pharm 2

Question 1

prokinetic agents

Answer 1

are used for GERD

Question 2

bethanechol (urecholine)

Answer 2

it is a cholinergic agent that is used when there is urinary retention happening

Question 3

metoclopramide is a

Answer 3

serotonin receptor modulator and a dopamine receptor modulator that works by blocking the dopamine receptor and suppressing the release of Ach which decreases transit time and stimulating the serotonin receptor that promotes motility

Question 4

side effects of blocking the dopamine receptor

Answer 4

parkisonian movements

Question 5

side effect of blocking the serotonin receptor

Answer 5

serotonin syndrome

Question 6

psyllium, methylcellulose, polycarbophil

Answer 6

bulk forming agents

Question 7

docusate and mineral oil

Answer 7

softeners/surfactants

Question 8

saline based agent, sugar/alcohol-based agent

Answer 8

osmotic agents

Question 9

bisacodyl, senna, cascara

Answer 9

stimulants for constipation

Question 10

bulk forming agents

Answer 10

are a source of fiber that enhances stool mass but can lead to bloating and abdominal pain so it is good to avoid if there is suspicion of obstruction. there might also be some drug interactions of absorption

Question 11

metamucil

Answer 11

natural bulk forming agent

Question 12

softeners/surfactants

Answer 12

lowers surface tension of stool but could lead to impaired absorption of fat soluble agents, oil leakage and lipid pneumonitis

Question 13

docusate

Answer 13

is a softeners that needs to combined with other laxative agent

Question 14

osmotic agents

Answer 14

osmotically-mediated water retention stimulates peristalsis but can lead to abdominal discomfort and flatulence and if it is saline based agent then we also need to be concerned with patients who have a renal or cardio disease, underlying electrolyte disorder.

*monitor Ca, K, Mg, Na and Phos

Question 15

because glycerin is sugar/alcohol based osmotic agent it needs to be coated enterically?

Answer 15

yep, we do not want it to be absorbed before reaching the site of action

Question 16

polyethylene glycol

Answer 16

it is an osmotic agent that comes from the same family of antifreeze but has no of those pesky side effects due to it being too large to be absorbed

Question 17

stimulant laxatives

Answer 17

produce migrating colonic contractions but we want to make sure we don’t overuse

Question 18

type 2 chloride channel agonists and guanylate cyclase agonists are used for

Answer 18

chronic idiopathic constipation, irritable bowel constipation and opioid used constipation

Question 19

tegaserod

Answer 19

is a serotonin receptor agonist that is used for IBS-C in women <65 years. it was thought that it had a great potential of causing ischemia and thus is just recently got approved and it is not prescribed to patients older than 65 due to their increase chance of ischemic events

Question 20

peripherally acting Mu-opioid receptor antagonist

Answer 20

they go to the bowel and antagonize Mu receptor to decrease constipation

Question 21

opioids such as loperamide can be used as

Answer 21

antimotility agents

Question 22

what efflux keeps loparamide out of the brain

Answer 22

P-gp

Question 23

what can happen is there is too much loparamide?

Answer 23

it can overwhelm the p-pg efflux transporter located in the BBB

Question 24

clonidine is a

Answer 24

alpha-2 receptor agaonist that supresses the release of epinephrine and is used as an anti-diarrheal but can cause rebound effect if suddenly taken away

Question 25

alosetron black box warning

Answer 25

ischemic colitis

Question 26

alosetron is used

Answer 26

when the primary symtpom is diarrhea; it is a serotonin receptor antagonist

Question 27

rifaximin

Answer 27

anti-diarrheal that has antibiotic effects but the great thing about it, is that it does not get absorbed systemically, it only changes the flora to exerts its effects

Question 28

crofelemer

Answer 28

blocks cl- channels and mainly used in people with HIV who have a watery diarrhea