GI Exam Deck 2

Question 1

Bulk forming laxatives

Answer 1

psyllium, methylcellulose, poly-carbopril

Question 2

The adverse effects of bulk forming laxatives:

Answer 2

there can be increased bloating and farts, avoid in opioid induced constipation,

Question 3

When are bulk forming laxatives used?

Answer 3

They are used in constipation and pregnancy

Question 4

What are emolients?

Answer 4

Emolients make stool smoother/ softer.

Question 5

What are the different kinds of emolients?

Answer 5

They are mineral oil and sodium docusate.

Question 6

When are emolients used?

Answer 6

when straining should be avoided, or when stool is hard and dry

Question 7

What are contra-indications for emolients?

Answer 7

Do not use for more than 7 days because it can lead to diarrhea. Do not give to children or pregnant women.

Question 8

What are osmotic laxatives?

Answer 8

they are saline laxative, PEG, and lactulose. Used for colonoscopy prep and can cause electrolyte abnormalities.

Question 9

How does lactulose work?

Answer 9

Breakdown into lactic acid and acetic acid in the gut –> causes more acid in the gut–> lower pH –> nH3 to NH4 conversion–> causes there to be more NH4 into the lumen–> peristalisis

Question 10

What are stimulant laxatives?

Answer 10

Stimulant laxatives are used in surgery/ bowel prep/cleanse, and most abused laxative.

Question 11

What are names of stimulant laxatives?

Answer 11

bisacodyl/senna.

Question 12

What are AE of bisacodyl/ senna?

Answer 12

They are melanosis coli and cathartic colon.

CI is obstruction of colon.

Question 13

What is used for severe constipation?

Answer 13

For severe. we use chloride secretion activators ( linaclotide and plecanatide) that work at CFTR channel to bring out sodium, that brings out sodium and water.

Question 14

Nucleus Tarctus Salitarius

Answer 14

Vomiting center receiving input from higher centers (CNS), GI tract, ventibular system, and from area postrema.

Question 15

What area is triggered by chemotherapy:

Answer 15

area postrema

Question 16

Vestibular system:

Answer 16

only has histamine and muscarinic receptors

Question 17

Anti-histamine and anti-muscarinics

Answer 17

great use in motion sickness and meclizine can be used be used in pregnancy induced nv

Question 18

Anti-muscarinic and anti-histamine

AE

Answer 18

Anti-muscarinic effects ( psychosis, dry mouth, unable to urinate)

Question 19

Dopamine receptor antagonists (prochrolperazine, promethazine, metochlopramide, domperidone, droperidol) ,

Answer 19

D2 antagonists 
(Metoclopramide and domperidone) have no anti-psychotic activity and also shown to have pro-kinetic properties (increased LES tone and increase gastric emptying and SB transit)--> great tx for gastroparesis

Question 20

What are the adverse effects of dopamine antagonists?

Answer 20

Tardive dyskenesia. Droperidol has risk of torsades

Question 21

5HT3 receptor antagonists: are —- drugs

Answer 21

“setron”

Question 22

5HT3 is when —-.

Answer 22

Standard of are CINV ,PONV, RINV.

Acute phase of CINV.

Question 23

5HT3 receptor antagonists

Answer 23

AE: prolonged QT

risk of torsades

Question 24

Cannabinoids are:

Answer 24

dronabinol and nabilone stimulate CB1 receptors.

not first line agents, but may effective in patients not responsive to 5HT3 and NK1 receptor blockers

Question 25

Benzodiazepines

Answer 25

alprazolam and lorazepam

great for calming effect and anticipatory nausea and vomiting

Question 26

NK 1 receptor antagonists

Answer 26

• ” prepitant”.

inhibit Substance P at NK1

work on acute phase but mostly delayed phase CINV and also effective on PONV

Question 27

Prokinetic agents

Answer 27

bethanecol: agonist at muscarinic receptor.

motilin and macrolide abx: stimluare receptor, great for tx of gastroparesis.

Question 28

Dexamathasone

Answer 28

enhances the effects of 5HT3 receptor blockers and NK1 receptor blockers in CINV