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GI Final > Pharmacology of IBS, Anti-Diarrheals, And Laxatives (Quiz 4) > Flashcards

Pharmacology of IBS, Anti-Diarrheals, And Laxatives (Quiz 4) Flashcards

1
Q

irritable bowel syndrome affects what part of the body

A
  • large intestine
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2
Q

what involves uncoordinated spasming of the colon

A
  • IBS
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3
Q

MOA of Dicyclomine and Hyocycamine

A
  • M3 anticholinergics
  • inhibit GI tract smooth muscle contractions
  • reduce motility
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4
Q

what is the sympathetic receptor that causes GI tract SM relaxation

A
  • Beta 2
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5
Q

toxicities of Dicyclomine and Hyocycamine

A
  • anti-parasympathetic effects
  • blurred vision
  • xerostoma (dry mouth)
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6
Q

you use Eluxadoline, Alosetron, and Rifamixin with what type of IBS

A
  • IBS with diarrhea

EAR drugs

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7
Q

MOA of Eluxadoline

A
  • activates mu opioid receptors on neurons in myenteric plexus
  • inhibits GI smooth muscle contraction
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8
Q

oral bioavailability of Eluxadoline

importance

A
  • poor

- effects limited to just GI tract

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9
Q

toxicities of Eluxadoline

A
  • constipation
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10
Q

MOA of Alosetron

A
  • inhibits serotonin signaling from ECL cells in lumen to the myenteric plexus
  • reduce GI motility
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11
Q

which gender do we use Alosetron

A
  • women
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12
Q

is Alosetron approved as an anti-emetic

A
  • no
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13
Q

toxicity of Alosetron

A
  • ischemic colitis
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14
Q

MOA of rifamixin

A
  • RNA polymerase inhibitor

- reduces effects of gut flora that cause diarrhea

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15
Q

MOA of Desipramine

A
  • anticholingeric effect

- slows GI transit

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16
Q

toxicities of Desipramine

A
  • blurred vision
  • xerostoma
  • prolonged - QT
  • urinary retention
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17
Q

the antidepressants Citalopram, Duloxetine, and Desipriamine as used to treat IBS why?

A
  • treat pain/psych symptoms of IBS

Anti-depressants of DCD for IBS-D

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18
Q

MOA of Citalopram, Duloxetine

A
  • may improve mood
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19
Q

Bismuth Subsalicylate treats what condition

A
  • anti-diarrheal
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20
Q

Loperamide and Diphenoxylate treats what condition

A
  • anti-diarrheal
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21
Q

Cholestyramine treats what condition

A
  • anti-diarrheal
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22
Q

Bismuth Subsalicylate MOA

A
  • anti-inflammatory
  • COX 1/2 inhibitor
  • antibacterial
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23
Q

what is the toxic effect of prolonged use of Bismuth Subsalicylate

what compound

A
  • neurotoxic

- bismuth oxychloride

24
Q

drug interactions of Bismuth Subsalicylate

A
  • anything containing aspirin
25
Q

MOA of Loperamide and Diphenoxylate

A
  • activate mu opioid receptor on neurons in myenteric plexus

- reduce GI motility

26
Q

Loperamide toxic effects at high dose

A
  • euphoria

- respiratory depression

27
Q

MOA of Cholestyramine

used for what

A
  • sequesters bile

- diarrhea caused by bile acid malabsorption

28
Q

We use Docusate for what

A
  • laxative
29
Q

We use Lactulose, Magnesium Citrate, and Polyethylene glycol for what

A
  • laxative

LMCP

30
Q

We use Lubripostone for what

A
  • laxative
31
Q

We use Lincaclotide/Plecanatide for what

A
  • laxative
32
Q

We use Alvimopan, Methylnaltrexone, Naldemidine, Naloxegol for what

A
  • laxative
33
Q

MOA of lectulose, polyethylene glycol, and magnesium citrate

A
  • stool softener

- creates osmotic pressure that draws water into the gut

34
Q

MOA of Docusate

A
  • stool softener

- allows water to penetrate feces

35
Q

MOA of Bisacodyl and Sienna

A
  • directly stimulates colonic enteric nerves
36
Q

MOA of Lubiprostone

A
  • promotes water secretion into GI lumen
  • opens Cl- channel
  • Cl- gradient draws Na/H2O into lumen
37
Q

MOA of Linaclotide and Plecanatide

A
  • promotes water secretion into GI lumen
  • acts on CFTR
  • allows in chloride
  • Na/H2O follows

-tide of CFTR

38
Q

What are Alvimopan, Methylnaltrexone, Naldemidine, Naloxegol

A
  • PAMORA
39
Q

what is a PAMORA

A
  • peripherals active mu opioids receptor antagonist
40
Q

MOA of PAMORAs

do they cross the blood brain barrier?

A
  • antagonize mu opioid receptors in enteric nervous system

- no

41
Q

how do Opioids cause constipation

A
  • agonist mu opioid receptors in enteric nervous system
42
Q

what are the first line anti-spasmodics for all types of IBS

A
  • hyoscyamine

- dicyclomine

43
Q

what are the mu opioids receptor agonists for IBS-D

A
  • Eluxadoline
44
Q

what are the serotonin antagonists for IBS-D

A
  • Alosetron
45
Q

what are the antibiotics for IBS-D

A
  • Rifamaxin
46
Q

what are the anti-depressants for IBS

which has the anti-cholinergic effect

A
  • citalopram
  • duloxetine
  • desipramine (anti-cholinergic effect)
47
Q

what are the anti-diarrheal with unclear etiology

A
  • bismuth subsalicylate
48
Q

what are the anti-diarrheal mu opioid receptor agonists

A
  • loperamide

- diphenoxylate

49
Q

what are the anti-diarrheal bile acid sequestrants

A
  • Cholestyramine
50
Q

What are the laxative stool softeners with unclear mechanisms

A
  • Docusate
51
Q

what are the laxative osmotic agent stool softeners

A
  • lactulose
  • magnesium citrate
  • polyethylene glycol
52
Q

what are the laxative stimulants

A
  • Bisacodyl

- Senna

53
Q

what are the laxative Cl-channel activators

A
  • Lubiprostone
54
Q

what are the laxative guanylate cyclase agonists

A
  • Linaclotide

- Plecanatide

55
Q

what are the laxative PAMORAs

A
  • Alvimopan
  • Methylnaltrexone
  • Naldemedine
  • Naloxegol

GI Final (27 decks)

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