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Pathopharm I > GI > Flashcards

GI Flashcards

1
Q

Constipation

A

Small, infrequent, or difficult BM

Fewer than 3 BMs/week

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2
Q

Constipation causes

A 
Diet (low in fiber)
Lack of exercise
Slowed peristalsis
Pathologic conditions causing constipation
Obstruction or diverticulitis
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3
Q

Impaction

A

Unrelieved constipation may lead to obstruction

Firm, immovable mass of stool obstructing lower GI tract

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4
Q

Impaction symptoms

A 
May have continuous oozing or diarrhea
Loss of appetite
N/V
Abdominal distention
Cramping and pain
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5
Q

Diarrhea

A

Increase in frequency and fluidity of bowel movements

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6
Q

Acute diarrhea causes

A

Infection, emotional stress, some medications

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7
Q

Acute diarrhea

A

Make sure liquid stool around an impaction is not misdiagnosed as acute diarrhea

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8
Q

Chronic diarrhea

A

Lasting more than 4 weeks

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9
Q

Chronic diarrhea causes

A

Chronic GI infection
Alterations in motility or integrity of GI tract
Malabsorption
Endocrine disorders

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10
Q

Episodic diarrhea

A

Food allergy or irritant (i.e. caffeine, enteral feeding)

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11
Q

Osmotic diarrhea

A

Caused by increasing amounts of osmotically active solutes
Typically related to magnesium sulfate or Epsom salt
Ingestion of magnesium sulfate causes sodium/water to enter colon
Common with tube feeding

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12
Q

Osmotic diarrhea

A

Magnesium sulfate

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13
Q

Secretory diarrhea

A

Caused by bacteria or toxin
Toxin can increase reabsorption of water in colon
Bacteria typically involved: Vibrio cholerae & Staphylococcus aureus

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14
Q

Exudative diarrhea

A

Active sites of inflammation in the bowel lumen that results in exudation of mucus, blood, and proteins which pulls water into the colon
Usually related to Cronhs or ulcerative colitis

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15
Q

Motility diarrhea

A

Related to decreased absorption in the small intestine/large amounts of fluid delivered to the colon
Example: dumping syndrome after gastrectomy or IBS

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16
Q

Problems caused by diarrhea

A

Skin breakdown
Fluid/Electrolyte imbalance
Nutritional concerns
More concerned for these complications in children and older adults

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17
Q

bismuth subsalicylate (Pepto-Bismol) class

A

Adsorbent anti-diarrheal

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18
Q

bismuth subsalicylate (Pepto-Bismol)

A

A form of aspirin

Activated charcoal

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19
Q

bismuth subsalicylate (Pepto-Bismol) MOA

A

Coats the walls of the GI tract and bind the causative agent for elimination through stool

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20
Q

bismuth subsalicylate (Pepto-Bismol) SE

A

Increased bleeding time (with warfarin)
Constipation
Dark stools and darkening of tongue

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21
Q

loperamide (Imodium), diphenoxylate with atropine (Lomotil) class

A

Antimotility anti-diarrheal

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22
Q

loperamide (Imodium) MOA

A

Inhibits peristalsis by reducing smooth muscle contractions of the GI tract
Inhibits intestinal secretion, decreasing stool water content
No anticholinergic effects

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23
Q

diphenoxylate with atropine (Lomotil) MOA

A

Inhibits GI motility

When taken in large dosages, atropine causes extreme anticholinergic effects (drying effects/reduce gastric secretions)

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24
Q

loperamide (Imodium), diphenoxylate with atropine (Lomotil)

