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Pharm 24 drugs Flashcards

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1
Q

Use of natural and synthetic fiber?

A

Softens and increases fecal mass, used for maintenance for constipation

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2
Q

List the 3 major bulk forming laxatives

A

Psyllium

Polycarbophil

Methylcellulose

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3
Q

Psyllium (Metamucil) clinical use?

A

Constipation

Hypercholesterolemia

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4
Q

Psyllium (Metamucil) ASEs?

A

Flatulence

Borborygmi

Abdominal pain

Anorexia

N/V/D

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5
Q

Psyllium (Metamucil) is formed from seeds of plantago psyllium, what are some warnings w/ use of this drug?

A

Chocking/esophageal obstruction

Allergic reaction

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6
Q

Polycarbophil clinical use?

A

Soften and stabilizes content

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7
Q

Methylcellulose clinical uses?

A

Constipation

More stable than psyllium, less flatulence and non-allergic.

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8
Q

Docusate Sodium clinical use?

A

Only good for softening “mush” not useful for “push”

less effective than psyllium

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9
Q

Docusate Sodium ASEs?

A

Usually well tolerated

Rash + throat irritation

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10
Q

List lubricants used

A

Mineral and castor oil

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11
Q

Lubricant clinical use?

A

Coats intestinal content, prevents absorption of water, and helps maintain a soft stool

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12
Q

Lubricant ASEs?

A

skin irritation and fecal urgency

Don’t give at bedtime

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13
Q

List secretory/osmotic drugs

A

Sugar alcohols (Sorbitol)

Polyethylene Glycol

Sodium phosphate

Magnesium

Glycerin

Lactulose

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14
Q

Sorbitol MOA?

A

stimulates bowel movement, increases water content in large intestine

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15
Q

Sorbitol ASEs?

A

Abdominal pain

Angina

Back pain

Flatulence

GI bleed

Vertigo

N/V

Xerostomia

Hyperglycemia

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16
Q

Polyethylene glycol (MiraLAX) MOA?

A

Binds to water, retains water, softens stool, increases stool frequency, helps induce evacuation.

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17
Q

Polyethylene glycol (MiraLAX) ASEs?

A

Rhinorrhea

Flatulance

Fecal urgency

Urticaria

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18
Q

Sodium Phosphate MOA?

A

Draws water into intestinal lumen, softens, stretches wall, and stimulates peristalsis.

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19
Q

Sodium Phosphate ASEs?

A

Dehydration

Renal Tox

Sodium retention

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20
Q

Magnesium Hydroxide MOA?

A

Unabsorbed magnesium draws water into the intestine, increases pressure, and increases motility.

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21
Q

Magnesium Citrate is only used in?

A

Severe cases

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22
Q

Glycerin 1st line for who?

A

Babies who are constipated

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23
Q

Glycerin MOA?

