Term
|
Definition
|
|
Term
| how many liters can the colon absorb max, how much on averate |
|
Definition
|
|
Term
| how many liters can the SI absorb |
|
Definition
|
|
Term
| what is the explain on why diarrhea and constipation occur |
|
Definition
when there is not enough fluid (<100mL) reabsorption takes it all up causing constipation
when there is too much fluid >50L then the colon can't take it up causing diarrhea |
|
|
Term
|
Definition
| excess fluid weight of stool >200g/d |
|
|
Term
|
Definition
retention of water in lumen
excessive secretion of electrolytes and water into lumen
exudation of protein and fluid from mucosa
altered intestinal motility
rapid transit |
|
|
Term
| sudden onset diarrhea complications 2 and prognosis |
|
Definition
dehydration
electrolyte imbalance esp in kids and elderly
benign and self limiting |
|
|
Term
| what is the general treatment for sudden onset diarrhea |
|
Definition
| solution with K, Na, Cl, glucose |
|
|
Term
| when should pharmacotherapy be used in diarrhea 5 |
|
Definition
when symptoms persistant
nonspecific antidiarrheal agents do not adress cause
symptomatic relief in mild diarrhea
need to decrease intestinal motility
avoided in acute diarrhea caused by invasive organisms (could delay clearance) |
|
|
Term
| what are the intraluminal antidiarrheals 5 |
|
Definition
Kal Lin does meth on cellulose paper in many cars. he chose to try, its his business
kaolin
methycellulose
polycarbophil
cholestyramine
bismuth subsalicylate |
|
|
Term
| what are the opioid antidiarrheals |
|
Definition
he lopped a dop of pares then gourged
loperamide
dophenoxylate
paregoric |
|
|
Term
| what is the somatostatin analalog antidiarrhea |
|
Definition
it too 8 tides for his diarrhea to stop
octreotide |
|
|
Term
|
Definition
| clay that binds water and some enterotxins |
|
|
Term
|
Definition
| symptomatic relief of mild diarrhea |
|
|
Term
| MOA methylcellulose/polycarbophil |
|
Definition
absorb water and increase stool bulk, poorly fermented
effect takes 1-3d |
|
|
Term
| USE and contrindications of methylcellulose/polycarbophil 2 |
|
Definition
constipation, chronic diarrhea IBS
contraindicated in patients with obstructive symptoms |
|
|
Term
|
Definition
| anion exchange resin that binds bile acids and some bacterial toxins |
|
|
Term
|
Definition
resection of distal ileum <100cm salt induced diarrhea
diarrhea caused by clindamycin
clostridium difficile colitis |
|
|
Term
| why cant cholestyramine be used for ieal resection salt induced diarrhea >100cm |
|
Definition
| drug aggrevates diarrhea because of evuntal bile salt deplation causing setaorrhea |
|
|
Term
| how does cholestyramine help with resection of distal ileum <100cm salt induced diarrhea |
|
Definition
| interrupts enterohepatic circulation of bile salts increasing concentrations and stimulating water and eletrolyte secretion |
|
|
Term
| bismuth subsalicylate composition 3 |
|
Definition
trivalent bismuth
salicylate
MgAl salicate clay |
|
|
Term
| bismuth subsalicylate MOA |
|
Definition
reacts with HCl in stomach to make bismuth oxychloride and salicylic acid (which is absorbed in stomach)
bismuth oxychloride passes unaltered into feces and stops inflammation, microbes, secretion, nausea, cramps |
|
|
Term
| bismuth subsalicylate use 4 |
|
Definition
non syndromic episodic diarrhea
TX and prevention of travelers diarrhea
H. pylori infection |
|
|
Term
|
Definition
| dark black stool and tongue due to reaction of drug and sulfides made by bacteria in mouth |
|
|
Term
| how do opioids affect diarrhea |
|
Definition
Mu receptor induces intestinal motility
delta receptor induces intestinal secretion
Mu and delta receptors both induce absorption
diarrhea is most affected by Mu receptors |
|
|
Term
| loperamide potency and distribution |
|
Definition
antidiarrheal 50x more potent that morphine
does not penetrate CNS (some does in kids) preventing abuse |
|
|
Term
|
Definition
chronic diarrhea diseases
travelers diarrhea
occasional bout of diarrhea |
|
|
Term
| dophenoxylate potency and related drug |
|
Definition
slightly more potent antidiarrheal than morphine
drug and metabolite structurly related to meperidine |
|
|
Term
|
Definition
CNS effects potential for abuse and addiction
atropine added to discourage abuse and deliberate OD |
|
|
Term
| paregoric: composition and use |
|
Definition
camphorated tincture of opium
rarley used due to addiction potential |
|
|
Term
|
Definition
| inhibit secretory diarrhea caused by hormone secreting tumors (usually VIP in carcinoid syndrome) of pancreas and GI |
|
|
Term
|
Definition
solidify, store, and evacuate stool
absorb water |
|
|
Term
| what determines the eficiency of the colon 4 |
|
Definition
luminal contents
integrity of colon
absorption
neuromuscular action |
|
|
Term
|
Definition
| stool <3x/wk, difficulty initiating poo, small poo, incomplete pooing |
|
|
Term
| define chronic constipation |
|
Definition
| defect in common motility (NMJ at rectoanal region) |
|
|
Term
| 5 reversible or secondary causes of constipation |
|
Definition
