Exam 4 - basic GI pharm

Question 1

constipation

Answer 1

• small, infrequent, or difficult BMS
• fewer than 3 a week
• know your pts baseline

Question 2

causes of constipation

Answer 2

• diet (low in fiber)
• lack of exercise
• slowed peristalsis
• pathologic conditions
• obstruction or diverticulitis

Question 3

impaction

Answer 3

• unrelieved constipation
• may have continuous oozing or diarrhea
• loss of appetite
• n/v
• abdominal distention
• cramping and pain

Question 4

diarrhea

Answer 4

• increase in frequency and fluidity of bowel movements

Question 5

acute diarrhea

Answer 5

• infection
• emotional stress
• some medications
• liquid stool around impaction

Question 6

chronic diarrhea

Answer 6

• lasting longer than 4 weeks
• chronic GI infection
• alterations in motility or integrity
• malabsorption
• endocrine disorders

Question 7

episodic diarrhea

Answer 7

• food allergy or irritant

Question 8

osmotic diarrhea

Answer 8

• magnesium sulfate
• tube feeds

Question 9

secretory diarrhea

Answer 9

• bacteria
• vibrio cholerae
• staphylococcus aureus

Question 10

exudative diarrhea

Answer 10

• chron disease
• ulcerative colitis
• active site of inflammation
• disease

Question 11

diarrhea related to motility disturbances

Answer 11

• dumping syndrome
• IBS
• decreased absorption

Question 12

bismuth subsalicylate

Answer 12

• adsorbents
• form of aspirin, activated charcoal
• MOA: coats the walls of the GI tract; bind the causative agent for elimination
• SE: increased bleeding time, constipation, dark stools and darkening of tongue

Question 13

loperamide and diphenoxylate

Answer 13

• anti motility
• MOA: slow peristalsis, drying effect*
• used alone or in combination with adsorbents and opiates
• SE* : urinary retention, headache etc, bradycardia, hypotension, dry skin, flushing
• relates to anticholingergics

Question 14

probiotics

Answer 14

• lactobacillus organisms: these bacteria make up the majority of normal flora in the gut
• saccharomyces boulardii: c-diff
• MOA: replenish these bacteria and restore normal flora

Question 15

laxatives

Answer 15

• used for treatment of constipation
• treatment is individualized
• groups: bulk-forming, emollient, hyperosmostic, saline, stimulant

Question 16

psyllium

Answer 16

• bulk-forming
• MOA: act similar; absorb water into the intestine, increasing bulk; distends bowel to initiate reflex bowel activity and bowel movement
• okay for long term use
• SE: impaction above structures, fluid/electrolyte imbalance, gas formation, esophageal blockage

Question 17

docusate sodium

Answer 17

• emollient
• MOA: lubricates fecal material and walls, promotes fat absorption into fecal mass
• indication: prevent opioid-induced constipation
  route: PO
• prevent water from moving out of intestines
• SE: skin rashes, decreased absorption of vitamins

Question 18

mineral oil

Answer 18

• emollient
• MOA: lubricate intestines
• indication: fecal impactions
• route: PO and PR
• prevent water from moving out of intestines
• SE: skin rashes, decreased absorption of vitamins

Question 19

glycerin, lactulose, and polyethylene glycol

Answer 19

• MOA: increasing water content in feces; promotes distention, peristalsis, and evacuation
• indications: evacuate bowels before diagnostics and surgical procedures
• SE: abdominal bloating, rectal irritation, electrolyte imbalance

Question 20

saline

Answer 20

• magnesium salts: magnesium citrate, magnesium hydroxide, magnesium sulfate
• sodium salts: fleet enema
• MOA: increase osmotic pressure and draw water into colon
• SE: magnesium toxicity, electrolyte imbalance, cramping, diarrhea

Question 21

bisacodyl and senna

Answer 21

• stimulants
• indications: constipation or whole bowel evacuation
• OTC
• SE: nutrient malabsorption, gastric irritation, electrolyte imbalance