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GI Pharm > Anti-Inflammatory > Flashcards

Anti-Inflammatory Flashcards

1
Q

LOPERAMIDE (Imodium) class

A

Anti-diarrheal, Opioid

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2
Q

LOPERAMIDE (Imodium) use

A

mild to moderate diarrhea without obstruction, IBD, IBS

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3
Q

When can we not use Loperamide (Imodium)?

A

Bowel obstruction or BLOODY diarrhea

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4
Q

When would a patient want to stop imodium?

A

If they have bloody diarrhea or they notice distention

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5
Q

What non-pharm treatment do we always suggest for diarrhea?

A

BRAT diet & avoid high sugar content foods

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6
Q

KAOLIN-PECTIN (Kaopectolin) class

A

Anti-diarrheal, non-opioid

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7
Q

KAOLIN-PECTIN (Kaopectolin) indication

A

mild diarrhea

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8
Q

Is Kaolin-pectin absorbed in the intestine?

A

Nope

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9
Q

DIETARY FIBER (Metamucil, Citrucel, Fibercon) class

A

Anti-diarrheal and laxative

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10
Q

DIETARY FIBER (Metamucil, Citrucel, Fibercon) indication

A

mild to moderate diarrhea, constipation

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11
Q

So, how can you use fiber to treat diarrhea?

A

Fiber + Less Fluid

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12
Q

How can you use fiber to treat constipation?

A

Fiber + more fluid

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13
Q

OCTREOTIDE (Sandostatin) Class

A

Synthetic somatostatin analogue, anti-diarrheal

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14
Q

OCTREOTIDE (Sandostatin) indication

A

diarrhea secondary to bowel dysmotility, carcinoid, VIP-oma, pancreatic fistulas, vagotomy, dumping syndrome, short bowel syndrome, HIV diarrhea; GI bleeding

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15
Q

What type of secretions is octreotide inhibiting?

A

Inhibits secretion of gastrin, cholecystokinin, glucagon, growth hormone, insulin, secretin, etc (Inhibits intestinal fluid and pancreatic secretions)

To slows GI motility and GB contraction

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16
Q

What is always a risk factor with octreotide?

A

Gallstones! Look for sxs like abdominal pain, right shoulder pain, and N/V

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17
Q

What if your patient is taking octreotide + metoprolol?

A

Watch BP, when combined with a BB it can cause bradycardia

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18
Q

Octreotide is an IM injection, what else might we need to give to patient taking it?

A

Possibly B12 & folate

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19
Q

MESALAMINE (Asacol) & SULFASALAZINE (Azulfadine) Class

A

5 ASA Anti-inflammatory

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20
Q

MESALAMINE or 5-ASA (Asacol) Indications

A

Ulcerative colitis, proctosigmoiditis, proctitis

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21
Q

SULFASALAZINE (Azulfadine) Indications

A

Ulcerative colitis, rheumatoid arthritis, Crohn’s disease, and psoriasis

22
Q

Where does Mesalamine work?

A
  • pH sensitive release = Ileum

- Delayed release = jejunum, ileum, and colon

23
Q

Where does sulfasalazine work?

A

Colon

24
Q

Do 5ASA anti-inflammatories have any affect on folate?

A

Yes, must supplement it!

25
Q

AZATHIOPRINE (Imuran) Class

A

Purine analogue immunosuppressant

26
Q

AZATHIOPRINE (Imuran) Indication

A

steroid sparing for steroid dependent Crohn’s disease, ulcerative colitis, maintain remission in CD, fistulizing CD; kidney transplant, rheumatoid arthritis

27
Q

METHOTREXATE (Rheumatrix) Class

A

Purine analogue immunosuppressant

28
Q

METHOTREXATE (Rheumatrix) Indicaiton

A

Crohn’s disease, +/- UC, psoriasis, rheumatoid arthritis

29
Q

INFLIXIMAB (Remicade) Class

A

Anti-TNF alfa anti-inflammatory agent

30
Q

INFLIXIMAB (Remicade) Indication

A

acute and maintenance Tx moderate to severe Crohn’s disease and UC

31
Q

NATALIZUMAB Class

A

Anti-integrin

32
Q

NATALIZUMAB Indicaiton

A

subset of patients with mod to severe Crohn’s disease who have failed other therapies

33
Q

When you combine sulfasalazine & azathioprine together, what can it cause?

A

Myelosupression

34
Q

How long does it typically take Azathioprine to work?

A

3-6 months

35
Q

What’s our one medication to treat gallstones?

A

URSODIOL (Actigall)

36
Q

URSODIOL (Actigall) Class

A

ursodeoxycholic acid gallstone dissolution

37
Q

SENAKOT (Senna) Class

A

Anthraquinone (stimulant) laxative

38
Q

SENAKOT (Senna) Indication

A

constipation (w/o bowel obstruction)

39
Q

LUBIPROSTONE (Amitiza) Class

A

Laxative, calcium channel activator

40
Q

LUBIPROSTONE (Amitiza) Indication

A

Chronic idiopathic constipation; IBS constipation–dominant in women >18yo; opioid induced constipation

41
Q

LINACLOTIDE (Linzess) Class

A

cGMP agonist Laxative

42
Q

LINACLOTIDE (Linzess) Indication

A

IBS-C (in adults not responsive to PEG); or, Chronic Idiopathic Constipation (CIC) in adults

43
Q

PG3350 (MiraLax) Class

A

Osmotic Laxative; PEG

44
Q

PG3350 (MiraLax) Indicaiton

A

occasional constipation; short=term use

45
Q

When taking MiraLax, when should you expect a bowel movement?

A

1-3 days

46
Q

Should you continue fiber while taking MiraLax?

A

MiraLax is for short term use, so you can continue daily fiber.

47
Q

If an elderly patient with dementia is seeing you for constipation, you get a BUN and notice it’s high. What does this tell you?

A

Hypovolemia

- Make sure he’s not dehydrated

48
Q

If after 3 days of MiraLax use, and no bowel movement, what do you do?

A

Suspect a bowel obstruction!

PE: Tinkering + high pitched noise with distention. Do a DRE!

49
Q

If octreotide is given IV, what is occuring physiologically?

A

Arterial vasoconstricion of the splanchnic arterial system.

50
Q

What other medication is an Osmotic Laxative?

A

Lactulose

51
Q

What medication is a Magnesium Laxative?

A

MgCitrate

52
Q

What medication is our stool softner?

A

Docusate Na (Colase)

GI Pharm (5 decks)

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