| lack of dietary fiber, drugs, hormone disturbances, neurogenic disorders, systemic illness |
|
|
Term
| what are the two sources of fiber and their effects |
|
Definition
wheat and branL high lignin, most effective at increasing stool weight
fruits/veggies: pectins/hemicellyloses, more fermentable, adds less weight |
|
|
Term
|
Definition
affects bulk, softness, and hydration of feces
resistant to enzyme digestion (fermentation)
enters colon unchanged
attracts water and increases stool bulk |
|
|
Term
|
Definition
psh your silly doing meth on cellulose paper in many cars
psyllium
methylcellulose |
|
|
Term
|
Definition
| hydrophillic mucilloid that is fermented in colon increasing colonic bacterial mass |
|
|
Term
| 3 stool wetting agents and emollients |
|
Definition
the document stated, the document stated use mineral oil, Na, Ca
docusate sodium
docusate calcium
mineral oil |
|
|
Term
| MOA docusate Na and docusate Ca |
|
Definition
stool softener
anionic surfactant that lowers surface tension of stool allowing mixing of aquous and fat softening stool |
|
|
Term
| use docusate Na and docusate Ca |
|
Definition
| marginal effects on constipation |
|
|
Term
| mineral oil MOA and administration |
|
Definition
| penetrates and softens stool, take for 2-3d |
|
|
Term
|
Definition
may interfere with absorption of water and fat soluble substances
foreign body reaction in mucosa
leakage of oil |
|
|
Term
| what are the osmotically active laxatives 3 |
|
Definition
| saline laxatives: Mg sulfate, Mg citrate, Na phosphate |
|
|
Term
| MOA saline laxatives, administration |
|
Definition
cathartic action due to osmotically mediated water retention which stimulates peristalsis
effective in 1-3h |
|
|
Term
|
Definition
evacuation of bowel
before exams
eliminate parasites |
|
|
Term
| saline laxatives 5 contraindications |
|
Definition
| avoid in renal damage, CV disease, electrolute imbalance, with diuretics |
|
|
Term
| what are the nondigestable sugar alcohols 2 |
|
Definition
|
|
Term
|
Definition
trihydeoxy alcohol absorbed orally and acts as hygroscopic agent and libricant when given rectally
water retention stimulates peristalsis and cause bowel movement in <1h |
|
|
Term
| define inflammatory bowel disease |
|
Definition
diseases affecting SI and LI caused by chronic inflammation without a cause
thought to be caused by putative antigen in genetically susceptible patient
inflammatory response mediated by cytokines, ROS, leukotrienes |
|
|
Term
| ulcerative colitis: location, depth |
|
Definition
continous, in colon
superificial |
|
|
Term
| chrons disease: location, depth, complications 2 |
|
Definition
small and large bowel, segmental
all wayers
abscess, fistulae |
|
|
Term
| signs of inflammatory bowel disease 6 |
|
Definition
diarrhea
ulceration
exudate
protein loss enteropathy
bleeding
malabsorption |
|
|
Term
| treatment of complex inflammatory bowel disease |
|
Definition
unknown inciting agent
chronic variable nature of inflammation
needs to incorporate variations in pharmacokinetics of drugs related to patient (genetic composition, age, severity of disease) |
|
|
Term
|
Definition
relieve symptoms
induce remission of active disease
prevent relapse with maintenance therapy
heal fistulae
avoid emergency surgery |
|
|
Term
| categories of drugs that treat IBD 4 |
|
Definition
5-aminosalicylates
glucacorticoids
immune supression
biological response modifers |
|
|
Term
|
Definition
(jamie) was messy and lame and took sulfa
mesalamine
sulfasalazine |
|
|
Term
|
Definition
(pH)
prednisone
hydrocortisone |
|
|
Term
|
Definition
i was doing meth while trecking on my cycle at the prince (concert)
methotrexate
cyclosporine
asathioprine |
|
|
Term
| 1 biological response modifier |
|
Definition
in the flick i got mad b/c my BF wouldnt stop binding me
infliximab |
|
|
Term
|
Definition
|
|
Term
|
Definition
mild to moderate UC
chronic UC prophylaxis |
|
|
Term
|
Definition
minor: headache, GI, rash
serious: nephrotoxicity (rare) |
|
|
Term
|
Definition
conjugate of mesalamine diazo bonded to sulfapyridine
bacterial azoreductases in colon split into components
MOA is of masalamine, sulfapryridine has minor role
AZO bond prevents early absorption of aminosalicylate in SI |
|
|
Term
|
Definition
acute to moderate UC
UC prophlyaxis |
|
|
Term
|
Definition
sulfapyridine causes fever, malaise, GI, megaloblastic anemia (give folate) agranulocytosis, SLE, SJS
additional SE of mesalamine |
|
|
Term
| use of prednisone in IBD 2 |
|
Definition
UC remission 90%
chrons remission 60-90% |
|
|
Term
| hydrocortizone use and administration in IBD |
|
Definition
severe IBD
enema or rectal |
|
|
Term
|
Definition
inhibit calcineurin
supress proinflammatory TF |
|
|
Term
|
Definition
| when glucacortioids dont work for remission of UC or chrons episode (80% effective, no prophylaxis) |
|
|
Term
|
Definition
| converted to 6-mercaptopurine, supresses lymphocytes |
|
|
Term
|
Definition
|
|
Term
|
Definition
reduce need for steroids
maintain serious UC and chrons |
|
|
Term
|
Definition
| Ig binds TNF and neutralizes it |
|
|
Term
|
Definition
severe chrons tx
heal fistula in chrons |
|
|
