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GI > Pharm 24 Objectives > Flashcards

Pharm 24 Objectives Flashcards

1
Q

List mediations/supplements that have potential for drug induced constipation

A 
Opioids
Anticholinergics
Verapamil (CCB)
Iron
Aluminum
Calcium
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2
Q

Identify dietary, lifestyle, or concomitant drug therapy interventions that are recommended as first line therapy for constipation and/or are required or recommended along with certain laxatives.

A

Increase the amount of fiber in the diet

Exercise

Bowel habit adjustments, taking the time to defecate

Increase fluid intake

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3
Q

List common adverse effects of laxatives

A 
Abdominal pain
Nausea
Vomiting
Diarrhea
Dizziness
Syncope
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4
Q

What are appropriate use of laxatives?

A

Constipation

As a part of a “bowel preparation”, for bowel evacuation

Preventing fecal impaction in bedridden patients

Obtaining fresh stool sample

Expelling dead parasites after treatment

Removing poisons

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5
Q

What are inappropriate use of laxatives?

A

Pts w/ symptoms attributable to appendicitis, regional enteritis, diverticulitis, and ulcerative colitis

Acute surgical abdomen

Fecal impaction or bowel obstruction >1wk —> can perforate the bowl

For weight loss

By people who dwell on bowel function

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6
Q

What are the 2 common clinical uses for lactulose?

A

Constipation

Hepatic encephalopathy

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7
Q

What are some common Components of Nulytely and Golytely?

A

PEG-350
Sodium Chloride
Sodium Bicarbonate
Potassium Chloride

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8
Q

What are some common Components of MoviPrep?

A 
PEG-350
Sodium Chloride 
Sodium Bicarbonate 
Potassium Chloride 
Sodium ascorbate 
Ascorbic acid
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9
Q

What are some common Components of SuPrep?

A

Sodium Sulfate
Potassium Sulfate
Magnesium Sulfate

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10
Q

What are some patient instructions when using a bowl prep?

A

Have a light breakfast day before
No dinner
Clear liquids only no red dye!
Drink last bowel prep 2 hours before procedure

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11
Q

Describe the role of antimuscarinic drugs in the treatment of lower GI symptoms associated with IBS?

A

Help with spasms and diarrhea

Inhibits gastrointestinal propulsive motility

Decreases gastric acid secretion

Controls excessive pharyngeal, tracheal, and bronchial secretions

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12
Q

Identify medications useful for IBS-D w/ persistent, but not severe sxs?

A

PRN GI anti-spasmodic or anti-diarrheal medication

GI antispasmodics can help with spasms and also with diarrhea

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13
Q

Identify medications useful for IBS-D w/ severe or refractory sxs to diet and symptom treatments?

A

Alosetron

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14
Q

Dehydration in children can cause?

A

loss of fluid and electrolytes, results in severe hypovolemia, shock and death.

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15
Q

What is the preferred rehydration therapy in children with mild to moderate dehydration?

A

ORT is preferred over IV —> effective, less invasive, and readily available.

Pedialyte

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16
Q

What is the preferred rehydration therapy in adults with mild to moderate diarrhea?

A

Oral rehydration

Sodium-glucose and sodium-citrate co-transport

ORS: oral rehydration salts

17
Q

Describe the proper clinical use of opioid agonists as antidiarrheal medication?

A

Direct effect on peristalsis - acts on circular and longitudinal muscles of intestines to slow peristalsis

Mu-opioid receptor agonists are useful as antidiarrheal medications

18
Q

List non-opioid antidiarrheal drugs and their mechanisms of action.

A

Polyacrylic Resin

MOA: binds to water and calcium content may slow bowel transit.

19
Q

What are the benefits of probiotics?

A

Altering GI flora, improving ratio of good to bad bacteria

Inducing anti-inflammatory actions

Modulating visceral hypersensitivity

20
Q

What global symptoms do probiotics improve?

A

Bloating and flatulence in IBS

21
Q

What are symptoms of lactose intolerance?

A

Bloating
Flatulence
Abdominal pain
Chronic diarrhea

22
Q

What are non-pharmacologic treatment of lactose intolerance?

A

Lactose restriction

If completely avoiding products with lactose, consider supplementing calcium and vitamin-D

23
Q

What are pharmacologic treatment of lactose intolerance?

A

Oral lactase enzyme preparations: Lactaid

24
Q

Describe the components of pancreatic enzyme products?

A

Lipase (the dose is always based on lipase content)

Protease

Amylase

25
Q

Describe the time of dosing with pancreatic enzyme products?

A

Half the mealtime dose is given with a snack

26
Q

Describe the clinical uses of pancreatic enzyme products?

A

Exocrine pancreatic insufficiency: chronic pancreatitis or pancreatectomy

Pancreatic insufficiency: cystic fibrosis or other conditions

27
Q

Describe the ASEs of pancreatic enzyme products?

A

Hyperuricemia and hyperuricosuria —> leads to dysuria

Folic acid deficiency

Irritation of the oral mucosa (take with meals)

GI (16 decks)

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