Module 13 agents affecting GI motility

Question 1

Antidiarrheal meds

Answer 1

bismuth subsalicylate (pepto)
loperamide
opium derivaties

Question 2

bismuth subsalicylate MOA

Answer 2

coats lining of GI tract and soothes irritation, preventing stimulation of local reflexes that cause excessive GI activity and diarrhea

Question 3

bismuth subsalicylate AE

Answer 3

black coating on tongue

Question 4

busmuth subsalicylate CI

Answer 4

renal failure

Question 5

loperamide MOA

Answer 5

mu opioid agonist
does not cross BBB
-> slows peristalsis, inc. time for absorption

Question 6

loperamide AE

Answer 6

abd. pain
N/V
bloating

Question 7

loperamide CI

Answer 7

less than 2 y/o: fetal paralytic ileus
fever
e.coli/salmonella infections

Question 8

laxatives MOA

Answer 8

promote defecation
retain fluid in GI tract
- dec. H2O absorption (salts produce osmotic effect, draw H2O in)
- inc. intestinal motility (inc. peristalsis)
- soften stool (surface active agents)
add bulk to stool

Question 9

Saline and osmotic laxatives meds

Answer 9

polycarbophyl 
methylcellulose psyllium 
methylcellulose
calcium polycarbophil 
mg salts
milk of mg
mg hydroxide
mg citrate
Na phosphate (enema)
lactulose
glycerin 
sorbitol

Question 10

saline and osmotic laxative MOA

Answer 10

inc. fecal bulk
inc. GI motility by inc. fluid in GI tract
stimulate stretch receptors

Question 11

Stimulant Laxatives meds

Answer 11

Senna
bisacodyl
castor oil
mineral oil

Question 12

stimulant laxative MOA

Answer 12

direct action on intestinal mucosa
stimulate myenteric plexus
alter H2O and electrolyte secretion

Question 13

Senna admin

Answer 13

tablets, granules, syrup

onset: 6-10hours

Question 14

bisacodyl admin

Answer 14

PO, suppository

onset: 15-60 minutes

Question 15

castor oil admin

Answer 15

onset: 2-6 hours

avoid in pregnancy

Question 16

mineral oil admin

Answer 16

Onset: 6-8 hours

Question 17

mineral oil MOA

Answer 17

lines GI tract

prevents absorption of water and electrolytes

Question 18

Saline and osmotic laxative use

Answer 18

retain H2O in intestinal lumen, inc. intra-luminal pressure -> cholecystokinin release

• empty bowel before surgery or colon procedures
• evacuates bowel in 3 hours

Question 19

Surfactant/stool softeners MOA

Answer 19

detergent activity

facilitates water to soften stool

Question 20

surfactant/stool softener meds

Answer 20

docosate sodium

docosate calcium

Question 21

docosate use

Answer 21

prevention of post-op and opioid induced constipation

- often in combo with senna

Question 22

Lanaclotide MOA

Answer 22

stimulates intestinal fluid secretion and transit

- long term risks unknown

Question 23

lanaclotide use

Answer 23

IBS with constipation

Question 24

lubiprostone MOA

Answer 24

locally acting Cl channel activator that enhances Cl-rich intestinal fluid secretion

Question 25

lubiprostone use

Answer 25

IBS with constipation