A

Antimotility

Used alone or in combination with adsorbents and opiates

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25
loperamide (Imodium), diphenoxylate with atropine (Lomotil) SEs (related to anticholinergic effects from atropine; wouldn’t have these with loperamide alone)
Urinary retention, headache, dizziness, anxiety, drowsiness, bradycardia, hypotension, dry skin, flushing
26
Probiotics
Obtained from bacterial cultures, most commonly lactobacillus organisms (Bacid, Culturelle) which make up normal flora
27
Lactobacillus organisms (Bacid, Culturelle)
These bacteria make up the majority of normal flora of gut; bacteria often destroyed by abx so probiotics good for patients with diarrhea from abx
28
Saccharomyces boulardii (Florastor)
Probiotic used to treat C-Diff
29
Probiotics MOA
Restore normal flora
30
Laxatives
``` For treatment of constipation One of the most misused medication; can lead to dependence Treatment is Individualized: Age Severity Contributing factors ```
31
Laxatives groups
``` Bulk-forming Emollient Hyperosmotic Saline Stimulant ```
32
psyllium (Metamucil)
Bulk-forming laxative
33
psyllium (Metamucil) MOA
Acts similar to dietary fiber Absorbs water into the intestine, increasing bulk Distends bowel to initiate reflex bowel activity and bowel movement
34
psyllium (Metamucil)
Safe for long-term use
35
psyllium (Metamucil) SEs
Impaction above strictures Fluid/electrolyte imbalance Gas formation Esophageal blockage (must take bulk-forming with increased water to avoid esophageal obstruction)
36
psyllium (Metamucil) systemic
No systemic effects; actions limited to GI
37
psyllium (Metamucil)/bulk-forming laxatives contraindication
Contraindicated in patients with intestinal obstruction or fecal impaction
38
docusate sodium (Colace)
Emollient laxative (stool softener)
39
docusate sodium (Colace) MOA
Lubricates fecal material and intestinal walls, promotes fat absorption into fecal mass which softens stool, increases secretion of water by the intestine Lubrication of fecal material and promoting fat absorption into fecal matter
40
docusate sodium (Colace) indications
Prevent opioid-induced constipation; commonly used post-op
41
docusate sodium (Colace)
Given PO
42
mineral oil
Emollient laxative
43
mineral oil MOA
lubricate intestines, prevents water from moving out of intestines
44
mineral oil indication
fecal impactions
45
mineral oil route
PO PR (per rectum) Enema
46
docusate sodium (Colace), mineral oil
Emollient laxative
47
docusate sodium (Colace), mineral oil SEs
Skin rashes | Decreased absorption of vitamins
48
glycerin, lactulose and polyethylene glycol
Hyperosmotic laxatives
49
glycerin, lactulose and polyethylene glycol MOA
INCREASES WATER CONTENT IN FECES | Promotes distention, peristalsis, and evacuation
50
glycerin
Mild, commonly used in children, typically given as a suppository
51
lactulose
Digested in the large intestine creating a hyperosmotic environment Draws water into the colon Helps reduce blood ammonia levels—commonly used in liver disease/hepatic encephalopathy
52
polyethylene glycol
Commonly given before surgical/diagnostic bowel procedures (i.e., colonoscopy) Very potent Usually reconstituted in fluids
53
glycerin, lactulose and polyethylene glycol/ hyperosmotic laxative indication
Evacuate bowels before diagnostics and surgical procedures
54
glycerin, lactulose and polyethylene glycol
Hyperosmotic laxatives
55
glycerin, lactulose and polyethylene glycol/ hyperosmotic laxatives SEs
Abdominal bloating Rectal irritation Electrolyte imbalances
56
Magnesium salts, sodium salts
Saline laxatives
57
Magnesium Salts (saline laxative)
``` magnesium citrate (Citroma) magnesium hydroxide (Phillips Milk of Magnesia) magnesium sulfate (epsom salts) ```
58
Magnesium Salts (saline laxative)
Available OTC | Can lead to hypermagnesemia so use cautiously in renal patients
59
Sodium Salts (saline laxative)
Fleet enema
60
Magnesium salts, sodium salts (saline laxatives) MOA
Increase osmotic pressure and draw water into colon; as water moves into the bowel, it increases the pressure in the bowel and increases peristalsis
61
Magnesium salts, sodium salts (saline laxatives) SEs
Magnesium toxicity Electrolyte imbalance Cramping Diarrhea
62
bisacodyl (Ducolax), senna (Senokot)
Stimulant laxatives
63
bisacodyl (Ducolax), senna (Senokot)/stimulant laxatives MOA
Induce intestinal peristalsis
64
bisacodyl (Ducolax) route
PO and PR
65
senna (Senokot) route
PO
66
bisacodyl (Ducolax), senna (Senokot): stimulant laxatives
Class of laxatives MOST LIKELY to cause dependence
67
bisacodyl (Ducolax), senna (Senokot)/ stimulant laxatives indications
Constipation or whole bowel evacuation; works on the entire GI tract
68
bisacodyl (Ducolax), senna (Senokot): stimulant laxatives SEs
Nutrient malabsorption, gastric irritation, electrolyte imbalance
69
Anti-diarrheals groups
Adsorbents Antimotility (anticholinergics and opiates; opiates not commonly used due to CNS depression) Probiotics
70
Antimotility anti-diarrheals
Anticholinergics and opiates; opiates not commonly used due to CNS depression
71
Anti-diarrheals route
All PO
72
Magnesium hydroxide contraindication
Kidney dysfunction due to magnesium buildup
73
Bulk forming laxative
Drug of choice for chronic constipation

Pathopharm I (10 decks)

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