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GK Pharm 2 Exam 2 > GI Motility 1 > Flashcards

GI Motility 1 Flashcards

1
Q

Drugs stimulating GI motility

  • What is the name of the agent that can selectively stimulate gut motor function?
A

Prokinetic

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2
Q

Submucosal IPANs activate the enteric neurons responsible for what 2 activities?

A
  • Peristaltic & Secretory reflex activity
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3
Q

Stimulation of 5-HT4 receptors on presynaptic terminals of IPANs enhances release of what 2 substances, therefore promoting reflex activity?

A
  • acetylcholine (ACh)
  • Calcitonin gene related peptide (CGRP)
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4
Q

What 3 drugs stimulate GI motility?

A
  • Cholinomimetic Agents (cholingergic or anticholinesterase)
  • Metoclopramide (dopamine & serotonin antagonist)
  • Macrolides (erythromycin antibiotic) motilin receptor
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5
Q

What are the 2 Cholinomimetic Agents?

A
  • Bethanechol
  • Neostigmine
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6
Q

Which Cholinomimetic Agent?

  • Stimulates muscarinic M3 receptors on muscle cells and at myenteric plexus synapses
  • History of use in the treatment of GERD and gastroparesis
A

Bethanechol

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7
Q

Which Cholinomimetic Agent?

  • Ach inhibitor
    • enhance gastric, small intestine, and colonic emptying
A

Neostigmine

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8
Q

What are the 5 ADEs of Cholinomimetic Agents?

(Drugs stimulating GI motility)

A

(Cholinergic effects)

  1. Excessive salivation
  2. Nausea
  3. Vomiting
  4. Diarrhea
  5. Bradycardia
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9
Q

4 uses of Cholinomimetic Agents

A
  • GERD
  • Impaired gastric emptying
  • Non-ulcer Dyspepsia
  • Prevention of vomiting
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10
Q

Which medication is used to tx the following:

  • treatment of symptomatic GERD
  • not effective in patients with erosive esophagitis
  • use prokinetic agents + antisecretory agents in pts with regurgitation or refractory heartburn
A

Cholinomimetic Agents

(Bethanechol & Neostigmine)

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11
Q

Which medication is used to tx the following:

Impaired Gastric Emptying

  • delayed gastric emptying due to postsurgical disorders (vagotomy, antrectomy)
  • diabetic gastroparesis
A

Cholinomimetic Agents

  • Bethanechol
  • Neostigmine
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12
Q

Which medication is used to tx the following:

  • Symptomatic improvement in a small number of patients with chronic dyspepsia
A

Cholinomimetic Agents

  • Bethanechol
  • Neostigmine
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13
Q

T/F

  • Cholinomimetic agents are approved by FDA and available in the US for postpartum lactation stimulation
A

False

  • NOT approved by FDA or available in the US for this purpose
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14
Q

Which medication?

  • Blocks dopamine D2 receptors in CTZ
  • increases esophageal peristalsis
  • enhances gastric emptying
A

Metoclopramide

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15
Q

ADEs of Metoclopramide

A

Extrapyramidal effects:

  • dystonia, akathisia,
  • Tardive dyskinesia

- elevated prolactin levels: galactorrhea, gynecomastia, impotence, menstrual d/o.

_**avoid long term uses especially in the elderly_

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16
Q

Which drug?

  • Directly stimulate motilin receptors on GI smooth muscle
  • Tolerance rapidly develops
  • Used in patients with acute upper gastrointestinal hemorrhage to promote gastric emptying of blood before endoscopy
A

Erythromycin

(Cholinomimetic Agents - Macrolides)

17
Q

4 medications which cause Constipation

A
  • Opiates
  • Calcium Carbonate Antacids
  • Diuretics
  • Iron preparations
18
Q

Laxatives

  • Intermittent constipation is best prevented with what 4 things?
A
  • High fiber diet
  • Adequate fluid intake
  • Regular exercise
  • Pooping when you need to
19
Q

If the patient suffers from constipation due to a secondary cause/disease, what is first line tx?

A

Treat the underlying cause

20
Q

If a patient suffers from constipation and has no underlying diagnosis, how should you treat? (5)

A

Choose symptomatic therapy

  1. add bulking agents to diet
  2. If no relief with bulking agents: add Osmotic laxative (PEG)
  3. If no relief with osmotic laxative: add stimulant laxative (Bisacodyl)
  4. If none of the above work, use: Lubiprostone or Linaclotide trial
  5. Opioid receptor antagonist (if opioid induced)
21
Q

What types of laxatives are these?

  • Non-absorbable sugars or salts
  • polyethylene glycol
A

Osmotic Laxatives

22
Q

What are the 2 stimulant laxatives?

A

Anthraquinone Derivatives (senna, cascara)

Diphenylmethane Derivatives (Bisacodyl)

23
Q

What type of Laxative?

  • Lubiprostone
A

Chloride Channel Activator

24
Q

Which type of laxative?

  • Linaclotide
  • Plecanatide
A

Guanylate Cyclase C Agonists

25
Q

What do these agents do?

  • Magnesium citrate
  • Magnesium hydroxide
  • Magnesium sulfate (high dose)
  • Sodium phosphates
  • Bisacodyl
  • Polyethylene glycol-electrolyte preparation
A

Cause watery evacuation in 1 - 6 hours

26
Q

Which laxative?

  • Indigestible, hydrophilic colloids that absorb water, forming a bulky, emollient gel that distends the colon and promotes peristalsis
A

Bulk-Forming Laxatives

(Psyllium & Methylcellulose)

27
Q

What is the name of the bulk forming laxative made w/ synthetic fibers?

A

Polycarbophil

28
Q

What are the 2 names of the common preparations of bulk forming laxatives which include natural plant products?

A
  • Psyllium
  • Methylcellulose
29
Q

Bulk Forming Laxatives

  • Bacterial digestion of plant fibers within the colon may lead to an increase in what 2 sxs?
A
  • bloating
  • flatus
30
Q

Which laxative?

  • mixing of aqueous and fatty materials within the intestinal tract
  • agent include: docusate (oral or enema)
A

Stool Surfactant Agents (Softeners)

31
Q

Which laxative?

  • clear, viscous oil that lubricates fecal material, retarding water absorption from the stool
  • used to prevent and treat fecal impaction in young children and debilitated adults
A

Mineral Oil

(Stool Surfactant Agents = Softeners)

32
Q

Which laxative?

•CAUTION–aspiration can result in a severe lipid pneumonitis

•long-term use can impair absorption of fat-soluble vitamins (A, D, E, K)

A

Mineral Oil

33
Q

What laxative do you use for acute constipation or prevention of chronic constipation?

A

Osmotic

34
Q

Which laxative?

  • commonly used osmotic laxative
  • not be used for prolonged periods in patients with renal insufficiency due to the risk of hypermagnesemia
A

Magnesium Hydroxide - (milk of magnesia)

35
Q

Which 2 laxatives?

  • nonabsorbable sugars that can be used to prevent or treat chronic constipation
  • sugars are metabolized by colonic bacteria, producing severe flatus and cramps
A
  • Sorbitol
  • Lactulose

GK Pharm 2 Exam 2 (19 decks)

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