Pharm Lower GI

Question 1

How does metoclopramide effect the GI tract?

Answer 1

1. Dopamine antagonist; results in the effects of Ach

2. Increases LES tone and peristaltic movement.

Question 2

Adverse Effects of Metoclopramide? Uses?

Answer 2

Breast tenderness, Drowsiness, galactorrhea. Used for esophagitis and GERD

Question 3

Name the Antidiarrheal drugs

Answer 3

Opiates, Loperamide, Diphenoxylate with atropine, Kaolin and pectin

Question 4

What is the effect of Opiates on the GI tract?

Answer 4

Cause constipation; Morphine increases GI smooth muscle tone and sphincter tone. Decreases peristaltic movement

Question 5

How do antimicrobials affect the GI tract?

Answer 5

Cause diarrhea

Question 6

Differentiate Laxatives from Cathartics.

Answer 6

Cathartic: Produces a fluid evacuation
Laxative: Produces a soft stool

Question 7

What are the adverse reactions to laxatives?

Answer 7

1. Prolonged used can cause IBS.

2. Cramping

Question 8

What should be used in patients with opoid induced constipation?

Answer 8

Methylnaltrexone

Question 9

Name two Antispasmodics

Answer 9

Dicyclomine and Hysocyamine

Question 10

Discuss Alosetron

Answer 10

5-HT3 antagonist; Used for diarrhea-predominant women. Must be in manufacturer’s prescirbing program.

Question 11

Discuss Tegaserod

Answer 11

Partial agonist at 5-HT4; Stimulates colonic motility

Question 12

How do you treat IBD

Answer 12

Mesalamine, Corticosteriods or TNF inhibitors

Question 13

Discuss Sulfasalzine

Answer 13

Used for Ulcerative colitis. Hydrolyzed to 5-aminosalicylic acid by bacteria in colon.