Diarrhea And Constipation Flashcards Preview

RESP & GIT Pharmacology > Diarrhea And Constipation > Flashcards

Flashcards in Diarrhea And Constipation Deck (34):
1

Drugs altering motility

Anti-spasmodics - decrease smooth muscle tone
Laxatives - accelerate passage
Anti-diarrhoeal drugs - decrease motiity
Pro-kinetics - increase motility of smooth muscle

2

Dicyclomine

Antimuscarinic

3

Hyoscine butyl-bromide

Anti-muscarinic

4

Mebeverine

Anti-muscarinic

5

Propantheline

Anti-muscarinic

6

Falvoxate

Antimuscarinic

7

Clidinium bromide

Anti-muscarinic

8

Anti-muscarinics indications

Used as anti-spasmodics

-intestinal
-biliary
-genitourinary

9

Diarrhea mechanisms

1. Increased osmotic load - water retention in lumen
2. Excessive secretion of electrolytes
3. Exudation of protein and fluid from mucosa
4. Altered motility - rapid transit and decreased fluid absorption (inflammatory/infectious)

10

Diarrhea Mx

1. Prevent dehydration
2. Anti-infective - curative
3. Spasmolytic or other antidiarrhoeal (symptomatic)

11

Loperamide

Anti-motility agent

12

Diphenoxylate

Antimotility agent

13

Codeine

Anti-motility agent

14

Anti-motility agents

-opioid derivatives - inhibits Ach release - decreased peristalsis and increased sphincter tone

15

Anti-motility agent indications

Traveller’s diarrhea
Adjunct in chronic diarrheal disease

16

Anti motility agent SE

-minimal
-some BBB crossing
-low incidence of addiction

Avoid in suspected inflammatory diarrhea
-prolonged fever with shigella
-toxic megacolon in pts w. C. difficile (>6cm dilation of transverse colon)

17

Bismuth subsalicylate

-decreases fluid secretion

-travellers diarrhoea, episodic diarrhea, acute gastroenteritis, H. Pylori eradication

18

Adsorbents

-adsorbs intestinal toxins and microorganisms
-coats intestinal mucosa
-interferes with abrorbtion of other drugs

19

Cholestiramine

Adsorbent - Bile acid sequestrant

20

Kaolin and Pectin

Adsorbent

21

Methylcellulose

Adsorbent (fermented fibre)

22

Aluminium hydroxide

Adsorbent

23

Probiotics indications

-acute diarrhea
-antibiotic associated diarrhea
-infectious diarrhea

24

Dietary fibre

Laxative - bulk forming
Unfermented fibre attracts H2O and increases stool bulk - distends intestine increasing peristalsis
(fermented fibre attracts stool water - used in diarrhea)

-hydrophilic colloids
-indigestible parts of fruit and veg
-psyllium seeds, bran, ispaghula

25

Osmotic active agents

Saline laxatives: magnesium citrate - non-absorbable salts

Electrolyte solution laxatives
-polyehtylene glycol

Nondigestible sugars & alcohols
-lactulose - semi-synthetic sugar cannot be hydrolized by intestinal enzymes
-increases osmotic pressure, increase fluid, increase lumen pressure, stimulate evacuation

26

Docusate sodium/calcium/potassium

Laxative - stool wetting agent
-lowers surface tension of stools - allow mixing
-may take days

27

Mineral oil

Indigestible
-causes anal leakage and lipid pneumonitis NB

28

Senna

Stimulant laxative
-induce limited low grade inflammation

29

Bisacodyl

Stimulant laxative
-induce limited low grade inflammation

30

Castor oil

-irritant laxative

-stimulates uterine contractions in pregnant

31

Pro-kinetic agents

-increase intensity of contractions in small intestine without rhythm disruption
-good in diabetics with gastroparesis

32

Dopamine receptor antagonists

Suppress Ach release
-inhibits motility, reduces LOS tone, reduce intragastric pressure

-metoclopramide
-domperidone

33

Cisapride

5HT4 agonist - prokinetic agent
-ventricular arrhythmia

34

Macrolide

Pro-kinetic agent

Only used in diabetics with gastroparesis