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Pharm Poo
KYCOM Block 15
77
Pharmacology
Graduate
04/06/2014

Additional Pharmacology Flashcards

 


 

Cards

Term
how much of poo is warer
Definition
70-85%
Term
how many liters can the colon absorb max, how much on averate
Definition
50L max, average 100mL
Term
how many liters can the SI absorb
Definition
16
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
define diarrhea
Definition
excess fluid weight of stool >200g/d
Term
causes of diarrhea 5
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
MOA kaolin
Definition
clay that binds water and some enterotxins
Term
USE kaolin
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
cholestyramine MOA
Definition
anion exchange resin that binds bile acids and some bacterial toxins
Term
cholestyramine use 3
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
bismuth subsalicylate SE
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
loperamide use 3
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
dophenoxylate SE
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
octerotide use
Definition
inhibit secretory diarrhea caused by hormone secreting tumors (usually VIP in carcinoid syndrome) of pancreas and GI
Term
4 functions of the colon
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
define constipation 4
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
MOA of fiber
Definition
affects bulk, softness, and hydration of feces
resistant to enzyme digestion (fermentation)
enters colon unchanged
attracts water and increases stool bulk
Term
fiber drugs
Definition
psh your silly doing meth on cellulose paper in many cars
psyllium
methylcellulose
Term
psyllium husk MOA
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
mineral oil SE 4
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
saline laxatives: use 3
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
glycerin
lactulose
Term
glycerin: MOA
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
goals of IBD treatment 5
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
5-aminosalicylates 2
Definition
(jamie) was messy and lame and took sulfa
mesalamine
sulfasalazine
Term
2 glucacorticoids
Definition
(pH)
prednisone
hydrocortisone
Term
3 immune supressors
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
mesalamine: MOA 2
Definition
inhibits COX
stops ROS
Term
mesalamine: use 2
Definition
mild to moderate UC
chronic UC prophylaxis
Term
mesalamine: SE 4
Definition
minor: headache, GI, rash
serious: nephrotoxicity (rare)
Term
sulfasalazine: MOA
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
sulfasalazine: use
Definition
acute to moderate UC
UC prophlyaxis
Term
sulfasalazine: SE 7
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
cyclosporine: MOA 2
Definition
inhibit calcineurin
supress proinflammatory TF
Term
cyclosporine: use
Definition
when glucacortioids dont work for remission of UC or chrons episode (80% effective, no prophylaxis)
Term
azathioprine: MOA
Definition
converted to 6-mercaptopurine, supresses lymphocytes
Term
azathioprine: onset time
Definition
slow 3-6mo
Term
azathioprine: use 2
Definition
reduce need for steroids
maintain serious UC and chrons
Term
infliximab: MOA
Definition
Ig binds TNF and neutralizes it
Term
infliximab: use 2
Definition
severe chrons tx
heal fistula in chrons
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