Agents for Diarrhea

Question 1

What is a Prostaglandin (-) that can be used to treat Diarrhea?

Answer 1

Bismuth

Question 2

What is a Prostaglandin (-) that can be used to treat Diarrhea?

Answer 2

Bismuth

Question 3

3 main classes of drugs to treat Diarrhea?

Answer 3

Opioid Agonists
Serotonin Antagonist
Cl- Channel Inhibitor

Question 4

3 main classes of drugs to treat Diarrhea?

Answer 4

Opioid Agonists
Serotonin Antagonist
Cl- Channel Inhibitor

Question 5

What are 3 Opioid Agonists to treat Diarrhea?

Answer 5

Loperamide
Diphenoxylate
Eluxadoline

Question 6

What are 3 Opioid Agonists to treat Diarrhea?

Answer 6

Loperamide
Diphenoxylate
Eluxadoline

Question 7

Does Loperamide exhibit analgesic/opiate-like effects?

Answer 7

No

- Nor physical dependence

Question 8

MOA for Loperamide?

Answer 8

(Opioid Agonist)

= Acts on muscles of intestinal wall to slow/interfere with peristalsis

Question 9

Possible adverse effects of Loperamide?

Answer 9

Cardiac toxicities leading to death
Anticholinergic effects
- Urinary retention, constipation, drowsy, blurred vision, etc.

Question 10

Does Diphenoxylate exhibit analgesic/opiate-like effects?

Answer 10

Yes, at very high doses!

Question 11

Diphenoxylate includes a small quantity of?

Answer 11

Atropine

Question 12

Diphenoxylate includes a small quantity of?

Answer 12

Atropine

Question 13

Why does Diphenoxylate have Atropine in it?

Answer 13

To discourage overdose/abuse

== Strong Anticholinergic effects!

Question 14

MOA for Diphenoxylate?

Answer 14

(Opioid Agonist)

= Slows GI motility by acting on central/peripheral GI smooth muscle cells

Question 15

What is the indication to use Eluxadoline?

Answer 15

IBS-D

irritable bowel syndrome - diarrhea subtype

Question 16

Eluxadoline has 2 MOA. What are they?

Answer 16

1. Agonist at mu and kappa receptors to slow peristalsis

2. Antagonist at delta receptors to decrease secretions

Question 17

Adverse effects of Eluxadoline?

Answer 17

Constipation
Hepatic/Pancreatic enzymes
CNS related

Question 18

Patients without a gallbladder on Eluxadoline are at an increased risk to develop?

Answer 18

Pancreatitis

Question 19

Contraindications for patients to take Eluxadoline?

Answer 19

Alcoholism/Hepatic impairment

Pancreatitis disease or NO gallbladder

Question 20

Which Opioid Agonist can treat IBS-D?

Answer 20

Eluxadoline

Question 21

What is a Serotonin Receptor Antagonist (5HT3) used to treat diarrhea?

Answer 21

Alosetron

Question 22

What is the indication to use Alosetron for Diarrhea?

Answer 22

Severe IBS-D that is NOT responsive to other treatments!!

Question 23

What is the indication to use Alosetron for Diarrhea?

Answer 23

Severe IBS-D that is NOT response to other treatments

Question 24

Adverse effect seen with Alosetron?

Answer 24

Ischemic Colitis

Question 25

Which drug to treat Diarrhea can cause Ischemic Colitis?

Answer 25

Alosetron | Serotonin Receptor 3 Antagonist

Question 26

You should not give your patients Alosetron if they have any?

Answer 26

GI or liver issues

Question 27

What is a Cl- Channel Inhibitor to treat Diarrhea?

Answer 27

Crofelemer

Question 28

What is a Cl- Channel Inhibitor to treat Diarrhea?

Answer 28

Crofelemer

Question 29

What is a Cl- Channel Inhibitor to treat Diarrhea?

Answer 29

Crofelemer

Question 30

What is the indication to give patients with Diarrhea Crofelemer?

Answer 30

Non-infectious diarrhea in HIV/AIDs patients on Anti-Retroviral Therapy!

Question 31

Crofelemer is given to what patients?

Answer 31

HIV/AIDS on ART

Question 32

HIV/AIDs patients with non-infectious diarrhea who are taking ART should be given what drug/class?

Answer 32

Crofelemer/Cl- Channel Inhibitor

Question 33

What drug for Diarrhea was derived from sap of a croton lechleri tree?

Answer 33

Crofelemer

Question 34

MOA for Crofelemer?

Answer 34

(-) Cl- secretion by blocking cAMP-stimluated CFTR and CaCC (calcium activated chloride channels)

Question 35

Crofelemer (-) Cl- secretion from channels. Which channels?

Answer 35

CFTR and CaCC | - (calcium activated chloride channels)