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Women's health + Pharm > PHARM II lecture 2 > Flashcards

PHARM II lecture 2 Flashcards

1
Q

Constipation are more common in

A

elderly, women, patient of lower socioeconomic class

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2
Q

What is the Rome Criteria

A

Two ore more of the following symptoms for at least 3 months
-hard stools at least 25% of the time
-2 or fewer bm per week
-difficulty passing at least 25% of the time
-incomplete evacuation at a minimum 25% of the time

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3
Q

why is urinary incontinence associated with constipation?

A

bowel presses on the bladder when it is impacted

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4
Q

Alarm symptoms of constipation

A

-change in bowel habits >2 week
-worsening of constipation despite treatment
-blood in stool

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5
Q

Which medications commonly cause constipation?

A

opioids, anticholinergics, calcium containing antacids

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6
Q

Which medications commonly cause constipation?

A

opioids, anticholinergics, calcium-containing antacids

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7
Q

What is the goal bm for constipation?

A

2 or 3 normal bm per week

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8
Q

non-harm treatment for constipation

A

-fluids
-activity
-fiber in diet (25-30g/day)

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9
Q

Can laxative abuse cause constipation?

A

Yes

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10
Q

Bulk forming aggent

A

psyllium

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11
Q

onset of psyllium

A

12-72 hours

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12
Q

SE of bulk forming agents

A

-bloating
-cramping
-flatulence

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13
Q

which constipation med is 1st line?

A

psyllium

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14
Q

MOA of psyllium

A

absorb water and increase fecal mass
- require adequate hydration (8oz)
-caution in debilitated patients

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15
Q

what is an osmotic

A

miralax

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16
Q

onset of miralax

A

2.24-96 hours

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17
Q

what line is miralax?

A

2nd

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18
Q

SE of osmotic meds

A

nausea, cramping, flatulence, electrolyte disturbance

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19
Q

stimulants

A

senna

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20
Q

onset of senna

A

6-12 hours

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21
Q

SE of stimulants

A

cramping, nausea, electrolyte disturbance

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22
Q

which line is senna considered

A

2nd or 3rd

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23
Q

MOA for stimulants

A

-increase contractions of intestinal walls by stimulating nerves
-possible dependence of long term use

24
Q

surfactant

A

docusate sodium

25
Q

onset of surfactants

A

12-72 hours

26
Q

SE of surfactants

A

cramping, fecal soiling

27
Q

MOA of surfactants

A

-increases mixing of fatty materials in stool
-2nd or 3rd line
-requires adequate hydration

28
Q

What can you use in patients who failed other options with chronic constipation

A

chloride channel activator and guaylate cyclase c agonist

29
Q

stimulant suppositories

A

Bisacodyl

30
Q

onset of stimulant suppositories

A

15-60 minutes

31
Q

Suppositories

A

glycerin

32
Q

Onset for suppositories

A

15-60 minutes

33
Q

Fleet enema

A

sodium phosphate

34
Q

Onset of fleet enema

A

5-15 minutes

35
Q

Saline enema

A

Warm saline

36
Q

Onset of saline enema

A

5-15 mintues

37
Q

concern with fleet enema

A

phosphate buildup in renal insufficiency pts

38
Q

Digital health vibrant

A

non drug vibrating capsule to stimulate bowel movements

39
Q

Acute diarrhea

A

<2 weeks

40
Q

Chronic diarrhea

A

> 4 weeks

41
Q

definition of diarrhea

A

3 > unformed stool per 24 hour

42
Q

Supportive care of diarrhea

A

hydration and electrolytes

43
Q

adults and kids with diarrhea

A

adults:no solids/dairy for 1 day
kids:BRAT diet

44
Q

Loperamide

A

drug of choice for diarrhea
-inhibit peristalsis, prolong transit time, reduce fecal volume and increase anal sphincter tone

45
Q

Dosage for loperamide

A

4 mg orally initially
- 2mg after each loose stool, max is 16 mg

46
Q

When is imodium use CI

A

c.diff is suspected

47
Q

opioid treatment for diarrhea

A

Diphenoxylate with atropine
-does not cause too much respiratory depression
-reduce abuse potential

48
Q

lactobacillus

A

-restore normal intestinal function
-may help with constipation

49
Q

lactase enzymes

A

-lactose intolerance

50
Q

which infectious diarrhea is the most common

A

viral

51
Q

how long does it take to resolve traveler’s diarrhea

A

48 hours

52
Q

antibiotics used for traveler’s diarrhea

A

cirpo if they are at high risk

53
Q

treatment for traveler’s diarrhea

A
  1. oral hydration
  2. imodium
  3. floroquinolone
54
Q

What kind of bacteria is c.diff

A

gram + spore forming anaerobic bacillus

55
Q

which antibiotics cause c.diff

A

ampicillin, clindamycin, cephalosporins, fluroquinolones

56
Q

fidaxomicin

A

1st line treatment but not used due to cost

57
Q

alternative for c.diff treatment

A

vancomycin, metronidazole for non severe

Women's health + Pharm (10 decks)

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