T2-Diarrhea Flashcards

1
Q

What are two types of GI receptors?

A
  1. Cholinergic (parasympathetic innervates the GI tract. When these neurons fire, they increase motility [push food], these neurons release Ach)
  2. Opioid (mu) receptors (when these neurons fire, they slow down GI motility–why when you take a lot of morphine [opioid] you get constipated)
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2
Q

So cholinergic increase motility and pushes food out. What happens when we give an anti-cholinergic?

A

We can slow down bowel motility and halt diarrhea

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3
Q

What is it called when you add something to the body?

A

Exogenous

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4
Q

Exogenous opioids slow down [decrease] the GI motility, which is what we would want in patients with _____.

A

Diarrhea

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5
Q

What are the three drugs that slow down motility?

A

Dicyclomine
Loperamide
Diphenoxylate/atropine

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6
Q

Which diarrhea drug isn’t given for your typical diarrhea. What is it given for instead?

A

Dicyclomine; it is given for a disorder that can CAUSE diarrhea

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7
Q

What disease is dicyclomine given for?

A

Irritable Bowel Syndrome (IBS)

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8
Q

How many Americans are affected by IBS?

A

20%

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9
Q

More than ___ visits to a GI doctor are about IBS.

A

1/4

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10
Q

What is IBS?

A

Involves having pain that is relieved by defecation

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11
Q

Is dicyclomine an anticholinergic or an exogenous opioid?

A

Anti-cholinergic

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12
Q

Does dicyclomine slow down bowel motility?

A

Yes

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13
Q

What is Loperamide given for?

A

Diarrhea

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14
Q

What receptor does Loperamide work on?

A

Mu

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15
Q

Loperamide and meperidine (another opioid) are very structurally similar to one another. What is the key difference between them?

A

Loperamide will not cross the BBB

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16
Q

Loperamide is an opioid. Do we see pain relief, euphoria, or addiction with this drug?

A

NO! It doesn’t cross the BBB so, you don’t have those effects even though it is an opioid

17
Q

What is the combination drug used for diarrhea?

A

Diphenoxylate/atropine

18
Q

What is diphenoxylate (an anti-cholinergic or an opioid)?

A

An opioid

19
Q

Can diphenoxylate dissolve in water?

A

No

20
Q

What happens if you take too high a dose of diphenoxylate?

A

You can get a “buzz”

21
Q

What drug did they add to dipphenoxylate so you can’t get a buzz with the opioid if you take too high a dose?

A

Atropine

22
Q

What kind of drug is atropine?

A

Anti-cholinergic

23
Q

What situations is atropine used in a lot?

A

Code situations

24
Q

At a low dose, atropine _____.

A

Doesn’t do much

25
Q

At a high dose, atropine ______

A

Has anticholinergic side effects

26
Q

Can you get diphenoxylate/atropine OTC?

A

No; prescription only

27
Q

What CSA schedule is diphenoxylate/atropine?

A

5

28
Q

What are the adverse effects to dicyclomine?

A

Dry eyes/blurry vision (can’t see)
Urinary retention (can’t pee)
Dry mouth (can’t spit)
Fatigue

29
Q

Dicyclomine is on ____.

A

Beer’s criteria list (avoid in geriatrics unless for acute comfort care)

30
Q

What are the adverse effects of loperamide?

A

Nothing stands out, Very well tolerated

31
Q

What are the adverse effects of diphenoxylate/atropins?

A

Nothing stands out, very well tolerated (unless you abuse them, then the anti-cholinergic effects)

32
Q

What is the important purpose of diarrhea?

A

It helps expel infectious agents or irritants from the body

33
Q

In the hospital, do we give a lot of anti-diarrhea?

A

No–instead go after the cause!! If there is an infection, we fight the infection

34
Q

What is another reason for diarrhea?

A

Food intolerance (lactose intolerance)

35
Q

T/F: Drugs that trigger opioid receptors in the gut don’t necessarily treat the underlying cause.

A

True

36
Q

If someone has an acute infection diarrhea, what drugs do we NOT want to give and why?

A

Drugs that trigger opioid receptors because they don’t treat the underlying cause