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GI Exam II > Pharm - Laxatives > Flashcards

Pharm - Laxatives Flashcards

1
Q

Name the 3 classifications of Laxatives

A
  1. Luminally active
  2. Nonspecific stimulants or irritants
  3. Prokinetic agents
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2
Q

Name 2 Dopamine receptor antagonists used in GI

A

Metoclopramide and Domperidone

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3
Q

Stimulate peristalsis by releasing Ach

A

Metoclopramide and Domperidone

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4
Q

Used by patients with hypomotility disorders associated with nausea

A

Metoclopramide and Domperidone

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5
Q

Adverse effects: Tardive Dyskinesia

A

Metoclopromide

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6
Q

Adverse effects: Decreased energy, diarrhea, dizziness, drowsiness, HA, nausea, restlessness, malaise, trouble sleeping

A

Metoclopromide

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7
Q

Adverse effects: HA, drymouth, dizziness, nervousness, flushing, irritability may occur first several days as your body adjusts. Trouble sleeping, stomach cramps, hot flashes, leg cramps

A

Domperidone

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8
Q

5-HT4 Receptor agonist

A

Prucalopride

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9
Q

Use for constipation and IBS

A

Prucalopride

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10
Q

Activates 5-HT4 receptors on: motor and sensory ENS, smooth muscle and epithelial cells lining mucosa and on ENTEROCHROMAFFIN cells

A

Prucalopride

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11
Q

Adverse Effects: Occur within first 24 hrs and subside

HA, nausea, Abdominal pain, Diarrhea

A

Prucalopride

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12
Q

Luminally active agent. The residue left when flour is made from cereal grains

A

Bran

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13
Q

Luminally active agent derived from the seed of the plantago herb. Contains hydrophilic mucilloid that undergoes significant fermentation in the colon

A

Psyllium husk

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14
Q

Luminally active agent. Extract of barley malt that contain polymeric carbs, proteins, electrolytes and vitamins

A

Malt soup extract

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15
Q

Contraindication for Fiber

A

Megacolon or Megarectum - obstructive symptoms

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16
Q

Hydrophilic colloids; bulk formers

A

Bran, Psyllium, Malt

*Attract water and increase fermentation

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17
Q

Describe osmotic agents?

A

non-absorbable inorganic salts

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18
Q

Name the saline laxatives

A

Mg Sulfate, Mg Hydroxide, Mg Citrate, Na Phosphates

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19
Q

MOA : Osmotically mediated water retention which then stimulates peristalsis

A

Saline laxatives

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20
Q

Which are absorbed easier? Phosphate or Mg salts?

Why know the difference?

A

Phosphate salts.

*They increase risk of phosphate nephropathy

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21
Q

FDA warning about using these OTC for constipation in a 24hr period if pt has bad kidneys or bad heart

A

Na Phosphate

22
Q

Combine Mg/Phosphate agents should be used with caution if pts have which conditions

A

Renal insufficiency, Cardiac Dz, Preexisting electrolyte abnormalities, already on diuretics

23
Q

Osmotically active, non-absorbable sugars

A

Lactulose, Sorbitol, Mannitol

24
Q

MOA: hydrolyzed in the colon to short chain FAs, stimulating motility and drawing in water via omosis

A

non-absorbable sugars

lactulose, sorbitol, mannitol

25
Q

Equal to lactulose when treating constipation caused by opioids, vincristine, constipation of the elderly and idiopathic chronic constipation

A

Sorbitol

26
Q

Can treat constipation AND hepatic encephalopathy

A

Lactulose

27
Q

Is metabolized to short chain FAs which lower pH and “traps” ammonia ions, thus increasing gut motility

A

Lactulose

28
Q

Can treat constipation caused by vincristine or opioids

A

Sorbitol and Lactulose

29
Q

What is PEG short for?

A

Polyethylene Glycol/Electrolyte Soln

*osmotic agent

30
Q

MOA: osmotic agent retained in the lumen which produces a high osmotic effect when used in high volume.

A

PEG

31
Q

Is itself an electrolyte, which assures little to no net ionic shift

A

PEG

32
Q

Used for colonic cleansing prior to radiology, surgery, endoscopic procedures

A

PEG

33
Q

240ml taken every 10mins until 4L is consumed or rectal effluent is clear

A

PEG

34
Q

Stool wetting agents and emollients

A

Docusate and Mineral Oil

35
Q

ionic surfactants the lowers surface tension of stool allowing mixing of aqueous and fatty substances

A

Docusate salts

36
Q

Stimulates intestinal fluid and electrolyte secretion; and alters intestinal mucosal permeability

A

Docusate salts

37
Q

Maginally effective

A

Docusate salts

38
Q

A mixture of aliphatic hydrocarbons obtained from pertolatum

A

Mineral oil

39
Q

luminally active petrolatum derivative. Indigestible. Interferes with fat absorption. May cause foreign body rxn. Anal leakage

A

Mineral oil

40
Q

MOA: produce a low-grade inflammation in the small and large bowel to promote accumulation of water and electrolytes and thus stimulates intestinal motility

A

Diphenylmethanes (bisacodyl)
Anthraquinones (senna and cascara)
Castor oil

41
Q

These have direct effects on enterocytes, enteric neurons, and GI smooth muscle

A

bisacodyl, senna and cascara, castor oil

42
Q

Require activation by endogenous esterases in the bowel

A

Diphenylmethanes (bisacodyl)

43
Q

Should not be used more than 10 days due to risk of atonic colon

A

Diphenylmethanes (bisacodyl)

44
Q

Not FDA approved

A

Anthraquinones (aloe, senna, cascara)

45
Q

Can produce giant migrating colonic contractions and induce water and electrolyte secretion

A

Anthraquinones (senna and cascara)

46
Q

Melatonic pigmentation of the colonic mucosa and “cathartic colon”

A

Anthraquinones (senna and cascara)

47
Q

irritating when activated by colonic bacteria

A

senna, aloe, cascara - Anthraquinones

48
Q

Oil derived from the bean of Ricinus communis

A

Castor oil

49
Q

Hydrolyzed in small bowel to glycerol and ricinoleic acid

- stimulating secreation of fluid, electrolytes and transit time

A

Castor oil

50
Q

Not recommended because of unpleasant taste and potential toxic effects

A

Castor oil

GI Exam II (5 decks)

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