INTESTINES: DIARRHEA, UC, CROHN'S- PHARM EXAM 1|
TOP SCORES MADE SIMPLE | TRUSTED TEST SOLUTIONS!
noninfectious diarrhea - causes Answer: increased GI motility or decreased fluid
absorption from the gut can both cause diarrhea to occur
classes of antidiarrheals Answer: anti-motility, adsorbents, agents that modify fluid and
electrolyte transport
anti-motility agent drug names Answer: diphenoyxlate + atropine
loperamide
diphenoxylate + atropine MOA Answer: diphenoxylate inhibits excessive GI motility and
GI propulsion
atropine is present to only discourage abuse
diphenoxylate + atropine SE Answer: dizziness, drowsiness, euphoria, n, urinary
retention, headace
diphenoxylate + atropine concerns Answer: do not use in the tx of infectious diarrhea
(we don't want to use anti-diarrheals if we are not treating an infection)
controlled substance
loperamide MOA Answer: acts directly on circular and longitudinal intestinal muscles
through the opioid receptor to inhibit peristalsis and prolong transit time; reduces fecal
volume, increases vicosity, and diminishes fluid and electrolyte loss
loperamide SE Answer: dizziness, constipation, n, abd cramping
loperamide concerns Answer: do not use in the treatment of infectious diarrhea
(compare to diphenoxylate + atropine)
don't give in pts that have agents w/ p glycoprotein??
adsorbents MOA Answer: act by adsorbing intestinal toxins or microorganisms and/or
by coating or protecting the intestinal mucosa
adsorbents SE Answer: constipation
adsorbents concerns Answer: interfere w/ the absorption of other drugs (don't give at
the same time as other meds, separate by 2-4 hours)
adsorbent drug examples Answer: aluminum hydroxide, methylcellulose
1
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, agents that modify fluid and electrolyte transport Answer: bismuth subsalicylate
bismuth subsalicylate MOA Answer: salicylate moiety provides antisecretory effect
bismuth exhibits antimicrobial effects
bismuth subsalicylate SE Answer: fecal discoloration, tongue discoloration
bismuth subsalicylate concerns Answer: cannot be given to kids
concern for those with salicylate allergies
infectious diarrhea causes Answer: caused by an infectious agent (Salmonella,
Shigella, Vibrio, C. Diff)
C diff Answer: spore forming Gram + bacteria that is a part of the natural flora of the GI
tract
if a change occurs in the intestinal flora, C Diff can take over and cause infectious
diarrhea
causes of C. Diff Answer: exposures to abx (Clindamycin, 3rd gen cephalosporins, and
FQs have association with C. diff)
exposure to healthcare settings (hospital, dialysis, nursing home)
acid-suppressing medication (PPIs - acid can help us keep C Diff in check, so if we
remove acid, predisposes to C diff)
C Diff sx Answer: watery stools (d), distinctive foul stool, fever, abd pain
C diff complications Answer: toxic megacolon
pseudomembranous colitis
C diff recommended tx for initial episode, non-severe Answer: Vanc 125 QID x10 days
OR
Fidaxomicin 200 mg BID x 10 days
OR
alternate if 2 above agents are unavailable ---> Metronidazole 500 mg TID x 10 days
C diff recommended tx for initial episode, severe Answer: Vanc 125 QID x10 days
OR
Fidaxomicin 200 mg BID x 10 days
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
TOP SCORES MADE SIMPLE | TRUSTED TEST SOLUTIONS!
noninfectious diarrhea - causes Answer: increased GI motility or decreased fluid
absorption from the gut can both cause diarrhea to occur
classes of antidiarrheals Answer: anti-motility, adsorbents, agents that modify fluid and
electrolyte transport
anti-motility agent drug names Answer: diphenoyxlate + atropine
loperamide
diphenoxylate + atropine MOA Answer: diphenoxylate inhibits excessive GI motility and
GI propulsion
atropine is present to only discourage abuse
diphenoxylate + atropine SE Answer: dizziness, drowsiness, euphoria, n, urinary
retention, headace
diphenoxylate + atropine concerns Answer: do not use in the tx of infectious diarrhea
(we don't want to use anti-diarrheals if we are not treating an infection)
controlled substance
loperamide MOA Answer: acts directly on circular and longitudinal intestinal muscles
through the opioid receptor to inhibit peristalsis and prolong transit time; reduces fecal
volume, increases vicosity, and diminishes fluid and electrolyte loss
loperamide SE Answer: dizziness, constipation, n, abd cramping
loperamide concerns Answer: do not use in the treatment of infectious diarrhea
(compare to diphenoxylate + atropine)
don't give in pts that have agents w/ p glycoprotein??
adsorbents MOA Answer: act by adsorbing intestinal toxins or microorganisms and/or
by coating or protecting the intestinal mucosa
adsorbents SE Answer: constipation
adsorbents concerns Answer: interfere w/ the absorption of other drugs (don't give at
the same time as other meds, separate by 2-4 hours)
adsorbent drug examples Answer: aluminum hydroxide, methylcellulose
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
, agents that modify fluid and electrolyte transport Answer: bismuth subsalicylate
bismuth subsalicylate MOA Answer: salicylate moiety provides antisecretory effect
bismuth exhibits antimicrobial effects
bismuth subsalicylate SE Answer: fecal discoloration, tongue discoloration
bismuth subsalicylate concerns Answer: cannot be given to kids
concern for those with salicylate allergies
infectious diarrhea causes Answer: caused by an infectious agent (Salmonella,
Shigella, Vibrio, C. Diff)
C diff Answer: spore forming Gram + bacteria that is a part of the natural flora of the GI
tract
if a change occurs in the intestinal flora, C Diff can take over and cause infectious
diarrhea
causes of C. Diff Answer: exposures to abx (Clindamycin, 3rd gen cephalosporins, and
FQs have association with C. diff)
exposure to healthcare settings (hospital, dialysis, nursing home)
acid-suppressing medication (PPIs - acid can help us keep C Diff in check, so if we
remove acid, predisposes to C diff)
C Diff sx Answer: watery stools (d), distinctive foul stool, fever, abd pain
C diff complications Answer: toxic megacolon
pseudomembranous colitis
C diff recommended tx for initial episode, non-severe Answer: Vanc 125 QID x10 days
OR
Fidaxomicin 200 mg BID x 10 days
OR
alternate if 2 above agents are unavailable ---> Metronidazole 500 mg TID x 10 days
C diff recommended tx for initial episode, severe Answer: Vanc 125 QID x10 days
OR
Fidaxomicin 200 mg BID x 10 days
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
