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GI 2 Final > Tx for Diarrhea, abdominal pain and constipation (laxative/cathartics) > Flashcards

Tx for Diarrhea, abdominal pain and constipation (laxative/cathartics) Flashcards

1
Q

drug families for diarrhea

A

prostaglandin inhibitors
opioid agonists
serotonin antagonists
chloride channel blockers

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2
Q

use of opioids for diarrhea

A

anti-propulsives

loperimide - does not exhibit analgesic affect, available OTC

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3
Q

MoA of loperamide

A

interferes iwth persitalsis (slows transit time)

direct action on circular and longitudinal muscles of intestinal wall, slowing motility

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4
Q

SE of loperamide

A

dizziness, fatigue, drowsiness, urinary retention (anticholinergic affects)

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5
Q

diphenoxylate is what kind of anti-diarrheal

A

opioid agonist

synthetic opiate agonist similar to meperidine

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6
Q

what does diphenoxylate have added to it to discourage abuse/overdosing

A

atropine

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7
Q

MoA of diphenoxylate

A

inhibits GI motility and slows excess GI propulsion

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8
Q

SE of diphenoxylate

A

dizziness, drowsiness, urinary retention

anticholinergic; atropine

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9
Q

eluxadoline is what type of anti-diarrheal

A

opioid agonist

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10
Q

indications for eluxadoline

A

IBS-D

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11
Q

MoA of eluxadoline

A

agonsit at opioid mu and kappa receptors in GI tract (slowing peristalsis/delays digestion)
antagonist at delta opioid receptors in GI - stomach, pancreas, biliary tree secretions decreased

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12
Q

SE of eluxadoline

A

GI -N/V/ abdominal pain
hepatic/pancreatic toxicity
PANCREATITIS HIGH RISK IN PATIENTS IWTHOUT A GALLBLADDER LEADING TO DEATH
CNS - dizziness/fatigue/sedation/euphoria/impaired congition

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13
Q

CI to eluxadoline

A 
biliary duct obstruction 
sphincter of oddi dysfunction
alcoholism
hx of pancreatitis
severe hepatic impairment 
STOP therapy if severe constipation develops
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14
Q

alosetron is what type of anti-diarrheal

A

5-HT antagonist

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15
Q

MoA of alosetron

A

selectively blocks GI-based 5HT3 recpetors

modulates regulation of vsiceral pain, colinic transit and GI secretions

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16
Q

indications ofr alosetron

A

IBS-D not responsive to otehr conventional therapies (in women) used off label in men as well

17
Q

SE of alosetron

A

CONSTIPATION
ischemic colitis ***
no refills without a fu exam

18
Q

CI to alosetron

A

hx or active
GI obstruction, perforation, stricture, adhesions or toxic megacolon
diverticulitis, CD, UC
impaired intestinal cirulation, thrombophlebitis or hypercoaguable state
severe constipation; D/C immediately if develops on alosetron therapy

19
Q

crofelemer is what type of anti-diarrheal

A

cl- channel inhibitor
inbhitis chloride ion secretion at CFTR and CaCC channels
regulating fluid secretion by intestinal epithelial cells

20
Q

what is unique about the production of crofelemer

A

comes from the sap of the croton lechleri tree

a botanical pharmaceutical

21
Q

indications for crofelemer

A

non-infectious diarrhea in HIV/AIDS pt on anti-retroviral therapy
**

22
Q

SE of crofelemer

A

GI - abdominal distension, elevated AST/ALT/bili

infections - respiratory/urinary

23
Q

drugs used in the tx of abdominal pain of IBS

A

antimuscarinics
HYOSCAMINE
DICYLOMINE
CLIDINIUM/CHLORDIAZEPOXIDE

24
Q

indications for antimuscarinics

A

abdominal pain/spasms, esp when associated with IBS

25
Q

drug families for constipation

A

laxative and cathartic agents
peripheral opioid antagonists
guanylate cyclase-c agonists
selective c2 channel activators

26
Q

linaclotide is used in the treatment of constipation - its MoA

A

selective guanylate cyclase agonist
binds GC-C on intestinal epithelial cells and icnreases cGMP, stimulating the secretion of chloride/bicarb into intestinal lumen via CFTR

27
Q

indications for linaclotide

A

IBS-C

chronic idiopathic constipation

28
Q

SE for linaclotide

A

diarrhea - dehydration/electrolyte imabalnce

gerd/dyspepsia/n/v

29
Q

lubiprostone is a PGE-1 derivative that is used in the treatment of

A

constipation

30
Q

MoA of lubiprostone

A

increases intestinal fluid secretion by activation GI specific chlordie channels CIC-2 in luminal cells of intestinal epithelium

GI 2 Final (4 decks)

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