GI Exam Deck 2 Flashcards
(28 cards)
Bulk forming laxatives
psyllium, methylcellulose, poly-carbopril
The adverse effects of bulk forming laxatives:
there can be increased bloating and farts, avoid in opioid induced constipation,
When are bulk forming laxatives used?
They are used in constipation and pregnancy
What are emolients?
Emolients make stool smoother/ softer.
What are the different kinds of emolients?
They are mineral oil and sodium docusate.
When are emolients used?
when straining should be avoided, or when stool is hard and dry
What are contra-indications for emolients?
Do not use for more than 7 days because it can lead to diarrhea. Do not give to children or pregnant women.
What are osmotic laxatives?
they are saline laxative, PEG, and lactulose. Used for colonoscopy prep and can cause electrolyte abnormalities.
How does lactulose work?
Breakdown into lactic acid and acetic acid in the gut –> causes more acid in the gut–> lower pH –> nH3 to NH4 conversion–> causes there to be more NH4 into the lumen–> peristalisis
What are stimulant laxatives?
Stimulant laxatives are used in surgery/ bowel prep/cleanse, and most abused laxative.
What are names of stimulant laxatives?
bisacodyl/senna.
What are AE of bisacodyl/ senna?
They are melanosis coli and cathartic colon.
CI is obstruction of colon.
What is used for severe constipation?
For severe. we use chloride secretion activators ( linaclotide and plecanatide) that work at CFTR channel to bring out sodium, that brings out sodium and water.
Nucleus Tarctus Salitarius
Vomiting center receiving input from higher centers (CNS), GI tract, ventibular system, and from area postrema.
What area is triggered by chemotherapy:
area postrema
Vestibular system:
only has histamine and muscarinic receptors
Anti-histamine and anti-muscarinics
great use in motion sickness and meclizine can be used be used in pregnancy induced nv
Anti-muscarinic and anti-histamine
AE
Anti-muscarinic effects ( psychosis, dry mouth, unable to urinate)
Dopamine receptor antagonists (prochrolperazine, promethazine, metochlopramide, domperidone, droperidol) ,
D2 antagonists (Metoclopramide and domperidone) have no anti-psychotic activity and also shown to have pro-kinetic properties (increased LES tone and increase gastric emptying and SB transit)--> great tx for gastroparesis
What are the adverse effects of dopamine antagonists?
Tardive dyskenesia. Droperidol has risk of torsades
5HT3 receptor antagonists: are —- drugs
“setron”
5HT3 is when —-.
Standard of are CINV ,PONV, RINV.
Acute phase of CINV.
5HT3 receptor antagonists
AE: prolonged QT
risk of torsades
Cannabinoids are:
dronabinol and nabilone stimulate CB1 receptors.
not first line agents, but may effective in patients not responsive to 5HT3 and NK1 receptor blockers
