NVDC Flashcards
Sub mucosal plexus
Control secretions
Myenteric plexus
Sympathetic and parasympathetic
GI tract motility
Laxative (formed) & cathartic (unformed fecal material
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
Dietary fiber
Cellulose (plants)
Colonic bacteria
Bulk forming laxative
Starch/cellulose draws water bulk
Psyllium (Metamucil) good if bed-ridden
Osmotic/saline laxative
Uses ions, sugars to draw water bulk (stimulates peristalsis)
Milk of magnesia
Sodium phosphate
Sorbitol, mannitol, PEG
Stimulant laxative
Bisacodyl
Senna
Castor oil- coats GIT
Stimulate inflammation
Stool softener
Docusate
Docusate - mush
Senna - push
Lubricant laxative
Mineral oil
Coats fecal contents and prevents water from being absorbed from stool
Avoid if bed-ridden, risk of aspiration
Methylnaltrexone, alvimopan
Mu opioid receptor antagonist
Indicated for opioid constipation
Alvimopan for post-op ileus
Dexpanthenol
Converted to coenzyme A and increases synthesis of ACh
Stimulate GIT
Bethanechol
Muscarinic ACh receptor agonist
Pro kinetic
Metoclopramide
5HT4 agonist
dopamine 2- antagonist
Prokinetic for constipation
Erythromycin
Motilin receptor agonist
Prokinetic
Domperidone
Dopamine 2 antagonist
Prokinetic
Cisapride
5HT4 agonist
Prokinetic
Antidiarrheals
Constipate, slow gut, retain water
Loperamide
Diphenoxylate
Mu opioid receptor agonist
Constipated and reduce motility
Lomotil has atropine to discourage abuse (BLURDC)
Octreotide
Blocking release of 5HT, insulin, secretin hormones
Inhibit secretory diarrhea
Bile salt binding resin
Bind bile salt to prevent reabsorption of bile out of colon and form soluble complex
Polycarbophil
High water binding capacity for diarrhea
Psyllium diarrhea
Soluble fiber absorbs water and adds bulk to stool
Travelers diarrhea
Loperamide +/- TMP/ SMX or cipro
Beano alpha galactosidase
Hydrolase breaks down polysaccharide sugars
Simethicone (gas-X)
Decrease surface area of bubbles - antifoaming
Emetic center
Medulla
Stimulated by 5HT3, D2, H1, ACh muscarinic
Ondansetron
5HT3 antagonist
For CINV, PONV (can be combined with dexamethasone)
Metoclopramide
Chlorpromazine
Haloperidol
D2 antagonists
Phenothi-AZINEs
May cause EPS
Chlorpromazine- antipsych also
Metoclopramide good for refractory CINV
Meclizine, hydroxyzine
H1 antagonist & anticholinergic
For opiate nausea, motion sickness
Scopolamine
Muscarinic antagonist
Vertigo, dizziness
Drugs that cause N/V
Opioids, NSAIDs, digoxin, erythromycin, metformin
CINV
Ondansetron (acute)
Metoclopramide
Dronabinol
Nabilone
Drug induced diarrhea
ACE inhibitor Cholinergic (activate gut) Digoxin NSAIDs PPIS H2RA Metformin
Drug-induced constipation
Opioid Anticholinergic Aluminum antacid Diuretic CCB
Soluble fiber
For diarrhea: slow digestion
Nuts, seeds, psyllium
Insoluble fiber
For constipation: help pass more quickly
Wheat, whole grain
Diverticulitis
Treat: increase fiber in diet
