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RB Y1 GI > Pharmacology of Fluid Motility > Flashcards

Pharmacology of Fluid Motility Flashcards

1
Q

causes of travellers diarrhoea

A

Enterotoxin producing E coli

also salmonela, shigella and campylobacteria

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2
Q

the most common strain of bacteria causing gasstroenteritis in the UK is

A

Campylobacter jejuni

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3
Q

non infectious causes of diarrhoea

A

IBS. IBD, bile salts excess and lactase deficiency
physiological factos eg anxiety
hyperthryoidism
drug induced - Mg salts, beta blockers, cytotoxic drugs

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4
Q

goals in management of diarrhoea

A

maintain fluid and electrolyte balance
antimicrobial agents in sever infective causes
antimotility and spasmolytic agents - symptomatic

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5
Q

rehydration in diarrhoea when fluid loss is severe

A

IV rehydration

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6
Q

rehydration in diarrhoea normally

A

ORT - Restore & maintain hydration till diarrhoea ceases (spontaneously)

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7
Q

which transporter does rehydration therapy exploit

A

SGLT1 - absorption of Na and glucose by SGLT1 cause accompanying absorption of water

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8
Q

what type of relief do anti motility agents give

A

symptomatic

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9
Q

what are anti motility agents contraindicated in

A

acute infective diarrhoea, IBS, IBD, diverticulosis

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10
Q

examples of anti motility agents

A

opiates

  • loperamide
  • Diphenoxylate
  • codeine
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11
Q

what negative effect do opioid drugs have

A

constipating

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12
Q

effects of opioid drugs

A

activate μ-receptors on myenteric neurones and cause hyperpolarization by increasing their potassium conductance.This inhibits acetylcholine release from the myenteric plexus and reduces bowel motility.

dec peristalsis, inc segmentation
inc fluid absorption
inc tone of large intestine

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13
Q

benefits of loperamide

A

weak antimuscarinic effect
longer acting
best for local effect on gut as has little effect on the brain
therefore unlikely to cause dependence

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14
Q

diphenoxylate

A

low CNS penetration
can contain atropine - discourage drug abuse due to side effects e.g. nausea, vomiting, blurred vision, headache, weakness

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15
Q

and atropine is used in cardio for

A

bradycardia

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16
Q

antidiarrhoeal agent examples

A

Racecadotril

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17
Q

what is Racecadotril a pro drug of

A

thiorphan

18
Q

what is a pro drug

A

A prodrug is a medication or compound that, after administration, is metabolized into a pharmacologically active drug.

19
Q

how does one use Racecadotril

A

in children over 3 months of age as an adjunct to rehydration

20
Q

what are loperamide or diphenoxylate contraindicated in

A

children

21
Q

what does Racecadotril inhibit

A

enkephalinase inhibitor - inhibits the breakdown of endogenous opioids & reduces intestinal secretions.

22
Q

what can the Hirschprung disease cause

A

impairment of motility/defaecation reflex e.g. constipation

23
Q

compare laxative and purgative action

A

laxative produce a midler action resulting in passage of soft but formed stools
purgative produce a stronger action resulting in more fluid evacuation

24
Q

can the same drug act as laxatives and purgatives at different doses

A

yes - laxative at low, and purgative at high

25
Q

contraindications of laxatives and purgatives

A

physical obstruction in the bowel

26
Q

reasons of laxative dependency

A
  • easily resorted to as OTC

- abused in eating disorders

27
Q

abuse of laxatives may result in what

A

hypokalaemia

28
Q

what does hypokalaemia do to you

A

make you tired or act as a stimulus for cardiac arrhythmias

29
Q

bulk laxative example

A

methycellulose

30
Q

bulk laxatives

A

inc volume of intestinal contents causing peristalsis

are indigestible polysaccharides

31
Q

osmotic laxatives mechanisms and examples

A

inc bulk in bowel by retaining water by an osmotic effect

Mg sulphate or hydroxide
sodium citrate
lactulose

32
Q

Mg sulphate or hydroxide administration route

and lactulose

A

oral

33
Q

sodium citrate administration route

A

rectal

34
Q

stimulant purgatives examples

A

bisacodyl- orally or suppository
senna
sodium picosulfate

35
Q

name an anthraquinone laxative

A

senna

36
Q

faecal softeners examples

A

softeners - docusate sodium - oral
lubricants - archis - oil as enema
oral liquid paraffin

37
Q

which class of laxatives are abdominal cramps less common with

A

stimulant purgatives

38
Q

what is diarrhoea defined as

A

loss of fluid and solutes from the GI tract in excess of 500ml per day

39
Q

how does rotavrus cause diarrhoea

A

inhibition of Na/K/ATPase & structural damage to mucosal cells leading to reduced absorption

40
Q

stimulant laxative mechanism

A

inc motility by actin g on mucosa/nerve plexuses, which may be damaged due to prolonged drug use

41
Q

faecal softeners

A

promote defecation by softening or lubricating the stool

RB Y1 GI (54 decks)

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