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HN 320 Clinical Nutrition I > GI Medications - Final Study Guide > Flashcards

GI Medications - Final Study Guide Flashcards

1
Q

What is the mechanism of action for cholinergic drugs?

A

Mimic acetycholine (Ach)

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2
Q

What affect do cholinergic drugs have on the GIT?

A

Increases motility and secretion

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3
Q

Describe the use for Motegrity

A

What drug would you give for chronic idiopathic constipation?

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4
Q

Metoclopramide

A

Drug for delayed gastric emptying or diabetic gastroparesis

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5
Q

What is the mechanism of action for anticholinergic drugs?

A

They block acetylcholine (Ach)

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6
Q

What affect do anticholinergic drugs have on the GIT?

A

Decrease motility and secretion

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7
Q

If a patient has mild GERD symptoms what type of drug would you recommend? Give possible side effects.

A

Antacids

Al: constipation, bone issues
Mg: diarrhea

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8
Q

If a patient has mild –> moderate GERD symptoms what type of drug would you recommend? Name one.

A

H2 Blockers

Ranitidine

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9
Q

If a patient has moderate –> severe GERD symptoms what type of drug would you recommend? Name one. What are the possible side effects

A

PPIs - Omeprazole

Side Effects: 
•Headache
•Diarrhea
•B12 deficiency
•Hypomagnesemia
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10
Q

What would you recommend for a patient with GERD and a swallowing disorder?

A

ODT, IV, compounding suspension or mixing with applesauce

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11
Q

Briefly describe the drug treatment of someone with H. Pylori

A

3 or 4 drugs regimens

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12
Q

Inhibiting COX-1 can lead to three toxicities. Name them.

A
  • GI
  • Blood
  • Renal
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13
Q

There are four drug tactics for treating diarrhea. Name them.

A
  • Anti-motility
  • Soluble Fibers
  • Bacterial replacement
  • Lactase enzymes
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14
Q

What is Loperamide? Give the method of action

A

Antimotility diarrhea medication

Bind to opioid receptor and block Ach release

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15
Q

What are the three broad categories of constipation medication? Name specific drugs in each category

A
  • Drugs work in 1-3 days: (Emollients- Miralax, stool softeners)
  • Drugs work in 6-12 hours: Bisacodyl tab, Senna
  • Drugs work in 1-6 hours: Bisacodyl suppl, Mg citrate, MoviPrep (used for colonoscopies)
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16
Q

What is the first drug choice for IBS-D? Name the other one

A

1st: Loperamide (Imodium)
2nd: Alosetron (serotonin antagonist, only women)

17
Q

What medications can exacerbate GERD?

A 
Asprin
Bisphosphonates
Iron
NSAIDs
Potassium chloride
18
Q

What is antacids’ method of action?

A
  • Decrease the activation of pepsinogen

* Neutralize gastric fluid

19
Q

Describe Ranitidine.
What is its MOA?
Side Effects?

A

H2-Receptor Antagonists (HSRA)

MOA: reduce basal acid secretion and pepsin production

SE: constipation, diarrhea, dry mouth, dry skin (from internet)

*Ok for pregnant women and children

20
Q

Describe Omeprazole.
What is its MOA?
Side Effects?
Nutrition/counseling points?

A

PPI - Proton Pump Inhibitor (for moderate to severe GERD)

MOA: block gastric acid secretion by inhibiting H+/K+ adenosine triphosphatase in gastric parietal cells

SE: headache, diarrhea, constipation, Vit B12 deficiency, hypomagnesemia
D
• Take on empty stomach before bed

•OK for children and elderly

21
Q

What is the preferred regimen for H. pylori treatment?

A

3-drug treatment: antibiotics + bismuth subsalicylate + PPI or H2RA

22
Q

What are the dietitian counseling points for H. pylori drug treatment?

A

Antibiotics: finish therapy, call MD if diarrhea

Bismuth subsalicylate: don’t take if asprin allergy, black stools, constipation, black hairy tongue

Tetracyline: avoid dairy and antacids

23
Q

Describe Loperamide.
What is its MOA?
Side Effects?

A

It is an antimotility drug for diarrhea treatment

MOA: Binds to opioid receptors in GI tract inhibiting release of acetylcholine. This reduces propulsive peristalsis and increases intestinal transit time

SE: (rare) dizziness, constipation

24
Q

What are common causes of constipation in adults?

A
  • Inadequate fiber or fluid intake**
  • Systemic disease
  • Medications (opiods, anticholinergics, psychotripics, Ca and Fe supplements)
25
Q

Describe Docusate.
What is its MOA?
Side Effects?
Nutrition/counseling points?

A

Emollient; stool softener used for constipation treatment; works in 1-3 days

MOA: Surfactant agent that mixes aqueous and fatty materials within the intestinal tract

SE: low
Nutrition: safe and effective for up to 6 months

26
Q

Describe Miralax.
What is its MOA?
Side Effects?
Nutrition/counseling points?

A

Emollient; stool softener used for constipation treatment; works in 1-3 days

MOA: Surfactant agent that mixes aqueous and fatty materials within the intestinal tract

SE: low
Nutrition: safe and effective for up to 6 months

27
Q

What drug is the first step in IBS-D therapy?

A

Loperamide

28
Q

Describe Sulfasalazine.
What is its MOA?
Side Effects?
Nutrition/counseling points?

A

The first step in IBD drug therapy; an aminosalicylate

MOA: Inhibits inflammatory mediator production from both COX and lipoxygenase pathways (suppression of IL-1 production and inhibition of leukotriene and prostaglandin prod)

SE/Points:
• N/V/D, take with food
• Take w/ 8oz water to prevent crystalluria
• 1 mg/day folic acid tablet to prevent folate deficiency
•capsules can be opened and mixed with applesauce or yogurt if have swallowing disorder

29
Q

Give the five steps in drug therapy for IBD

A
  1. aminosalicylates (Sulfasalazine)
  2. Corticosteroids (Predisone)
  3. Immunosuppressive agents
  4. TNF Inhibitors
  5. Antibiotics
30
Q

Describe Predisone.
What is its MOA?
Side Effects?
Nutrition/counseling points?

A

Corticosteroid

MOA: Modulate immune system and inhibit production of cytokines and mediators

SE: hyperglycemia, hypertension, increased appetite/weight gain, fluid retention, GI upset, osteoporosis

Counseling Points: Have to be tapered off of usage; if not adrenal gland will go crazy b/c it has been relying on it

31
Q

When would you use Prednisone as first-choice drug in IBD therapy?

A

If patient is showing acute symptoms in ER, so can reduce inflammation right away

32
Q

Give the pathophysiology of ascites

A

Cirrhosis → portal hypertension → NO overproduction → splanchnic arterial vasodilation → reduced arterial pressure → activation of renin-angiotensin-aldosterone system → release of antidiuretic hormone → renal sodium and water retention

33
Q

What are the three goals of diuretics in treating ascites/edema? What is each trying to prevent?

A
  • To maintain urine volume: renal failure
  • To mobilize edema fluid: heart failure, liver failure
  • To manage hypertension

HN 320 Clinical Nutrition I (10 decks)

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