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GI > Pharm 24 drugs > Flashcards

Pharm 24 drugs Flashcards

1
Q

Use of natural and synthetic fiber?

A

Softens and increases fecal mass, used for maintenance for constipation

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2
Q

List the 3 major bulk forming laxatives

A

Psyllium

Polycarbophil

Methylcellulose

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3
Q

Psyllium (Metamucil) clinical use?

A

Constipation

Hypercholesterolemia

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4
Q

Psyllium (Metamucil) ASEs?

A

Flatulence

Borborygmi

Abdominal pain

Anorexia

N/V/D

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5
Q

Psyllium (Metamucil) is formed from seeds of plantago psyllium, what are some warnings w/ use of this drug?

A

Chocking/esophageal obstruction

Allergic reaction

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6
Q

Polycarbophil clinical use?

A

Soften and stabilizes content

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7
Q

Methylcellulose clinical uses?

A

Constipation

More stable than psyllium, less flatulence and non-allergic.

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8
Q

Docusate Sodium clinical use?

A

Only good for softening “mush” not useful for “push”

less effective than psyllium

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9
Q

Docusate Sodium ASEs?

A

Usually well tolerated

Rash + throat irritation

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10
Q

List lubricants used

A

Mineral and castor oil

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11
Q

Lubricant clinical use?

A

Coats intestinal content, prevents absorption of water, and helps maintain a soft stool

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12
Q

Lubricant ASEs?

A

skin irritation and fecal urgency

Don’t give at bedtime

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13
Q

List secretory/osmotic drugs

A

Sugar alcohols (Sorbitol)

Polyethylene Glycol

Sodium phosphate

Magnesium

Glycerin

Lactulose

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14
Q

Sorbitol MOA?

A

stimulates bowel movement, increases water content in large intestine

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15
Q

Sorbitol ASEs?

A

Abdominal pain

Angina

Back pain

Flatulence

GI bleed

Vertigo

N/V

Xerostomia

Hyperglycemia

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16
Q

Polyethylene glycol (MiraLAX) MOA?

A

Binds to water, retains water, softens stool, increases stool frequency, helps induce evacuation.

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17
Q

Polyethylene glycol (MiraLAX) ASEs?

A

Rhinorrhea

Flatulance

Fecal urgency

Urticaria

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18
Q

Sodium Phosphate MOA?

A

Draws water into intestinal lumen, softens, stretches wall, and stimulates peristalsis.

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19
Q

Sodium Phosphate ASEs?

A

Dehydration

Renal Tox

Sodium retention

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20
Q

Magnesium Hydroxide MOA?

A

Unabsorbed magnesium draws water into the intestine, increases pressure, and increases motility.

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21
Q

Magnesium Citrate is only used in?

A

Severe cases

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22
Q

Glycerin 1st line for who?

A

Babies who are constipated

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23
Q

Glycerin MOA?

A

osmotically draws water into the colon aiding in defication

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24
Q

List surface active/stimulant laxatives

A

Senna

Bisacodyl

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25
Q

Surface active/stimulant laxatives MOA?

A

Stimulate sensory nerve endings produce parasympathetic reflexes and peristalsis.

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26
Q

Senna ASEs?

A

Hypocalcemia

Hypokalemia

Urine/stool discoloration

Clubbed finngers

Nephritis

Severe electrolyte imbalances

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27
Q

Bisacodyl ASEs?

A

More GI irritation

Proctitis (w/rectal suppository)

Hypokalemia

28
Q

Lactulose MOA?

A

Breaks down bacteria from lactose into lactic acid

Local acidity ionizes ammonia to ammonium

29
Q

Lactulose unique use?

A

Useful to lower GI ammonia absorption in pts w/ hepatic encephalopathy

30
Q

Lactulose AESs?

A

Abdominal pain

Diarrhea

Flatulance

N/V

Hypokalemia

Hyponatremia

Metabolic acidosis

31
Q

List opioid antagonists

A

Naloxegol

Methylnalrexone

32
Q

Naloxegol clinical use?

A

FDA indicated for tx of OIC

chronic and non-cancer pain

33
Q

Naloxegol is contraindicated in?

A

Pts receiving strong CYP3A4 inhibitors (clarythromycin, ketoconazole)

pts w/GI obstruction d/t perforation.

34
Q

Naloxegol ASEs?

A

Abominal pain

Diarrhea

Flatulence

N/V

Arthralgia

HA

W/d sign and sxs

35
Q

List pro-secretory drugs used for IBS-C

A

Lubiprostone

Linaclotide

Plecanatide

36
Q

Lubiprostone MOA?

