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pharmacology module III exam II > constipation and IBS > Flashcards

constipation and IBS Flashcards

1
Q

stool softeners

A

docusate sodium

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2
Q

docusate sodium MOA

A

lowers the surface tension at the oil-water interface of the feces, allowing water and lipids to penetrate the stool – this helps hydrate and soften the fecal material, facilitating natural defecation

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3
Q

docusate sodium side effects

A

throat irritation

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4
Q

docusate sodium indications

A

NO MAJOR INTERACTIONS

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5
Q

bulking laxatives

A

methycellulose
psyllium husk powder
wheat dextrin
calcium polycarbophil

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6
Q

bulking laxatives MOA

A

absorb and retain water in the intestine thus increasing the mass of stool – promotes peristalsis through distention of intestinal lumen

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7
Q

bulking laxatives side effects

A

bloating, flatulence, GI distress

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8
Q

some bulking laxatives contain

A

phenylalanine

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9
Q

bulking laxatives education

A

must take with 8oz of fluid
can be a choking hazard

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10
Q

bulking laxatives interactions

A

NO MAJOR INTERACTIONS

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11
Q

osmotic laxatives

A

saline
lactulose
polyethylene glycol
glycerin

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12
Q

saline laxatives

A

magnesium oxide (milk of magnesium)
sodium phosphate (FLEETS)

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13
Q

saline laxatives MOA

A

retain water in the intestine thus increasing intraluminal and promotion of peristalsis

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14
Q

saline laxatives side effects

A

bloating, abdominal pain, aphthous stomatitis, hypokalemia, and hypophosphatemia

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15
Q

saline laxatives interactions

A

ARBs/ACEs, antacids, diuretics, NSAIDs, TCAs, sucralfate

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16
Q

lactulose MOA

A

disaccharide that promotes fluid retention in intestine thus increasing intraluminal pressure and promoting peristalsis

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17
Q

lactulose colonic microbiota converts

A

sugars into lactic and aecitic acids

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18
Q

lactulose may cause

A

electrolyte imbalances

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19
Q

lactulose side effects

A

dehydration, hypernatremia, hypokalemia, bloating, nausea, abdominal cramping, diarrhea

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20
Q

lactulose interactions

A

glutamine

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21
Q

polyethylene glycol

A

not absorbed - excreted fecally

22
Q

polyethylene glycol may cause

A

electrolyte imbalances

23
Q

polyethylene glycol side effects

A

diarrhea, flatulence, abdominal pain, nausea

24
Q

polyethylene glycol interactions

A

digoxin

25
Q

glycerin suppositories can cause

A

rectal burning
abdominal cramping, bloating, diarrhea, irritation, tenesmus

26
Q

glycerin suppositories interactions

A

NO MAJOR INTERACTIONS

27
Q

stimulant laxatives

A

biscodyl, sennosides

28
Q

stimulant laxatives MOA

A

alter fluid excretion by acting directly on the cells of the intestinal mucosa – increase motility by acting on cells

29
Q

stimulant laxatives side effects

A

abdominal pain, protein losing enteropathy, diarrhea, and hypokalemia

30
Q

stimulant laxatives interactions

A

antacids, PEG

31
Q

opioid antagonists

A

naloxegol
methylnaltrexone

32
Q

naloxegol MOA

A

Mu opioid receptor antagonist – bound to polyethylene glycol to prevent crossing BBB – blocks the effects of opioids on GI tract thus decreasing constipation

33
Q

naloxegol absorption/metabolism

A

rapid - CYP3A4

34
Q

naloxegol education

A

take with food to increase absorption

35
Q

naloxegol may cause

A

GI perforation rarely

36
Q

naloxegol side effects

A

abdominal pain, HA, diarrhea, nausea

37
Q

naloxegol interactions

A

CYP3A4 inducers and inhibitors, grapefruit juice, st johns wart

38
Q

methylnaltrexone MOA

A

derivative of naltrexone

39
Q

methylnaltrexone education

A

take with food to increase absorption

40
Q

methylnaltrexone side effects

A

abdominal pain, flatulence, nausea, diarrhea, muscle spasm, tremor, hot flashes

41
Q

methylnaltrexone interactions

A

other opioid antagonists

42
Q

IBS constipation meds

A

lubiprostone
linaclotide

43
Q

lubiprostone MOA

A

activates chloride channels and increases fluid secretion by the cells in the intestinal membrane – also counteracts the antisecretory effects of opioids

44
Q

lubiprostone metabolsim

A

in the stomach and jejunum

45
Q

lubiprostone education

A

take with food to decrease nausea

46
Q

lubiprostone side effects

A

HA, nausea, diarrhea, edema, chest pain

47
Q

lubiprostone interactions

A

levomethadone and methadone

48
Q

linaclotide MOA

A

acts on guanylate cyclase on the epithelium of the intestine increasing cyclic guanosine monophosphate – stimulates chloride and bicarb secretion and intraluminal pressure – promotes peristalsis – cGMP is thought to decrease visceral pain

49
Q

linaclotide education

A

take at least 30 min before breakfast

50
Q

linaclotide side effects

A

HA, diarrhea, fatigue, abdominal pain

51
Q

linaclotide interactions

A

NO MAJOR INTERACTIONS

52
Q

linaclotide metabolism

A

GI tract

pharmacology module III exam II (6 decks)

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