Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PC 707 Pharmacology > Module 3: GI Unit B > Flashcards

Module 3: GI Unit B Flashcards

1
Q

Contraindication for laxative use for ALL laxatives?

A

patients with undiagnosed abdominal pain, nausea, vomiting, or suspected bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is your first line laxative choice?

A

Osmotic such as lactulose, magnesium, and polyethylene glycol (Miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Second line laxative choice?

A

bulk-forming laxatives (Metamucil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MOA of bulk forming laxatives?

A

Absorb water, soften and enlarge fecal mass, and promotes peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Safety considerations/contraindications/

D2D with bulking laxatives?

A

Take with a full glass of water to avoid esophageal obstruction.

Do not use if there is a narrowing of the intestinal lumen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What bulking laxative is good in pregnancy?

A

Methylcellulose (Citrucel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MOA of Surfactant laxatives or stool softeners

A

facilitate the movement of water into the stool by lowering surface tension. Surfactant laxatives also alter stool consistency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Examples of surfactant or stool softeners?

A

Docusate Sodium (Colace)
Docusate calcium
Mineral oil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Safety consideration with mineral oil?

A

Frequent use of mineral oil can deplete fat-soluble vitamins (ADEK). Category X for pregnancy due to causing contractions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MOA of stimulant laxatives?

A

Stimulate intestinal motility and increase the amount of water and electrolytes in the intestinal lumen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Examples of stimulant laxatives?

A

Bisacodyl
Senna
Castor oil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Time of onset of stimulant laxatives?

A

6 to 12 hours. Fastest onset of all, can be explosive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What specific constipation indication are simulant laxatives used for?

A

opioid-induced constipation. Treatment of constipation in an individual with slowed transit time (paraplegia or quadriplegia).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which class of laxatives has a history of abuse and should be used cautiously in patients with eating disorders?

A

Stimulant laxatives.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examples of osmotic laxatives?

A 
Polyethylene glycol (PEG) (Miralax)
Lactulose 
Magnesium Hydroxide
Magnesium Sulfate
Magnesium citrate
Sodium phosphate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOA of osmotic laxatives?

A

Retains water which causes the fecal mass to soften and swell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Time of onset for osmotic laxatives Miralax (PEG)?

A

1-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Safety considerations with osmotic laxatives?

A

Can cause substantial water loss.

Use of laxative salts can cause worsening of heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Safety considerations with sodium phosphate (osmotic laxative)?

A

exacerbates heart failure, HTN, and edema. Can cause acute renal failure. Do not use in patients with renal impairment or with patients on ACES or ARBS. More than one dose in 24 hours can case harm to kidneys, heart, and possibly death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What patients should not use Magnesium (osmotic laxative)?

A

patients with renal impairment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What osmotic laxative is recommended for children?

A

Miralax (PEG), lactulose

22
Q

Time of onset for osmotic laxative Magnesium and sodium salt?

A

Low doses can have an effect within 6-12 hours. High-dose therapy can have an effect within 2-6 hours.

23
Q

Side effect of Miralax (PEG)?

A

Flatulence and cramping

24
Q

Examples of Chloride channel activators laxatives?

A

Lubiprostone (Amitiza)

25
Q

Indication for Chloride channel activators: Lubiprostone (Amitiza)?

A

Chronic Idiopathic Constipation in adults
IBS-C in women > 18 years old
Treatment of opioid-induced constipation

26
Q

MOA of Chloride channel activators (Amitizia):

A

Activates chloride channels in the intestine, increases chloride-rich fluid in the intestines, and increases motility.

27
Q

Examples of Guanylate cyclase-C agonists laxatives?

A

Linaclotide (Linzess),

Plecanatide (Trulance)

28
Q

Indication for Guanylate cyclase-C agonists laxatives?

A

Chronic Idiopathic Constipation in adults

IBS-C

29
Q

MOA of Guanylate cyclase-C agonists?