A

Chloride channel activator

acts locally on membrane on the GI tract to increase intestinal fluid secretion and improve fecal transit in IBS and OIC.

37
Q

Linaclotide and Plecanatide MOA?

A

Increase secretion of chloride and bicarbonate

bypass antisecretory effects of opiates, suppresses secretomotor neuron excitability

38
Q

Contraindications of pro-secretory drugs?

A

<6 yrs of age = risk for dehydration.

39
Q

Loperamide (imodium) MOA?

A

acts on circular and longitudinal muscles of intestines = slows peristalsis

Inhibits fluid and electrolyte secretion and reduces fecal volume

40
Q

Loperamide (imodium) ASEs?

A

Abdominal pain

Constipation

Dizziness

Fatigue

Flatulence

HA

Urinary retention

N/V

41
Q

Loperamide (imodium) contraindications?

A

Children <2 yrs old

Dysentery

GI bleeding

Infections

Pseudomembranous colitis

UC

42
Q

Loperamide (imodium) drug interactions?

A

Alosetron (L1 -severe)

Metaclopramide, Cisapride, Atropine (L2-major)

43
Q

Bismuth subsalicylate (Pepto Bismol) clinical uses?

A

Nausea

Heartburn

Indigestion

Upset stomach

Diarrhea

YAY PEPTO BISMOL!

44
Q

Diphenoxylate/atropine (Lomotil) MOA?

A

Used as antidiarrheal agent RX ONLY C-V

  • Diphenoxylate opioid w/low bioavilability
  • Atropine slow peristalsis and reduces abuse potential
45
Q

Eluxadoline clinical use?

A

C-IV drug

IBS-D in adults

46
Q

Eluxadoline MOA?

A

Mixed mu-opioid receptor agonist

works to reduce abdominal pain and diarrhea in pts with IBS-D w/o constipation side effects

47
Q

Eluxadoline ASEs?

A

Dizziness

Fatigue

Drowsiness

Euphoria

Intoxicated feeling

Sedation

Rash

Constipation

N/V

Abdominal pain

Increase AST and ALT

48
Q

Eluxadoline contraindications?

A

Hypersensitivity

Pts w/o gallbladder

h/o pancreatitis

Biliary duct obstruction

Alcoholism

Chronic/severe constipation

GI obstruction

49
Q

Alosetron MOA?

A

Targets 5-HT3 and 5-HT4 receptors

Serotonin 3 receptor antagonists

50
Q

Alosetron clinical use?

A

IBS-D

51
Q

Cholestyramine is an antidiarrheal drug that causes what?

A

Binding of bile acids needed for vitamin D absorption results in vitamin d deficiency

52
Q

List bowel preps

A

GoLYTELY

MoviPrep

Suprep Bowel Prep Kit

53
Q

What bowel preps do you avoid in pts with kidney problems?

A

Phosphate containing preps

54
Q

Clinical use of bowel preps?

A

GI scopes

55
Q

Simethicone (Gas-X) clinical use?

A

Dissolve gas bubbles

Relieves pressure, bloating, fullness, and GI gas discomfort.

56
Q

List hemorrhoid tx: protectants

A

Petrolatum

Glycerine

Aloe

Various oils(shark liver oil)

57
Q

List hemorrhoid tx: vasoactive substance

A

CCB: nifedipine and diltiazem

Nitroglycerine ointment

Intra-anal application of NTG: reduces sphincter tone and resting intra-anal pressure”

58
Q

List hemorrhoid tx: topical anti-inflammatory drugs

A

Hydrocortisone cream or suppositories.

59
Q

Lactose intolerant tx?

A

Lactase dietary supplment

Take PO: whole, chewed, swallowed, or sprinkled on food

60
Q

Indication for pancreatic enzyme replacement?

A

Exocrine pancreatic insufficiency: chronic pancreatitis or pancreatectomy

Pancreatic insufficiency: CF and others

61
Q

MC pancreatic enzyme replacement drug?

A

Creon

62
Q

How do you administer pancreatic enzyme replacement drugs?

A

Swallow cap whole

DO NOT crush

OK to sprinkle into infants mouth or applesauce.

63
Q

ASEs of pancreatic enzyme replacement drugs?

A

Hyperuricemia and Hyperuricosuria

Folic acid deficiency

Irritation of oral mucosa (take with meals)

64
Q

What is listed on Creon medication guide?

A

May increase chance of having a rare bowel disorder: fibrosing colonopathy,

This may require surgery.

65
Q

What is the clinical use of TCAs?

A

Slow intestinal transit time

Used for IBS-D

Start low and go slow.

GI (16 decks)

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