate

116
Q

Misc acid reducers ex

A

Sucralfate, and misoprostol

117
Q

GI stimulants ex

A

Metoclopramide

118
Q

Antidopaminergic antiemetics

A

Chlorpromazine, perphenazine, prochlorperazine, promethazine

119
Q

Anticholinergic antiemetics ex

A

Trimethobenzamide

120
Q

5-HT3 receptor antagonists ex

A

Dolasetron, granisetron, odansetron, palonosetron

121
Q

Misc antiemetics

A

Dronabinol, nabilone

122
Q

Emetogenic

A

Causing vomiting

123
Q

Chemoreceptor trigger zone (CTZ)

A

Group of nerve fibers located on the surface of the 4th ventricle of the brain, that, which stimulated, results in vomiting

124
Q

Antiflatulents

A

Drugs that work against flats (gas)

124
Q

Constipation

A

Hardened fecal matter that is difficult to pass

124
Q

Diarrhea

A

Loose, watery stool

124
Q

Inflammatory bowel disease

A

Inflammation of the bowel (crohn disease, and ulcerative colitis)

124
Q

Obstipation

A

Watery stool leakage around a hard fecal impaction

124
Q

Symptoms of crohn disease

A

Abdominal pain and distension, as the disease progresses, anorexia, diarrhea, weight loss, dehydration and nutritional deficiencies can occur

124
Q

Drugs used to treat IBD

A

Antibiotics, corticosteroids, biologic agents, and aminosalicylates

125
Q

Aminosalicylates MOA

A

Exert a topical anti-inflammatory effect in the bowel

126
Q

Aminosalicylates contraindications

A

Allergy to salicylate-containing drugs, allergy to sulfonamides and sulfites, intestinal obstruction, kids younger than 2, pregnancy (cat B), and lactation

127
Q

Natalizumab use

A

Parenteral, used for crohn disease and multiple sclerosis

128
Q

Natalizumab side effects

A

Rare brain infection called leukoencephalopathy. Risk for this is greater if taking immunosuppressants or have been exposed to John cunning virus (JCV)

129
Q

Generic name of lomotil

A

Diphenoxylate

130
Q

Difenoxin use

A

Chemically related to opioid drugs, decrease intestinal peristalsis (used for diarrhea), are usually combined with atropine

131
Q

Loperamide use

A

Chronic diarrhea associated with IBD

132
Q

Crofelemer MOA

A

Blocks the secretion of chloride, which causes high water volume loss in the diarrhea associated with HIV/AIDS

133
Q

Antidiarrheals side effects

A

Anorexia, vomiting, constipation, abdominal discomfort, pain and distension, dizzy, drowsy, headache, sedation, euphoria, rash

134
Q

Loperamide pregnancy cat

A

B, but isn’t recommended for use during pregnancy and lactation

135
Q

Crofelemer pregnancy cat

A

C, hasn’t been stifled for pregnancy, lactation, or pediatric use

136
Q

Antidiarrheals interactions

A

Antihistamines, opioids, hypnotics, and sedatives increase risk of CNS depression, antihistamines and antidepressants increase anticholinergic side effects,
MAOIs increase risk of hypertensive crisis

137
Q

Simétrico e MOA

A

Deforming action that dispersed and prevents the formation of gas pockets in the intestine

138
Q

Charcoal MOA

A

Helps bind gas for expulsion

139
Q

Antiflatulents uses

A

Relieve painful symptoms of excess gas in the digestive tract that may be caused by postoperative gaseous distention and air swallowing, dyspepsia, peptic ulcer, IBS or diverticulosis

140
Q

Charcoal pregnancy cat

141
Q

Simethicone precautions

A

Pregnancy (cat not known, but may be safe)

142
Q

Charcoal interactions

A

Decrease in efedtcveness of other drugs because charcoal adsorbs them, and can adsorb drugs in the GI tract

143
Q

Bulk producing laxatives MOA

A

Add bulk and water to the contents of the intestines, not digested by the body, which stimulates peristalsis, moves the products of digestion through the intestine and encourages evacuation of the stool

