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Pharmacology 2 > GI 2 > Flashcards

GI 2 Flashcards

5 questions

1
Q

most cases of diarrhea are acute and self-limiting; what’s the duration and common causes (3)?

A

< 2 weeks
bacterial/viral infection
antibiotics = C. diff
food poisoning (salmonella, E. coli)

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2
Q

what are the 3 therapeutic goals for diarrhea?

A

decrease fluid/electrolyte imbalance
decrease peristalsis
increase absorption

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3
Q

anti-motility agent that stimulates mu receptor on enteric nerves, inhibiting acetylcholine release and decreasing peristalsis

A

loperamide

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4
Q

what are 2 ADR of loperamide at high doses?

A

dizziness
drowsiness

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5
Q

what are 3 uses for loperamide?

A

diarrhea
traveler’s diarrhea
diarrhea component of IBS

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6
Q

what anti-motility agent is opioid-like?

A

loperamide

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7
Q

what are the 4 mu opioid receptor agonists? how do they work as anti-motility agents?

A

codeine
morphine
tincture of opium
diphenoxylate

act on mu receptor in bowel to decrease peristalsis

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8
Q

what are the ADR of mu opioid receptor agonists? (2)

A

CNS effects
abuse potential

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9
Q

what is the name of the anticholinergic used as a anti-motility agent?
how does it work?

A

atropine + diphenoxylate

atropine decreases the abuse potential of diphenoxylate

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10
Q

what kind of anti-diarrheal agents bind or neutralize bacterial toxins, like E. coli?

A

absorbents

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11
Q

what is an absorbent use for diarrhea and symptomatic relief?

A

bismuth subsalicylate (pepto-bismol)

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12
Q

how do the different components of bismuth subsalicylate work as anti-diarrheal agents?

A

bismuth coats irritated intestinal mucosa
salicylate decreases Cl secretion

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13
Q

what are the symptoms of salicylate toxicity? (2)

A

N/V
tinnitus

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14
Q

what is the tablet version of bismuth subsalicylate?

A

kaopectate

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15
Q

what can be used to replace normal colonic microflora to restore intestinal function and suppress growth of pathogenic bacteria?
what’s the specific name?

A

probiotics
lactobacillus acidophilus

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16
Q

when should probiotics be used?

A

after antibiotic use

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17
Q

when should diarrhea be treated?

A

if present over 2-3 days

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18
Q

what should not be used in patients with shigella infection?

A

loperamide

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19
Q

in management of diarrhea, what can be used for associated N/V?

A

promethazine

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20
Q

what is the most common organism associated with traveler’s diarrhea?

A

E. coli

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21
Q

what are the 3 treatment steps for management of traveler’s diarrhea?

A

rehydration
bismuth subsalicylate
loperamide

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22
Q

what should be added to pepto and loperamide regimen if a patient has severe traveler’s diarrhea + bloody, febrile, or persistent?

A

antibiotics

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23
Q

what antibiotic is indicated in an adult with traveler’s diarrhea?

A

fluoroquinolone

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24
Q

what antibiotic is indicated in a child with traveler’s diarrhea?

A

trime-sulfa

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25
Q

disturbed interaction of intestine, brain, and ANS that results in altered bowel motility, leading to recurrent lower abdominal pain and bloating.

A

irritable bowel syndrome

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26
Q

what can be used for the pain component of IBS by relieving smooth muscle spasms?

A

anticholinergic: dicyclomine

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27
Q

what should be used for the diarrhea component of IBS?

A

loperamide

28
Q

what can be used for the constipation component of IBS? (3)

A

fiber
stool softeners
Cl channel activators: lubiprostone or linaclotide

29
Q

inflammation or chronic swelling of the intestines that is associated with ulcerative colitis and crohn’s disease

A

IBD

30
Q

what are the 3 treatment options for mild symptoms of IBD?

A

5-ASA
olsalazine
sulfasalazine (5-ASA + sulfapyridine)

31
Q

MOA of 5-ASA?

A

inhibits leukotriene

31
Q

MOA of olsalazine?

A

converted into 5-ASA in large intestine
inhibits leukotriene

32
Q

2 ADR of sulfasalazine?

A

crystalluria (drink water to prevent)
hypersensitivity

33
Q

what is the treatment for moderate symptoms of IBD?

A

corticosteroids

34
Q

what are the 2 treatment options for active and chronic symptoms of IBD?

A

immunosuppressants (thiopurines)
biologics

35
Q

name the 2 thiopurines used as immunosuppressants for active and chronic symptoms of IBD

A

azathioprine
mercaptopurine

36
Q

name 2 immunosuppressants used for active and chronic symptoms of IBD

A

methotrexate
cyclosporine

37
Q

what should be monitored in a patient taking an immunosuppressant for IBD? (2)

A

WBCs
RBCs

38
Q

how do biologics/anti TNF-alpha antibodies provide management of IBD? (2)

A

decrease symptoms
heal mucosal ulcers

39
Q

what are 3 drug classes and 1 drug used for chemotherapy induced emesis?

A

5-HT3 antagonists
NK1 antagonists
D2 antagonists
dexamethasone

40
Q

which phase of CINV is the central pathway via chemoreceptor trigger zone associated with?

A

delayed phase (more than 24 hrs after chemo)

41
Q

which phase of CINV is the peripheral pathway via chemoreceptor trigger zone associated with?

A

acute phase (1-2 hrs after chemo)

42
Q

what drug class is used for the management of central pathway/delayed phase CINV?

A

NK1 receptor antagonists

43
Q

what drug class is used for the management of peripheral pathway/acute phase CINV?

A

5-HT3 antagonists

44
Q

-pitant

A

NK1 receptor antagonists

45
Q

2 uses for NK1 receptor antagonists?

A

high/moderately emetogenic drugs
postop N/V

46
Q

4 ADR of NK1 receptor antagonists?

A

headache
constipation
fatigue
loss of appetite

47
Q

-setron

A

5-HT3 antagonists

48
Q

3 uses for 5-HT3 antagonists?

A

postop N/V
post-radiation N/V
N/V in pregnancy (off-label)

49
Q

5 ADR of 5-HT3 antagonists?

A

headache
abdominal discomfort
constipation
rash/allergy (after IV)
QT prolongation (esp dolasetron)

50
Q

what can be used for anticipatory CINV?

A

lorazepam

51
Q

dopamine D2 antagonist that increases gastric emptying

A

metoclopramide

52
Q

ADR of metoclopramide? (2)

A

movement disorders (crosses BBB)
tardive dyskinesia (black box warning)

53
Q

what is the FDA rule when using metoclopramide?

A

do not use for more than 12 weeks/3 months

54
Q

drug class that is a potent D2 antagonist, an antimuscarinic and an H1 antagonist

A

phenothiazines

55
Q

-azine

A

phenothiazines

56
Q

-peridol

A

butyrophenones (antipsychotic)

57
Q

what is the use of butyrophenones?

A

prophylactic management of postop N/V

58
Q

name the H1-receptor antagonists (5)

A

meclizine
cyclizine
promethazine
dimenhydrinate
diphenydramine

59
Q

what is the use of H1 receptor antagonists?

A

motion sickness

60
Q

what is promethazine (H1 receptor antagonist) used for? (2)

A

space motion sickness
pregnancy

61
Q

anticholinergic that blocks muscarinic receptors in the vestibular nuclei

A

scopolamine

62
Q

what is the use for scopolamine? administration?

A

motion sickness
transdermal

63
Q

MOA of cannabinoids?

A

THC stimulates CB1 and prevents emesis

64
Q

name the 2 cannabinoids

A

dronabinol
nabilone

65
Q

use for cannabinoids?

A

adjunctive in CINV

66
Q

ADR of cannabinoids?

A

psychoactive

Pharmacology 2 (22 decks)

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