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