144
Q

Bulk producing laxatives ex

A

Psyllium, and polycarbophil, and methylcellulose

145
Q

Stool softeners MOA

A

Promote water retention in the fecal mass and soften the stool

146
Q

Stool softener ex

147
Q

Emollient laxatives ex

A

Mineral oil

148
Q

Emollient laxatives MOA

A

Lubricate the intestinal and soften stool

149
Q

Hypersmolar laxatives MOA

A

Dehydrated local tissues, which causes irritation and increased peristalsis

150
Q

Hypersmolar laxatives ex

A

Glycerin, lactulose, lubiprostone

151
Q

Stimulant laxatives MOA

A

Increase peristalsis by direct action on the intestine

152
Q

Saline laxatives MOA

A

Attract water into the intestine, increasing pressure, which is followed by an increase in peristalsis

153
Q

Saline laxatives ex

154
Q

Stimulant laxatives use

A

Evacuate colon for rectal and bowel examinations

155
Q

Emollient laxatives use

A

Evacuate colon for rectal and bowel examinations

156
Q

Saline laxatives use

A

Evacuate the colon for rectal and bowel examinations

157
Q

Stool softeners use

A

Prevention of strain during defecation (after anorectal surgery or myocardial infarction)

158
Q

Mineral oil use

A

Prevention of strain during defecation (after anorectal surgery or myocardial infarction)

159
Q

Psyllium use

A

IBS and diverticular disease

160
Q

Polycarbophil use

A

IBS and diverticular disease

161
Q

Hypersmotic agents use

A

Reduction of blood ammonia levels in hepatic encephalopathy

162
Q

Laxatives side effects

A

Diarrhea, loss of water and electrolytes, abdominal pain, nausea, vomiting, perianal irritation, fainting, bloating, flatulence, cramps, and weakness

163
Q

Prolonged use of laxatives can result in

A

Serious electrolyte imbalances, or dependance on a laxative to have a bowel movement

164
Q

Bulk forming laxatives side effects

A

Obstruction of the esophagus, stomach, small intestine, and colon when these are administered without good fluid intake or in people with intestinal stenosis

165
Q

Mineral oil considerations

A

The very young, very old, and debilitated are at the highest risk for the aspiration of mineral oil into lungs, which can cause a lipid pneumonitis

166
Q

Laxatives contraindications

A

Persistent abdominal pain, nausea, vomiting of unknown cause, signs of acute appendicitis, fecal impaction, intestinal obstruction, or acute hepatitis, or sensitive to tartrazine

167
Q

Magnesium precautions

A

Renal impairment

168
Q

Laxatives precaution

A

Rectal bleeding, pregnancy, lactation

169
Q

Pregnancy cat C laxatives

A

Cascara sagrada, docusate, glycerin, phenophthalein, magnesium, senna

170
Q

Mineral oil interactions

A

Can impair the absorption of fat soluble vitamins (

A, D, E, K), and surfactants can increase mineral oil absorption,

171
Q

Laxatives interactions

A

Can reduce absorption of other drugs in the GI tract by combining with them chemically or hastening their passage through the intestinal tract

172
Q

Bisacodyl tablets interactions

A

Milk, antacids, histamine H2 antagonists and PPIs shouldn’t be administered 1-2 hours before bisacodyl tablets

173
Q

Orlistat MOA

A

Inhibits lipase, which can result in loose stools and increased flatulence

174
Q

Orlistat use

A

Obesity management

175
Q

Orlistat side effects nature

A

Side effects usually diminish by the 4th week, but can come back when a meal high in fat is eaten

176
Q

Orlistat side effects

A

Loose stools, increased flatulence, fecal urgency, incontinence with fat or oily stools

177
Q

Orlistat contraindications

A

Gallstones

178
Q

Charcoal interactions considerations

A

Since charcoal can absorb other drugs, it shouldn’t be given 2 hours before or 1 hour after the administration of other drugs

179
Q

Aminosalicylates ex

A

Balsalazide, mesalamine, olsalazine, sulfasalazine

180
Q

Biológicas for bowel disorders ex

A

Adalimumab, certolizumab, infliximab, natalizumab,

181
Q

Misc drugs for bowel disorders ex

A

Alosetron, alvimopan, eluxadoline, linaclotide, methylnaltrexone

182
Q

Andidiarrheals ex

A

Bismuth, crofelemer, difenoxin with atropine, diphenoxylate with atropine, loperamide, tincture of opium

183
Q

Antiflatulents ex

A

Charcoal, simethicone

184
Q

Bulk producing laxatives ex

A

Methylcellulode, psyllium, polycarbophil

Pharmacology HOSA (37 decks)

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