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GI II > Treatments for Abd pain, diarrhea, and constipation > Flashcards

Treatments for Abd pain, diarrhea, and constipation Flashcards

1
Q

Opioid agonists for diarrhea

A

Loperamide, dephenoxylate, eluxadoline

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2
Q

Loperamide MOA

A

interferes with peristalsis and slows transit time, acts directly on circular and longitudinal muscles

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3
Q

Side effects of loperamide

A

anticholinergic

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4
Q

Diphenoxylate MOA

A

inhibits GI motility and slows excess GI propulsion

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5
Q

Side effects of diphenoxylate

A

anticholinergic

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6
Q

Eluxadoline MOA

A

agonist at mu and kappa receptors in GI (slows peristalsis), antagonist at delta opioid receptors (decrease GI secretions)

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7
Q

Indications for eluxadoline

A

irritable bowel syndrome, diarrhea-precominant subtyoe

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8
Q

Side effects eluxadoline

A

hepatic/pancreatic toxicity (increased enzymes), CNS-related (sedation, euphoria)

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9
Q

Contraindications eluxadoline

A

biliary duct obstruction, alcoholism, history of pancreatitis, severe hepatic impairment

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10
Q

Alosetron MOA

A

selectively blockd GI-based 5HT3 receptors

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11
Q

Indications for Alosetron

A

chronic, severe IBS-D not responsive to other therapies

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12
Q

Side effects alosetron

A

GI-related, ischemic cholitis

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13
Q

Ischemic colitis (Black Box Warning)

A

physicians must enroll in a prescribing program, patients and physicians must sign a risk-benefit statement, additional training by physicians required, follow up for refills

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14
Q

Alosetron contraindications

A

GI obstruction, perforation, stricture, toxic mega colon, diverticulitis, IBD, impaired intestinal circulation, severe constipation

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15
Q

Crofelemer MOA

A

inhibits Cl ion secretion by blocking cAMP-CFTR and CaCC (regulate fluid secretion by intestinal epithelial cells)

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16
Q

Indications for Crofelemor

A

non-infectious diarrhea in HIV/AIDS

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17
Q

Side effects crofelemor

A

GI-related, infections

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18
Q

Drugs used for abdominal pain

A

antimuscarinic agents - hyoscyamine and dicycloamine

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19
Q

Antimuscarinics for Abd Pain MOA

A

competitively-inhibit autonomic, post-ganglionic cholinergic receptors

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20
Q

Side effects for antimuscarinics for abd pain

A

anticholinergic-based

21
Q

Drugs in peripheral opioid antagonists class

A

methylnaltrexone, naloxegol, alvimopan

22
Q

MOA peripheral opioid antagonist class

A

antagonist of mu-opioid receptor

23
Q

Indications for methylnaltrexone, naloxegol, and alivmopan

A

opioid-induced constipation; alvimopan used for accelerating GI recovery time and prevent postop ileus

24
Q

Side effects peripheral opioid antagonist

A

GI-related

25
Q

Alvimopan warnings

A

risk of MI

26
Q

Linaclotide MOA

A

selective gunylate cyclase-C agonist, increases cGMP, stimulates secretion of Cl and HCO3 via activation of CFTR

27
Q

Indications for linaclotide

A

IBS-C, chronic idiopathic constipation

28
Q

Lubiprostone MOA

A

PGE1 derivative, increases intestinal fluid secretion by activating GI-specific Cl channels

29
Q

Indications for lubiprostone

A

IBS-C, chronic and opioid-induced constipation

30
Q

Bulk-forming/Hydrophilic Colloidal Agents

A

fiber/bran, psyllium, cellulose, polycarbophil

31
Q

MOA hydrophilic colloidal agents

A

increase bulk-volume and water content, increasing GI motility

32
Q

AE hydrophilic colloidal agents

A

bloating/obstruction, lots of drug interactions

33
Q

Examples of stool softeners

A

surfactant, emollient laxatives (Docusate, mineral oil)

34
Q

MOA anionic surfactants

A

soften/lubricate feces by increasing fluid secretion and decrease fluid reabsorption from GI tract

35
Q

Efficacy of stool softeners

A

1-3 days

36
Q

Examples of GI stimulants

A

senna, bisacodyl, castor oil, glycerin, sodium picosulfate

37
Q

MOA GI stimulants

A

irritant to enterocytes, promote water/electrolyte accumulation in GI tract

38
Q

Efficacy of GI stimulants

A

12-36 hours

39
Q

AE stimulants

A

abdominal cramping, urine discoloration, fluid/electrolyte disturbances

40
Q

Saline agents used for constipation

A

Magnesium salts, sodium phosphate

41
Q

MOA saline agents for constipation

A

Mg/PO4 ions poorly absorbed, creates hyperosmolar solutions and osmotically retains water in GI tract

42
Q

Saline agent drug interactions

A

diuretics, causes an electrolyte imbalance

43
Q

Cautions for use of saline agents

A

pts with renal disease and CHF/HTN should not use

44
Q

Osmotic agents used for constipation

A

lactulose, mag citreate, sorbitol, PEG

45
Q

MOA osmotic agents for constipation

A

attract and retain increased water in colon increasing moisture, softness, and volume

46
Q

Efficacy of osmotic agents

A

1-2 days, 1-3 hours if large volume administered

47
Q

Other uses of lactulose

A

severe liver disease (hyperammonemia)

48
Q

AE osmotic agents

A

electrolyte disturbances, GI-related

49
Q

PEG is used for…

A

bowel prep prior to GI scopes, radiological procedures or surgery, smaller doses for constipation

GI II (8 decks)

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