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GIT & HEPATOBILIARY PMCLGY > Lecture 8 > Flashcards

Lecture 8 Flashcards

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1
Q

What is antispasmodic

A

A medication that relieves, prevents, or lowers the incidence of muscle spasms, especially those of smooth muscle such as in the bowel wall

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2
Q

Antispasmodic also called as what?

A

anticholinergic agents or spasmolytic agents

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3
Q

what is mebeverine?

A

“an antispasmodic agent which exerts direct action on the GI smooth muscle without affecting normal gut motility”

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4
Q

What is the mechanism of mebeverine

A

the exact mechanism is unknown, but multiple mechanisms might contribute to its local effect in the
GI tract, e.g. a decrease in ion channel permeabilities, blockade of norepinephrine reuptake, a local
anaesth effect, changes in water absorption and weak
anti-muscarinergic and phosphodiesterase inhibitory
effect.

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5
Q

What is the cautions for mebeverine

A

CAUTIONS-patient with cardiac disorders (e.g. heart block).

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6
Q

Doses for methscopolamine?

A

2.5 mg 1/2 hour before meals, 2.5-5 mg at bedtime

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7
Q

What is diarrhea ?

A

Diarrhea defined as an increased frequency and fluidity of bowel movements.

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8
Q

What is traveler’s diarrhea and what will it causes?

A

-Infectious disease of the gastrointestinal tract that
results in loose, urgent bowel movements, cramping, abdominal pain, malaise, nausea, and occasionally fever and dehydration.

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9
Q

what can be the cause of traveler’s diarrhea

A

acquired through ingestion of food or water
contaminated with fecal material typically containing
bacteria (especially Escherichia coli); viruses or
protozoan parasites are less common causes.

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10
Q

what is the mechanisms of action of loperamide?

A
  • reduces propulsive peristalsis and increases intestinal transit by binding to the opiate receptor in the gut wall.
  • increases the tone of the anal sphincter, thereby reducing incontinence and urgency
  • reduces steel frequency
  • decrease bowel movement
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11
Q

what is the cautions of loperamide?

A

CAUTIONS-patient with hepatic impairment.

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12
Q

What is the two type of treatment of diarrhea

A
  • SPECIFIC ( CAUSATIVE)TREATMENT

- NON SPECIFIC (SYMPTOMATIC)TREATMENT

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13
Q

what is antidiarrheal agents

A

A medication that be used safely in patients with mild to moderate acute diarrhea.

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14
Q

State 6 antidiarrheal agents

A
  1. GIT Protectives
  2. Antispasmodic
  3. Opiates
  4. Glucocorticoids
  5. Octreotide
  6. Bile salt binding resin
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15
Q

What is the cautions for antidiarrheal agents

A

Cautions:
● Should not be used in patients with
bloody diarrhea, high fever, or systemic toxicity.
● should be discontinued in patients whose diarrhea is
worsening despite therapy.

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16
Q

Explain GIT protectives

A

● Adsorbents : Kaolin, Bismuth, Chalk & Charcoal.
● Absorbents : Pectin, which is present in rice, carrots, apple.
● Astringents : Tr. Catechol → Release tannic acid in
intestine.

17
Q

Explain antispasmodic as antidiarrheal agent

A 
● Anticholinergics:
*Atropine methyl nitrate
*Hyoscine butyl bromide
* Dicyclomine
● Direct spasmolytics:
*Mebeverine
*Khelline
*Papaverine
*Aminophylline
*Nitrite
*Volatile oils
18
Q

Explain opiates

A

*Codeine *Diphenoxylate
(poor CNS penetration)
*Loperamide ( selective in GIT)

They ↓↓ propulsive
contractions &
↑↑ non-propulsive
(segmental) contractions.

Side effects.: Paralytic ileus - Sedation

19
Q

Explain glucocorticoids

A

● in refractory diarrhea as it ↑↑Na absorption

20
Q

Explain octreotide

A

● synthetic somatostatin analogue given parenterally
● ↓↓ Hcl - Pepsin -Gastrin - Secretin - VIP
- Sm.M.contraction
● Used in:
a) Refractory diarrhea
b) Symptomatic ttt of gut
tumors

21
Q

Explain bile salt binding resin

A

● Cholestyramine and colestipol binding to bile salt → ↓ diarrhea caused by excess fecal bile acids (Crohn’s disease).
● Disadvantages: Flatulence, constipation, fecal impaction

22
Q

what is the side effects of mebeverine

A

SIDE EFFECTS

  • Dizziness
  • Headache
  • GI disturbances
  • Insomnia
  • Anorexia
  • Decreased heart rate
23
Q

what are the side effects of loperamide

A

SIDE EFFECTS-abdominal pain or bloating, nausea and vomiting, constipation, dry mouth, drowsiness, dizziness, fatigue, epigastric pain, hypersensitivity reactions (e.g.rash)

24
Q

what are the causes of diarrhea?

A

CAUSES-acute infection, stress, fecal impaction, malabsorption disorders, ingestion of bowel irritants

GIT & HEPATOBILIARY PMCLGY (3 decks)

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