GI disorders & basic GI pharmocology Flashcards
(15 cards)
CONSTIPATION
defined:
fewer than __ BM/wk.
causes:
- diet low in ____
- ___ of exercise
- ____ peristalsis
- _____ conditions, such as _____ or ____.
defined: small, infrequent, or difficult BM
fewer than 3 BM/wk.
causes:
- diet low in FIBER
- LACK of exercise
- SLOWED peristalsis
- PATHOLOGIC conditions, such as OBSTRUCTION or DIVERTICULITIS
IMPACTION
_____ constipation.
may lead to _____ = a firm, immovable mass of stool obstructs lower GI tract.
may have continuous ___ or _____.
___ of appetite.
___/___
abdominal ______.
_____ & ______.
UNRELIEVED constipation
may lead to OBSTRUCTION = a firm immovable mass of stool obstructs lower GI tract.
may have continuous OOZING or DIARRHEA.
LOSS of appetite.
N/V
abdominal DISTENTION
CRAMPING & PAIN
DIARRHEA
defined:
acute:
chronic:
ex: x4
episodic:
ex: x2
defined: increase in frequency and fluidity of bowel movements
acute: infection, emotional stress, some meds, and liquid stool around an impaction
chronic: lasting more than 4 wks
- chronic GI indectoin
- alterations in motility or integrity
- malabsorption
- endocrine disorders
episodic: food allergy or irritant (ex: caffeine, enteral feedings)
PATHOPHYSIOLOGIC MECHANISMS
osmotic diarrhea:
ex:
secretory diarrhea:
ex:
exudative diarrhea:
ex:
r/t motility disturbances:
ex:
osmotic diarrhea: increased amt of osmotically active solutes cause NA & H2O to rush into gut
ex: magnesium sulfate, epsom salt
secretory diarrhea: occurs in presence of bacterial toxin that causes increased secretion & inhibits reabsorption
ex: vibrio cholera & staphylococcus aureus
exudative diarrhea: active site of inflammation in bowel lumen that results from excitation of mucous, blood, and proteins from these sites into stool
ex: Crohn disease, ulcerative colitis
r/t motility disturbances: result of decreased absorption in small intestine which creates large amt of fluid that is delivered to the colon
ex: dumping syndrome, IBS
WHY DIARRHEA A PROBLEM?
- 3.
- fluid/electrolyte imbalance
- nutritional concerns
- skin breakdown
ANTI-DIARRHEALS
used to treat:
different groups: x3
route:
used to treat: DIARRHEA
groups:
1. adsorbants
2. anti-motility (anticholinergics & opiates)
3. probiotics
route: PO
ADSORBANTS
med:
a form of _____.
activated _____.
MOA:
- ____ walls of GI tract
- _____ the causative agent for ______.
AE:
med: bismuth subsalicylate
a form of ASPIRIN
activated CHARCOAL
MOA:
- COATS walls of GI tract
- BINDS the causative agent for ELIMINATION
AE: increased bleeding time, constipation, dark stools & darkening tongue
ANTI-MOTILITY
meds: x2
MOA:
- _____ peristalsis
- _____ effect
used alone or in combo with ___ & ____.
AE:
meds:
1. loperamide
2. diphenoxylate [atropine] (antocholinergic)
MOA:
- SLOWS peristalsis
- DRYING effect
used alone or in combo with ADSORBANTS & OPIATES
AE: urinary retention, h/a, dizzy, anxiety, drowsy, bradycardia, hypotension, dry skin, flushing
PROBIOTICS
- lactonacillius organisms:
- saccharomyces boulardii:
MOA:
_____ bacteria and ____ normal flora
- bacteria make up majority of normal flora in gut
- responsible for c.diff
MOA:
REPLENISH bacteria and RESTORE normal flora
LAXATIVES
used for treatment of:
treatment is ______:
1.
2.
3.
different groups:
1.
2.
3.
4.
5.
not meant for ______.
used for treatment of: CONSTIPATION
treatment is INDIVIDUALIZED:
1. AGE
2. SEVERITY
3. CONTRIBUTING FACTORS
different groups: bulk forming, emollient, saline, stimulant, hyperosmotic
not meant for LONG TERM USE
BULK FORMING
med:
MOA:
- act similar to ______
- ____ water into intestine, _____ bulk
- ______ bowel to initiate _______ & _____.
___ for long term use.
AE:
contraindicated:
NC:
med: psyllium
MOA:
- act similar to DIETARY FIBER
- ABSORB water into intestine, INCREASING bulk
- DISTENDS bowel to initiate REFLEX BOWEL ACTIVITY & BM
OK for long term use
AE: impaction above strictures, fluid/electrolyte imbalance, gas formation, esophageal blockage
contraindicated: pt with intestinal obstruction, fecal impaction, abdominal pain, N/V
NC: taken with lots of water
EMOLLIENT
med: x2
1.
MOA:
use:
route:
2.
MOA:
use:
route:
both prevent water from ______.
AE:
- docusate sodium
MOA: lubricated fecal material and walls, promotes fat absorption into fecal mass
use: prevent opioid induced constipation
route: PO - mineral oil
MOA: lubricates intestines
use: fecal impactions
route: PO and PR
both prevent water from MOVING OUT OF INTESTINES
AE: skin rashes, decreased absorption of vitamins
HYPEROSMOTIC
med: x3
MOA
- ______ water content in _____
- promotes ______, _____ & _______
uses:
AE:
- glycerin
- lactulose
- polyethylene glycol
MOA:
- INCREASING water content in FECES
- promotes DISTENTION, PERISTALSIS, & EVACUATION
uses: evacuate bowels before diagnostics & surgical procedures
AE: abdominal bloating, rectal irritation, electrolyte imbalance
SALINE
med: x4
MOA: increase ______ & draw water into _____.
AE:
magnesium salts: citrate, hydroxide, sulfate
sodium salts: fleet enema
MOA: increase OSMOTIC PRESSURE and draw water into COLON
AE: mag toxicity, electrolyte imbalance, cramping, diarrhea
STIMULANTS
med: x2
1.
route:
2.
route:
MOA:
uses:
type of drug:
AE:
- bisacodyl
route: PO and PR - senna
route: PO
MOA: induce intestinal peristalsis, works on entire GI tract
uses: constipation, whole bowel evacuation
types of drug: OTC
AE: nutrient absorption, gastric irritation, electrolyte imbalance
