NVDC

Question 0

Sub mucosal plexus

Answer 0

Control secretions

Question 1

Myenteric plexus

Answer 1

Sympathetic and parasympathetic

GI tract motility

Question 2

Laxative (formed) & cathartic (unformed fecal material

Answer 2

Increase bulk and softness by retaining water in the colon

Decrease water absorption from colon

Increase motility, reduce transit time

Quick relief: glycerine suppository, water enema, milk of magnesia

Question 3

Dietary fiber

Answer 3

Cellulose (plants)

Colonic bacteria

Question 4

Bulk forming laxative

Answer 4

Starch/cellulose draws water bulk

Psyllium (Metamucil) good if bed-ridden

Question 5

Osmotic/saline laxative

Answer 5

Uses ions, sugars to draw water bulk (stimulates peristalsis)

Milk of magnesia
Sodium phosphate

Sorbitol, mannitol, PEG

Question 6

Stimulant laxative

Answer 6

Bisacodyl
Senna
Castor oil- coats GIT

Stimulate inflammation

Question 7

Stool softener

Answer 7

Docusate

Docusate - mush
Senna - push

Question 8

Lubricant laxative

Answer 8

Mineral oil

Coats fecal contents and prevents water from being absorbed from stool

Avoid if bed-ridden, risk of aspiration

Question 9

Methylnaltrexone, alvimopan

Answer 9

Mu opioid receptor antagonist

Indicated for opioid constipation

Alvimopan for post-op ileus

Question 10

Dexpanthenol

Answer 10

Converted to coenzyme A and increases synthesis of ACh

Stimulate GIT

Question 11

Bethanechol

Answer 11

Muscarinic ACh receptor agonist

Pro kinetic

Question 12

Metoclopramide

Answer 12

5HT4 agonist
dopamine 2- antagonist

Prokinetic for constipation

Question 13

Erythromycin

Answer 13

Motilin receptor agonist

Prokinetic

Question 14

Domperidone

Answer 14

Dopamine 2 antagonist

Prokinetic

Question 15

Cisapride

Answer 15

5HT4 agonist

Prokinetic

Question 16

Antidiarrheals

Answer 16

Constipate, slow gut, retain water

Question 17

Loperamide

Diphenoxylate

Answer 17

Mu opioid receptor agonist

Constipated and reduce motility

Lomotil has atropine to discourage abuse (BLURDC)

Question 18

Octreotide

Answer 18

Blocking release of 5HT, insulin, secretin hormones

Inhibit secretory diarrhea

Question 19

Bile salt binding resin

Answer 19

Bind bile salt to prevent reabsorption of bile out of colon and form soluble complex

Question 20

Polycarbophil

Answer 20

High water binding capacity for diarrhea

Question 21

Psyllium diarrhea

Answer 21

Soluble fiber absorbs water and adds bulk to stool

Question 22

Travelers diarrhea

Answer 22

Loperamide +/- TMP/ SMX or cipro

Question 23

Beano alpha galactosidase

Answer 23

Hydrolase breaks down polysaccharide sugars

Question 24

Simethicone (gas-X)

Answer 24

Decrease surface area of bubbles - antifoaming

Question 25

Emetic center

Answer 25

Medulla Stimulated by 5HT3, D2, H1, ACh muscarinic

Question 26

Ondansetron

Answer 26

5HT3 antagonist For CINV, PONV (can be combined with dexamethasone)

Question 27

Metoclopramide Chlorpromazine Haloperidol

Answer 27

D2 antagonists Phenothi-AZINEs May cause EPS Chlorpromazine- antipsych also Metoclopramide good for refractory CINV

Question 28

Meclizine, hydroxyzine

Answer 28

H1 antagonist & anticholinergic For opiate nausea, motion sickness

Question 29

Scopolamine

Answer 29

Muscarinic antagonist Vertigo, dizziness

Question 30

Drugs that cause N/V

Answer 30

Opioids, NSAIDs, digoxin, erythromycin, metformin

Question 31

CINV

Answer 31

Ondansetron (acute) Metoclopramide Dronabinol Nabilone

Question 32

Drug induced diarrhea

Answer 32

``` ACE inhibitor Cholinergic (activate gut) Digoxin NSAIDs PPIS H2RA Metformin ```

Question 33

Drug-induced constipation

Answer 33

``` Opioid Anticholinergic Aluminum antacid Diuretic CCB ```

Question 34

Soluble fiber

Answer 34

For diarrhea: slow digestion Nuts, seeds, psyllium

Question 35

Insoluble fiber

Answer 35

For constipation: help pass more quickly Wheat, whole grain

Question 36

Diverticulitis

Answer 36

Treat: increase fiber in diet