A

Activation of Guanylate cyclase-C stimulates the secretion of chloride and bicarb in the intestinal lumen.

30
Q

Safety considerations with Guanylate cyclase-C agonists (Linzess and Trulance)?

A

Avoid in pts 6-18. Can cause serious dehydration. Contraindicated in those less than 6.

31
Q

What does “Red Flag” mean in terms of treatment?

A

Suggest organic causes of constipation and require referral for evaluation and treatment

32
Q

What are the “Red Flags” for your consideration in treating constipation in children?

A 
Constipation starting extremely early in life (<1 mo)
Passage of meconium >48 h
Family history of Hirschsprung’s Disease (HD). 
Blood in the stool
Failure to thrive
Fever
Bilious vomiting
Severe abdominal distension
33
Q

Name two good laxatives for treating children with constipation.

A

Polyethylene glycol (Miralax) and lactulose

34
Q

What are the two main categories of diarrhea?

A

Acute or chronic

35
Q

What is the first step in the treatment of diarrhea?

A

determining the etiology

36
Q

Why do we typically delay using medications to treat diarrhea?

A

For acute diarrhea, typically antidiarrheals are not given in the first couple of days because the body needs to rid itself of the offending pathogen.

37
Q

While most acute diarrhea is self-limiting, what conditions might indicate treatment is needed?

A

children, the elderly, and anyone who may be at risk of dehydration, weight loss, and more serious consequences.

38
Q

What is the best treatment for drug-induced diarrhea?

A

Stop the drug.

39
Q

What are the most effective antidiarrheals?

A

Opioids (Lomotil-ScheduleV) are one of the most effective antidiarrheals available. They activate receptor sites in the GI tract and slow intestinal transit time.

40
Q

Which antidiarrheal contains salicylate?

A

Pepto-Bismol and Kaopectate

41
Q

Who needs to avoid salicylate?

A

Do not use in same conditions that ASA is contraindicated (pregnant, previous MI, children with a viral infection, bleeding or clotting disorders, or medications that interact with ASA).

42
Q

Which antidiarrheals are the best choice of treatment for diarrhea caused by parasites?

A

an antibiotic and a medication that slows intestinal transit time (Loperamide, Imodium®) are given together

Treatment is unnecessary unless the patient is severely ill, running a high fever, or symptoms last longer than 7 days

43
Q

What is a good anti-diarrhea medication for pregnancy, if indicated?

A

Loperamide (Imodium) is pregnancy category B and is the first-line therapy for diarrhea during pregnancy and breastfeeding.

44
Q

MOA of Imodium?

A

Structural analog of meperidine. Causes decreased secretions and decreased peristalsis.

45
Q

MOA of opioid anti-diarrheal Lomotil?

A

Diphenoxylate Structural analog of meperidine. Causes decreased secretions and decreased peristalsis. Atropine is an anticholinergic that helps dry up body fluids and slow gut movement.

46
Q

Safety considerations with Lomotil?

A

Schedule V

The use of opioids in patients with IBD may result in toxic megacolon.

47
Q

MOA of Bismuth subsalicylate?

A

Antisecretory, antimicrobial and anti-inflammatory.

48
Q

Side effects of bismuth subsalicylate?

A

It can cause”black hairy tongue” and black tarry stools.

49
Q

Examples of Bismuth subsalicylate anti-diarrheals?

A

Pepto-Bismol, Kaopectate

50
Q

What cause of diarrhea would you prescribe Flagyl for?

A

Giardia and E. histolytic

51
Q

What drugs should not be used in pregnant people?

A

cytotec- causes uterine contractions
sodium bicarb (Alka Selzter)- risk of fetal alkalosis or fluid overload
bismuth (Pepto)- because ASA component it is contraindicated in pregnancy
Mineral oil

52
Q

Examples of bulk-forming laxatives?

A

Methylcellulose (Citrucel)

Psyllium (Metamucil)

PC 707 Pharmacology (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions