GI deck 2

Question 1

Bismuth subsalicylate effects

Answer 1

antisecretory and antimicrobial effects

Question 2

Atropine causes

Answer 2

causes decreased bowel secretions and slows peristalsis

Question 3

Loperamide binds to

Answer 3

opioid receptors and slows gastric motility

Question 4

5-HT3 receptor antagonist example

Answer 4

Lotronex

Question 5

Diphenoxylate is an

Answer 5

opioid

Question 6

Lotronex is used in

Answer 6

long term. IBS

Question 7

Treatment for diarrhea

Answer 7

1 to 7 days fluids and culture

after 7 days treatment with medication IF the culture comes back negative

Question 8

Kaolin and pectin are not

Answer 8

absorbed and are eliminated in feces.

Question 9

Bismuth subsalicylate dissociates into

Answer 9

salicylate that is absorbed (similar to aspirin), metabolized in the liver, and excreted in urine with the bismuth that is not absorbed.

Question 10

The opioid agents are all absorbed and distributed

Answer 10

systemically, metabolized in the liver, and eliminated in urine and/or feces.

Question 11

Opioids decrease intestinal motility and may cause

Answer 11

toxic megacolon.

Question 12

Bismuth subsalicylate is contraindicated

Answer 12

in children with viral or flu-like illness.

Question 13

Antidiarrheals use cautiously in

Answer 13

older adults

Question 14

Antidiarrheals are contraindicated in the treatment

Answer 14

of diarrhea in most children.

Question 15

Monitor patients taking eluxadoline for

Answer 15

pancreatitits

Question 16

Alosteron has a boxed warning and is contraindicated in

Answer 16

patients with constipation

Question 17

Bismuth: causes

Answer 17

black tongue and gray-black stools

Question 18

Diphenoxylate and difenoxin with atropine

Answer 18

have ADR anticholinergic effects

Question 19

Opioid ADR

Answer 19

have central nervous system (CNS) effects

Dizziness, drowsiness, sedation, headache

Question 20

Acute diarrhea clinical use

Answer 20

Treat source of diarrhea

Absorbents (kaolin-pectin or bismuth subsalicylate) used after each loose stool

Maintain hydration
Electrolyte solution in infants and young children
Flat soda or water in adults

Opioids dosed 3 or 4 times/day or after each stool

Question 21

bismuth is in

Answer 21

peptobsimol

Question 22

Antidiarrheals bowel disease clinical use

Answer 22

Loperamide QID: may be used as adjunct therapy

Question 23

antdiarrheal chronic infantil diarrhea treatment

Answer 23

Bismuth subsalicylate

Question 24

traveler’s diarrhea treatment

Answer 24

Bismuth subsalicylate with each meal and at bedtime to prevent traveler’s diarrhea

Question 25

Irritable bowel syndrome | treatment

Answer 25

Eluxadoline or loperamide | Alosetron in women with severe irritable bowel syndrome (IBS) not responsive to other treatments

Question 26

Patients taking HIV antiretroviral drugs dirrhea treatment

Answer 26

Crofelemer

Question 27

Any antidiarrheal can be used for

Answer 27

acute diarrhea in adults

Question 28

Bismuth subsalicylate and loperamide are used for

Answer 28

traveler’s diarrhea.

Question 29

Cost of antidiarrheal

Answer 29

OTC drugs are inexpensive. | Eluxadoline and alosetron are very expensive.

Question 30

Antidiarrheal patient education

Answer 30

``` Rebound constipation Bismuth turning tongue and stool black Products with atropine may cause dry mouth and anticholinergic effects Opioids may cause CNS effects Fluxadoline may cause pancreatitis ```

Question 31

NSAIDs: cause

Answer 31

gastric mucosal damage and ulcer formation

Question 32

Cucralfate (Carafate): selectively binds

Answer 32

to ulcer tissue, acting as a barrier

Question 33

Mosprostol (Cytotec): inhibits

Answer 33

gastric secretion, has mucosal protective qualities

Question 34

cytroprotecitve agent is a

Answer 34

cell protective agent

Question 35

Precautions and contraindications | Cytoprotective agents

Answer 35

Misoprostol pregnancy category X (abortifacient)

Question 36

Cytoprotecitve agent ADR

Answer 36

Sucralfate: constipation Misoprostol: diarrhea, menstrual problems

Question 37

Cytoprotective Agents Drug interactions

Answer 37

Sucralfate: decreases absorption of other drugs Misoprostol: diarrhea with magnesium-containing antacids

Question 38

Cytoprotective Agents Ulcers associated with NSAID use

Answer 38

First choice is to stop NSAIDs. Use misoprostol if patient requires NSAID therapy. Dose four times per day. Women of childbearing age need pregnancy test.

Question 39

Misoprostal is

Answer 39

pregnancy category X and will cause abortion

Question 40

Cytoprotective Agents Duodenal ulcers from other causes

Answer 40

Sucralfate for up to 8 weeks to heal ulcer | Given four times per day, 1 hour before meals

Question 41

Misoprostol taken

Answer 41

with food

Question 42

sucralfate taken on

Answer 42

empty stomach

Question 43

Sucralfate ADR

Answer 43

constipation prevention

Question 44

ADR

Answer 44

diarrhea; contact provider if lasts more than 1 week Misoprostol: pregnancy category X