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Cology 2 Exam 4 > GI Pharmacology 2 - Slides 16-30 > Flashcards

GI Pharmacology 2 - Slides 16-30 Flashcards

1
Q

MOA of laxatives?

A

Increase motility
Increase water content of stool
Decrease colonic water and NaCl absorption (keeps more water in the stool)

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2
Q

Indications for laxatives?

A 
Prepare bowel for surgery
Hasten bowel excretion of toxins
Post-operative stimulation
Minimize straining in CV disease pts
Relief of TEMPORARY constipation
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3
Q

Contraindications for laxatives?

A

Underlying bowel disease

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4
Q

Side effects of laxatives?

A

Acute: Nausea, abdominal cramps, diarrhea

Chronic (Cathartic Colon Syndrome):
Mucosal inflammation
Atrophy of outer muscle layers
Damage to nerve plexus
Malabsorption, dehydration, protein loss
Disruption of intestinal flora
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5
Q

What types of laxatives are there?

A

Stimulants or irritants
Bulk forming - dietary fiber
Stool softeners
Osmotic agents

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6
Q

What is castor oil?

A

A laxative (stimulant/irritant), increases motility and electrolyte secretion

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7
Q

What is Senna?

A

A laxative (stimulant/irritant), increases colonic motility

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8
Q

What is Bisacodyl?

A

A laxative (stimulant, irritant), increases colonic motility

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9
Q

What is Phenothalin?

A

A laxative (stimulant/irritant) - was removed

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10
Q

Side effects of laxatives?

A

Abdominal cramps
Diarrhea
Muscle weakness

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11
Q

What type of laxative is the strongest?

A

Stimulants or irritants

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12
Q

Name the bulk forming, non-digestable dietary fibers

A

Psyllium

Methylcellulose

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13
Q

How should Psyllium, Methylcellulose be taken

A

Mixed with water before taking

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14
Q

How do Psyllium, Methylcellulose work?

A

They increase bulk and water content of stool to increase motility
Also increased volume augments peristalsis

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15
Q

Adverse effects of Psyllium, Methylcellulose?

A

Binds drug
Flatulence
Cramps

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16
Q

Name the stool softeners

A

Mineral oil
Glycerin
Docusate sodium (Colase)

17
Q

How do stool softeners work?

A

They emulsify with stool to increase water content and lubricate

18
Q

Name the osmotic agents

A

Magnesium sulfate
Magnesium hydroxide
Lactulose
Mannitol

19
Q

How do osmotic agents work?

A

Increase water content

Increase motility

20
Q

What is Diphenoxylate?

A

Atropine

Ant-diarrheal agent, increases water absorption and decreases GI motility locally

21
Q

What is Difenoxin?

A

Active metabolite of diphenoxylate
Atropine
Ant-diarrheal agent, increases water absorption and decreases GI motility locally

22
Q

What is Loperimide?

A

Ant-diarrheal agent, increases water absorption and decreases GI motility locally

23
Q

Adverse effects of anti-diarrheal agents?

A

Constipation
Exaggerated GI effects
Megacolon

24
Q

What is Bismuth subsalicylate?

A

Inhibits intestinal secretions
Effective in INFECTIOUS diarrhea
Taken frequently
Worry about bismuth and salicyalate toxicity

25
Q

What is Kaopectate?

A

Anti-diarrheal agent

Now contains bismuth subsalicylate

26
Q

What is Ulcerative collitis?

A

Confluent inflammation of mucosal layer of the colon

27
Q

What is Chron’s disease?

A

Transmural nonconfluent inflammation of submucosal layer near ileocecal valve leads to strictures and fistulas

28
Q

What is Mesalamine?

A

5-ASA
Metabolized to 5-ASA in colon
Exact mechanism unknown
Inhibits TNF, IL-2, NF-KB

29
Q

Toxicities of Mesalamine?

A

Headache
Dyspepsia
Sulfa
Headache, fatigue, allergic reactions

30
Q

What is Sulfasalazine?

A

Prodrugs for 5ASA in ulcerative collitis

31
Q

What is Olsalazine?

A

Prodrug for 5ASA in ulcerative collitis

32
Q

What is Balsalazide?

A

Prodrug for 5ASA in ulcerative collitis

33
Q

Where do Sulfasalazine and Osalazine release 5ASA?

A

In the colon

34
Q

How do dif Mesalamine preparations differ?

A

Vary in where along the GI tract 5 ASA is released

Sulfasalazine and Osalazine release 5 ASA in the colon

35
Q

Other tx for IBS (Chrohn’s disease)?

A

Glucocorticoids
Azathioprine, 6-Mercaptopurine (severe chrohn’s disease after surgery)
Methotrexate
Cyclosporine
Infliximab (anti TNF antibody)
Antibiotics (Metronidazole, ciprofloxacin, clarithromycin)

Cology 2 Exam 4 (16 decks)

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