A

osmotically draws water into the colon aiding in defication

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24
Q

List surface active/stimulant laxatives

A

Senna

Bisacodyl

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25
Surface active/stimulant laxatives MOA?
Stimulate sensory nerve endings produce parasympathetic reflexes and peristalsis.
26
Senna ASEs?
Hypocalcemia Hypokalemia Urine/stool discoloration Clubbed finngers Nephritis Severe electrolyte imbalances
27
Bisacodyl ASEs?
More GI irritation Proctitis (w/rectal suppository) Hypokalemia
28
Lactulose MOA?
Breaks down bacteria from lactose into lactic acid Local acidity ionizes ammonia to ammonium
29
Lactulose unique use?
Useful to lower GI ammonia absorption in pts w/ hepatic encephalopathy
30
Lactulose AESs?
Abdominal pain Diarrhea Flatulance N/V Hypokalemia Hyponatremia Metabolic acidosis
31
List opioid antagonists
Naloxegol Methylnalrexone
32
Naloxegol clinical use?
FDA indicated for tx of OIC | chronic and non-cancer pain
33
Naloxegol is contraindicated in?
Pts receiving strong CYP3A4 inhibitors (clarythromycin, ketoconazole) pts w/GI obstruction d/t perforation.
34
Naloxegol ASEs?
Abominal pain Diarrhea Flatulence N/V Arthralgia HA W/d sign and sxs
35
List pro-secretory drugs used for IBS-C
Lubiprostone Linaclotide Plecanatide
36
Lubiprostone MOA?
Chloride channel activator acts locally on membrane on the GI tract to increase intestinal fluid secretion and improve fecal transit in IBS and OIC.
37
Linaclotide and Plecanatide MOA?
Increase secretion of chloride and bicarbonate bypass antisecretory effects of opiates, suppresses secretomotor neuron excitability
38
Contraindications of pro-secretory drugs?
<6 yrs of age = risk for dehydration.
39
Loperamide (imodium) MOA?
acts on circular and longitudinal muscles of intestines = slows peristalsis Inhibits fluid and electrolyte secretion and reduces fecal volume
40
Loperamide (imodium) ASEs?
Abdominal pain Constipation Dizziness Fatigue Flatulence HA Urinary retention N/V
41
Loperamide (imodium) contraindications?
Children <2 yrs old Dysentery GI bleeding Infections Pseudomembranous colitis UC
42
Loperamide (imodium) drug interactions?
Alosetron (L1 -severe) Metaclopramide, Cisapride, Atropine (L2-major)
43
Bismuth subsalicylate (Pepto Bismol) clinical uses?
Nausea Heartburn Indigestion Upset stomach Diarrhea YAY PEPTO BISMOL!
44
Diphenoxylate/atropine (Lomotil) MOA?
Used as antidiarrheal agent RX ONLY C-V - Diphenoxylate opioid w/low bioavilability - Atropine slow peristalsis and reduces abuse potential
45
Eluxadoline clinical use?
C-IV drug | IBS-D in adults
46
Eluxadoline MOA?
Mixed mu-opioid receptor agonist works to reduce abdominal pain and diarrhea in pts with IBS-D w/o constipation side effects
47
Eluxadoline ASEs?
Dizziness Fatigue Drowsiness Euphoria Intoxicated feeling Sedation Rash Constipation N/V Abdominal pain Increase AST and ALT
48
Eluxadoline contraindications?
Hypersensitivity Pts w/o gallbladder h/o pancreatitis Biliary duct obstruction Alcoholism Chronic/severe constipation GI obstruction
49
Alosetron MOA?
Targets 5-HT3 and 5-HT4 receptors Serotonin 3 receptor antagonists
50
Alosetron clinical use?
IBS-D
51
Cholestyramine is an antidiarrheal drug that causes what?
Binding of bile acids needed for vitamin D absorption results in vitamin d deficiency
52
List bowel preps
GoLYTELY MoviPrep Suprep Bowel Prep Kit
53
What bowel preps do you avoid in pts with kidney problems?
Phosphate containing preps
54
Clinical use of bowel preps?
GI scopes
55
Simethicone (Gas-X) clinical use?
Dissolve gas bubbles Relieves pressure, bloating, fullness, and GI gas discomfort.
56
List hemorrhoid tx: protectants
Petrolatum Glycerine Aloe Various oils(shark liver oil)
57
List hemorrhoid tx: vasoactive substance
CCB: nifedipine and diltiazem Nitroglycerine ointment Intra-anal application of NTG: reduces sphincter tone and resting intra-anal pressure"
58
List hemorrhoid tx: topical anti-inflammatory drugs
Hydrocortisone cream or suppositories.
59
Lactose intolerant tx?
Lactase dietary supplment Take PO: whole, chewed, swallowed, or sprinkled on food
60
Indication for pancreatic enzyme replacement?
Exocrine pancreatic insufficiency: chronic pancreatitis or pancreatectomy Pancreatic insufficiency: CF and others
61
MC pancreatic enzyme replacement drug?
Creon
62
How do you administer pancreatic enzyme replacement drugs?
Swallow cap whole DO NOT crush OK to sprinkle into infants mouth or applesauce.
63
ASEs of pancreatic enzyme replacement drugs?
Hyperuricemia and Hyperuricosuria Folic acid deficiency Irritation of oral mucosa (take with meals)
64
What is listed on Creon medication guide?
May increase chance of having a rare bowel disorder: fibrosing colonopathy, This may require surgery.
65
What is the clinical use of TCAs?
Slow intestinal transit time Used for IBS-D Start low and go slow.

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