GI pt 4 Flashcards
(49 cards)
What is the definition of diarrhea?
Increased stool, liquidity, and or stool weight associated with increased frequency, perianal discomfort, urgency, and incontinence
What is the definition of acute diarrhea?
Lasting less than two weeks that is infectious, toxic, drug or diet induced
What is the definition of chronic diarrhea?
Lasting greater than two weeks to months symptoms of a serious illness or secondary to many different diseases
What is the treatment plan for any type of diarrhea?
Terminate fluid loss and replace electrolytes
What are the over-the-counter antidiarrheal’s?
The bulk producing agents like carbooxymethylcellulose
And the absorbent like bismuth compounds kaolin and pectin
What diarrhea medication is contraindicated in people younger than 20 years old with a viral illness
Bismith subsalicylate like Pepto-Bismol
What are motility inhibitors?
Opiates and opioid derivatives that inhibit acetylcholine receptors to slow down G.I. motility and promote increased water absorption in the large bowel
What are the adverse effects of motility inhibitors?
Anticholinergic and CNS effects
How does loperamide hydrochloride work?
It is a motility inhibitor that binds to opioid receptors and is an opioid agonist is also known as as Imodium
How does camphorated tincture of opium work?
It increases, smooth, muscle tone
How does Diphenoxalate hydrochloride plus atropine sulfate work?
It is a prescription drug opioid agonist plus an anticholinergic
What is the drug of choice for acute nonspecific diarrhea?
Loperamide
When is loperamide contraindicated?
When diarrhea is caused by an infection because it can delay explosion of the harmful substances from the bowel
What symptoms indicate an infection of harmful substances when loperamide should not be recommended
One in the presence of diarrhea for greater than 48 hours to when diarrhea is accompanied by fever over 101 three when there is blood in the stools or four a history of liver disease
Which antidiarrheal motility inhibitors can lead to opioid dependence
Paregoric and lomotil
How should you educate patients taking antidiarrheal
They should rest hydrate and gradually resume a regular diet avoid CNS depressants and alcohol. Use them less than 48 hours and do not use if they have a high fever or in children less than three year-old.
How is vomiting triggered
By impulses sent to the vomiting center by a nucleus of cells in the medulla of the brain and they are received from sensory centers like chemo receptor trigger zone or CTZ the cerebral cortex and the visceral efferent pathways from the pharynx and the G.I. tract
What are the dopamine D2 receptor antagonist that are used as anti-medics
Compazine and phenergan
What are the muscarinic M1 and histamine one receptor antagonist used for anti-medics
Meclizine, dimenhydrinate, and promethazine
What are the serotonin 5HT3 receptor antagonist used for nausea
Zofran and aloxi
What is the neurokinin one receptor antagonist used for nausea?
Aprepitant
What kind of medications would you use to prevent nausea and vomiting that is associated with motion, sickness and vertigo
Dopamine and muscarinic histamine receptor antagonist like Compazine, Phenergan and promethazine
What drug class would you use to prevent chemotherapy related nausea and vomiting?
Neurokinin – one like aprepitant
What is the mechanism of action of dopamine D2 receptor antagonist used in nausea?
They act on the CTZ to inhibit, nausea and emesis induced by stimuli from the dopamine agonist
