Motility Flashcards
What are some drugs that cause diarrhea?
LOTS
ex. laxatives, antacids containing Mg, antineoplastics, Auranofin, abx, antihypertensives, etc.
Tx goals for managing diarrhea?
Manage diet
Prevent excessive water, electrolyte, and acid–base disturbances
Provide sxs relief
Tx curable causes
Manage secondary disorders causing diarrhea
sxs tx for pts with diarrhea who have no fever or systemic sxs?
fluid/electrolyte replacement
Loperamide, Diphenoxylate or absorbent
diet
What is considered chronic diarrhea?
diarrhea >14 days
Possible causes for chronic diarrhea?
Intestinal infx
inflammatory bowel disease
malabsorption
secretory hormonal tumor
drug, factitious
Motility
Tx for chronic diarrhea with no specific diagnosis?
replete hydration
discontinue potential drug inducer
adjust diet
Loperamide or absorbent
What are some antidiarrheal agents?
antimotility: opioid agonists
adsorbents
antisecretory
Bacterial replacement and enzymes
Ex of adsorbent agents?
kaolin-pectin mixture
Polycarbophil
Attapulgite
Ex. of antisecretory agents?
Colloidal Bismuth
Compounds
Bile Salt-Binding Resins
Octreotide
In which pts should antidiarrheal agents NOT be used?
patients with bloody diarrhea, high fever, or systemic toxicity
MOA of opioid agonists?
constipating effects
increase colonic phasic segmenting activity by inhibition of presynaptic cholinergic nerves in the submucosal and myenteric plexuses > increased colonic transit time and fecal water absorption
decrease mass colonic movements and the gastrocolic reflex
Describe loperamide
no-Rx opioid agonists
does not cross BBB, no analgesic properties
Describe Diphenoxylate
Rx opioid agonists
no analgesic properties in standard dose
anticholinergic properties of atropine may contribute to the antidiarrheal action
MOA of adsorbent anti-diarrheal agents?
Adsorb nutrients, toxins, drugs, and digestive juices
