Test 2 - Diarrhea & Vomiting (RM) In progress

Question 1

What is the most common disorder of the GI tract?

Answer 1

Irritable Bowel Syndrom (IBS); affects about 20% of Americans

Question 2

What are the 2 major types of GI receptors that regulate bowel motility?

Answer 2

• Cholinergic

- Opioid (Mu)

Question 3

What neurotransmitter is released by cholinergic receptors?

Answer 3

Acetylcholine

Question 4

Which GI receptor increases bowel motility?

Answer 4

Cholinergic

Question 5

Which GI receptor decreases bowel motility?

Answer 5

Opioid (Mu)

This is why morphine can cause constipation.

Question 6

What are the drugs that slow bowel motility?

Answer 6

• dicyclomine
• loperamide
• diphenoxylate/atropine

Question 7

What are some adverse effects of dicyclomine?

Answer 7

It is an anticholinergic!
(Can't see, can't spit, can't pee, can't sh**)
- dry eyes
- blurry vision
- dry mouth
- urinary retention
- fatigue

Question 8

Loperamide is structurally similar to meperidine, but it can’t cross the blood brain barrier. What effects are not seen in loperamide, then?

Answer 8

• no pain relief
• no euphoria
• no addiction

Question 9

Why is atropine added to diphenoxylate?

Answer 9

Because diphenoxylate can cause a “buzz”. Atropine will counteract this effect.

Question 10

Why do antidiarrheal meds that trigger opioid receptors not usually abused?

Answer 10

The doses used to relieve diarrhea are not usually enough to cause dependence.

Question 11

What can excessively high doses of antidiarrheal meds cause? What is a condition that may require these high doses?

Answer 11

Dependence;

Nausea/vomiting from chemotheraphy

Question 12

In patients with IBS, opioids may cause ____ ____.

Answer 12

toxic megacolon

Question 13

When can giving an antidiarrheal med to someone with diarrhea be a problem?

Answer 13

When there is an underlying cause of the diarrhea (infection, food intolerance). We must address the underlying issue for the diarrhea to subside.

Question 14

Where is the vomiting center located?

Answer 14

medulla oblongata

Question 15

What are the 2 types of stimuli that work on the vomiting center?

Answer 15

Direct-acting stimuli

Indirect-acting stimuli

Question 16

What 3 types of signals are direct-acting stimuli of the vomiting center?

Answer 16

Signals from:

• cerebral cortex (anticipation/fear)
• sensory organs (upsetting sights/noxious odors/pain)
• vestibular apparatus of inner ear

Question 17

Signals sent from the vestibular apparatus of the inner ear to the vomiting center in the brain are responsible for ______ _____.

Answer 17

Motion sickness

Question 18

What is the pathway from an indirect-acting stimuli to vomiting?

Answer 18

stimuli –> activation of CTZ –> activation of vomiting center

Question 19

What does CTZ stand for?

Answer 19

chemoreceptor trigger zone

Question 20

What are 2 ways indirect-acting stimuli can activate the CTZ?

Answer 20

1) signals from stomach/small intestine traveling along vagal afferent nerves
2) emetogenic compounds that are carried in the blood (like anticancer drugs, opioids, ipecac)