012315 lower GI pharm Flashcards Preview

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Flashcards in 012315 lower GI pharm Deck (27):
1

diarrhea-when should you treat with pharmacological therapy

reserved for pts w significant or persistent symptoms (to provide symptomatic relief)

2

narcotics used for anti-diarrheal therapy

loperamide
diphenoxylate

3

loperamide

opioid derivative (opioids slow action of intestinal tract). mu receptor agonist
best agent-poorly penetrates CNS

4

diphenoxylate

opioid derivative
mu receptor agonist
at high conc, can produce CNS effects--so there's an abuse potential, so it's given with atropine

5

fiber

increases stool bulk
used to tx diarrhea and constipation

6

bismuth subsalicylate

pepto bismo
MOA unclear
used to tx traveler's diarrhea, episodic diarrhea

7

what is used to tx diarrhea associated w carcinoid syndrome

octreotide (a somatostatin analog)-it inhibits hormone secretion

8

side effects of octreotide

many--
short term: nausea, bloating
long term: gallstone

9

two types of dietary fiber are used to tx constipation--what are they?

fermented fiber--colon bacteria ferments the fiber and produces short chain fatty acids which are somewhat prokinetic. fermentation increases stool bacterial mass. side effect: gas

nonfermented fiber-retains water and increases stool bulk

10

Mg(OH)2

milk of magnesia
used to tx constipation
inorganic salts that aren't absorbed, so causes water retention (osmotic)

11

lactulose

osmotic laxative
it's an unabsorbed carbohydrate. it's metabolized to short chain fatty acids by gut bacteria

can decrease ammonia levels by acidifying

12

polyethylene glycol (PEG)

to tx constipation
it's not absorbed. retains water due to osmosis

13

ducosate salts

to tx constipation
anionic surfactant that lowers surface tension

14

contact cathartics/stimulant laxatives--ex and MOA

MOA: cause mucosa irritation/inflam

ex:
bisacodyl
senna

both act on large intestine

15

lubiprostone

to tx constipation
activates Cl channels in intestine to increase water secretion

16

use of lubiprostone

tx of adult chronic constipation and women w IBS

17

linaclotide

to tx constipation
binds and activates the guanylate cyclase C receptor on luminal surface of intestinal epithelial cells to increase intracellular and extracellular cGMP.

its two effects:
--Cl and bicarb secretion
--extracecllular cGMP may decrease visceral pain

18

use of linaclotide

chronic idiopathic constipation
IBS with constipation

19

methylnaltrexone

selective antagonist of peripheral mu opioid receptor

used to tx constipation
used for opioid-associated consitipation

20

prednisone

used to tx MODERATE/SEVERE ACUTE attacks of UC or Crohn's

21

budesonide

used to tx Crohn's

ENTERIC release steroid used for Crohn's
minimal side effects b/c not systemic like prednisone

22

the 5-aminosalicylates

mesalamine
olsalazine
sulfasalazine

latter two are prodrugs that are converted to mesalamine by colonic bacteria

23

use of 5-aminosalicylates

mild to moderate UC

24

MOA of 5-aminosalicylates

unclear

25

sulfasalazine side eeffects

related to the converted form sulfapyridine

fever, malaise, vomiting, headache

26

mesalamine and olsalazine side effects

less side effects than sulfasalazine

27

infliximab

used for mod/severe Crohn's and UC