Exam 4-5 Bowel Disorder Drugs Flashcards Preview

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Flashcards in Exam 4-5 Bowel Disorder Drugs Deck (32):
1

Diarrhea

Abnormal passage of feces with increased frequency, fluidity, and weight, or with increased feces water excretion

2

Acute diarrhea

*Sudden onset in a previously health person
*Lasts from 3 days to 2 weeks
*Self-limiting
*Resolves without sequelae

3

Chronic diarrhea

*Lasts for more than 3 weeks
*Associated with recurring passage of diarrheal feces, fever, loss of appetite, nausea, vomiting, weight loss, and chronic weakness

4

Causes of acute diarrhea

*Bacterial, viral, drug induced, nutritional factors, protozoa

5

Causes of chronic diarrhea

*tumors, diabetes mellitus, Addison's disease, Hyperthyroidism, Irritable bowel syndrome, AIDS

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Antidiarrheals: Mechanism of Action

Adsorbents: Coat the walls of the GI tract
Bind to the causative bacteria or toxin, which is then eliminated through the feces
Examples: bismuth, subsalicylate (Pepto-Bismol), kaolin-pectin, activated charcoal, attapulgite

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Antidiarrheals: Mechanism of Action/Amtimotility drugs: anticholinergics

*Decreased intestinal muscle tone and peristalsis of GI tract
*Result: slowing the movement of fecal matter through the GI tract
*Examples: belladonna alkaloids, atropine, hyoscyamine

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Antidiarrheals: Mechanism of Action Antimotility drugs: Opioids

*Decrease intestinal motility and relieve rectal spasms
*Slow transit through the intestines, allowing more time for water and electrolyte to be absorbed
*Reduce pain by relief of rectal spasms
-examples: paregoric, opium tincture, codeine, loperamide (OTC), diphenoxylate

9

Antidiarrheals: Mechanism of Action: Intestinal flora modifiers

*Probiotics or bacterial replacement drugs
*Bacteria cultures of Lactobacillus organisms work by:
-supplying missing bacteria to the GI tract
-suppressing the growth of diarrhea-causing bacteria
*Example: L acidophilus (Lactinex)

10

Antidiarrheals: Comibination Products

Diphenoxylate and atropine
*Diphenoxylate is combined with subtherapeutic amounts of atropine
*This discourages recreational opioid use
*Large dosages will result in extreme anticholinergic effects (dry mouth, abdominal pain, tachycardia, blurred vision)

11

Antidiarrheals: Adverse Effects: Adsorbents

*Increased bleeding time
*Constipation, dark feces
*Confusion, twitching
*Hearing loss, tinnitus, metallic taste, blue gums

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Antidiarrheals: Adverse Effects: Anticholinergics

*Urinary retention, hesitancy, impotence
*Headache, dizziness, confusion, anxiety, drowsiness
*Dry skin, rash, flushing
*Blurred vision, photophobia, increased intraocular pressure
*Hypotension, hypertension, bradycardia, tachycardia

13

Antidiarrheals: Adverse Effects

Opioids
*drowsiness, sedation, dizziness, lethargy
*Nausea, vomiting, anorexia, constipation
*Respiratory depression
*Hypotension
*Urinary retention
*flushing

14

Constipation

*Abnormally infrequent and difficult passage of feces through the lower GI tract
*Symptom, not a disease
*Disorder of movement through the colon and/or rectum
*Can be caused by a variety of diseases or drugs

15

Laxatives

*bulk forming
*emollient
*hyperosmotic
*saline
*stimulant
*peripherally acting opioid antagonists

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Laxatives: Mechanism of Action: Bulk forming

*High fiber
*Absorb water to increase bulk
*Distend intestines to initiate reflex intestinal activity
Examples: phyllium (Metamucil)
methylcellulose (Citrucel)

17

Laxatives: Mechanism of Action: Emollient

*Stool softners and lubricants
*Promote more water and fat in the feces
*Lubricate the fecal material and intestinal walls
Examples: Fecal softeners: docusate salts (Colace, Surfak)
*Lubricants: mineral oil

18

Laxatives: Mechanism of Action: Hyperosmotic

*Increase fecal water content
*Result: bowel distention, increased peristalsis, and evacuation
Examples:
-polyethylene glycol (GoLTELY)
-sorbitol, glycerin
-lactulose (also used to reduce elevated serum ammonia levels)

19

Laxatives: Mechanism of Action: Saline

*Increase osmotic pressure within the intestinal tract, causing more water to enter the intestines
*Result: intestinal distention, increased peristalsis, and evacuation
Examples
-Magnesium hydroxide (Milk of Magnesia)
-Magnesium citrate (Citroma)

20

Laxatives: Mechanism of Action: Stimulant

*Increases peristalsis via intestinal nerve stimulation
Examples-
-senna (Senekot)
-bisacodyl (Dulcolax)

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Peripherally Acting Opioid: Antagonists

*Treatment of constipation related to opioid use and bowel resection therapy
*Allow bowel to function normally with continued opioid use
-methylnaltrexone (Relistor)
-alvimopan (Entereg)

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Laxatives: Indications: Bulk forming

Use/ acute and chronic constipation
Irritable bowel syndrome
Diverticulosis

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Laxatives: Indications: Emollient

Use/acute and chronic constipation
Softening of fecal impaction, facilitation of BMs in anorectal conditions

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Laxatives: Indications: Hyperosmotic

Use/Chronic constipation
Diagnostic and surgical preps

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Laxatives: Indications: Saline

Use/Constipation
Diagnostic and surgical preps

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Laxatives: Indications: Stimulant

Use/Acute constipation
Diagnostic and surgical preps

27

Laxatives: Adverse Effects: Bulk forming

*Impaction
*Fluid overload
*Electrolyte imbalances
*Esophageal blockage

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Laxatives: Adverse Effects: Emollient

*Skin rashes
*Decreased absorption of vitamins
*Electrolyte imbalances

29

Laxatives: Adverse Effects: Hyperosmotic

*Abdominal bloating
*Electrolyte imbalances
*Rectal irritation

30

Laxatives: Adverse Effects: Saline

*Magnesium toxicity (with renal insufficiency)
*Cramping
*Electrolyte imbalances
*Diarrhea
*Increased thirst

31

Laxatives: Adverse Effects: Stimulant

*Nutrient malabsorption
*Skin rashes
*Gastric irritation
*Electrolyte imbalances
*Discolored urine
*Rectal irriation

32

All laxatives can cause

electrolyte imbalances