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GII Exam 1 [Path, Pharm, Immuno, CLMD] > [Pharm] Diarrhea, Abdominal pain, Constipation > Flashcards

[Pharm] Diarrhea, Abdominal pain, Constipation Flashcards

1
Q

What are the 4 classes of drugs you would prescribe for DIARRHEA?

A

Prostaglandin inhibitors

Opioid agonists

Serotonin antagonists

Chloride channel inhibitors

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2
Q

What is the prostaglandin inhibitor you would prescribe for DIARRHEA?

A

Bismuth

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3
Q

What are the (3) opioid agonists that you would prescribe for DIARRHEA?

A

Loperamide

Diphenoxylate

Eluxadoline

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4
Q

What is the (1) serotonin antagonist you would prescribe for DIARRHEA?

A

Alosetron

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5
Q

What is the (1) chloride channel inhibitor you would prescribe for DIARRHEA?

A

Crofelemer

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6
Q

What is the GENERAL MOA of opioid agonists for treating diarrhea?

A

Anti-propulsive

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7
Q

What is one of the clever designs put into diphenoxylate to prevent opioid abuse?

A

Diphenoxylate (opioid agonist) has a small quantity of ATROPINE added to discourage deliberate abuse/over-dosage of drug

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8
Q

What is the one drug that has a unique indication within the opioid agonist category?

What is that indication?

A

Eluxadoline

Irritable bowel syndrome, diarrhea predominant subtype [IBS-D]

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9
Q

What is the major side effect of eluxadoline?

A

Pancreatitis!!!!

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10
Q

MOA of alosetron?

A

Selectively blocks GI BASED 5HT3 receptors

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11
Q

Indication for alosetron?

A

Chronic, severe IBS-D that are NOT RESPONSIVE to other conventional therapies in WOMEN

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12
Q

What are the major side effects associated with ALOSETRON?

A

GI related = dyspepsia

BLACK BOX = ISCHEMIC COLITIS

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13
Q

MOA of crofelemer?

A

Inhibits

chloride ion secretion

by

blocking cAMP stimulated CFTR* and *calcium activated chloride channels

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14
Q

What is the super unique indication for CROFELEMER?

A

Non infectious diarrhea in HIV/AIDS pts that are on ANTI-RETROVIRAL THERAPY

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15
Q

What is the ONE class of drugs used for abdominal pain?

A

Antimuscarinic agents

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16
Q

What are the (3) antimuscarinic agents used in treatment of abdominal pain?

A

Hyoscyamine

Dicyclomine

Clidinium/Chlordiazepoxide

17
Q

Side effects of antimuscarinics?

A

Classic anticholinergic based

Dry mouth

Urinary retention

Constipation

Drowsiness

Mental confusion

Blurred vision

18
Q

What are the (4) classes of drugs used for treating CONSTIPATION?

A

Peripheral opioid antagonists

Guanylate Cyclase-C Agonists

Selective Chloride (C2) Channel Activators

Laxative and Cathartic Agents

19
Q

MOA of LINACLOTHIDE?

A

Selective guanylate cyclase-C (GC-C) agonist

Stimulates secretion of chloride/bicarb into the intestinal lumen, this results in increased intestinal fluid and accelerated transit

20
Q

What are the indications for LINACLOTIDE?

A

Irritable bowel syndrome-constipation predominant subtype [IBS-C]

Chronic idiopathic constipation [CIC]

21
Q

MOA of LUPIPROSTONE?

A

Prostaglandin E1 derivative

Increases intestinal fluid secretion by activating GI specific CHLORIDE CHANNELS (CIC-2) in the luminal cells of intestinal epithelium

22
Q

What is the “claim to fame” indication for LUBIPROSTONE?

A

Opioid induced constipation (OIC)

(*also treats IBS-C and CIC)

23
Q

MOA of Methylnaltrexone?

A

Peripheral MU-OPIOD receptor ANTAGONIST

(MethylnaltrexOne) blocks Mu-Opioid

24
Q

Indications for methylnaltrexone?

A

Opioid induced constipation (OIC)

25
Q

What is the ONE indication for ALVIMOPAN?

A

PREVENTION OF POST OPERATIVE ILEUS

26
Q

What is the BLACK BOX WARNING of ALVIMOPAN?

A

RISK OF MI

Must enter a risk mitigation systmic process (REMS) in order to prescribe

27
Q

What would be a great class of drugs to prescribe for your patient that complains of:

“I poop once every other day, but when I do…MAN it’s hard and painful to pass…”

Help me

A

STOOL SOFTENER

28
Q

What is the one stimulant given pre-colonoscopy for bowel prep?

A

Sodium picosulfate

29
Q

What is the MOA of stimulants (irritants)?

A

IRRITANT to enterocytes, GI smooth muscle which leads to INFLAMMATION

This inflammation leads to an increase in prostaglandin synthesis

30
Q

Contraindications of stimulants?

A

GI obstruction/Ileus/Impaction

31
Q

What is the MOA of saline agents?

A

Mg/Phosphate ions poorly absorbed…

Osmotically retain water in GI tract

32
Q

What OSMOTIC agent is used for severe liver disease?

A

Lactulose

33
Q

What is the osmotic agent that when given at HIGH DOSES is used for bowel prep prior to GI scopes?

A

Polyethylene glycol (PEG-3350)

34
Q

What are the two drugs given for pre-colonoscopy bowel prep?

State what type of drug and dose

A

Sodium Picosulfate (low dose, stimulant)

Polyethylene glycol (high dose; osmotic)

GII Exam 1 [Path, Pharm, Immuno, CLMD] (16 decks)

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