motility, laxatives, anti-diarrheals

drugs stimulating GI motility are often reffered to as __ agents

prokinetic

What are the two components of the physiology of enteric nervous system

CNS and enteric nervous system

enteric nervous systen uses __ afferent neurons, and the CNS uses __afferent neurons

Intrinsic primary, extrinsic primary

what NT is released from mucosal cells due to gut distension or pressure

5HT

Drugs that stimulate GI motility can inhibit breakdown of __

Ach

drugs that stimulate GI motility can increase Ach release by antagonizing __ receptors

dopamine

__ antibiotics can be used to stimulate GI motility

Macrolide

Of the dopamine receptor antagonists for GI motility, __ is not tolerated but __is

metoclopramide, domperidone

causes of constipation include

diet, drugs, stress, dx states, laxative overuse

do not use laxatives in the presence of __

n/v, pain, bloating, cramping

__ are first line agents for laxatives

bulk-forming laxatives

__ are required when taking bulk-forming laxatives

large amount of water

bulk forming laxatives have a longer__ than other laxatives

onset of action

__ are first line agents that generally have shorter onset of action

stool softeners

__ act by softening stool material and allow ware and lipids to penetrate

emollient

emollients have a faster time to effect when given __

rectally

__ are second line laxatives that increase water retention

lubricants

__ are usually used for surgical prep

osmotic laxatives

__ channels in the GI tract are important for fluid transport, cell volume and PH

chloride

chloride channel __ are newer laxative agents with novel mechanism

activators

__ can be used to prevent opioid induced constipation, but are rarely used because of __

opioid receptor antagonists, CV toxicity

__ can be used when all other agents fail

serotonin 5HT4 agonists

cisapride has a high risk of __

arrhythmias

prucalopride has __ CV events

no

causes of chronic diarrhea include

disease, psychogenic, enzyme imbalance

do not give food for the first __ hours in acute diarrhea

4-6

drugs should not be used for diarrhea in cases of __

blood, high fever, systemic toxicity

most effective antidiarrheal is __

opioid agonists

opioid agonists bind to the__ receptor and __ intestinal motility and __fluid absorption

mu opioid, decrease, increase

there is a potential for __ with opioids

dependence

diphenoxylate is an opioid agonist that binds to__ and is given with __ to prevent abuse

peripheral mu opioid receptors, atropine

first line antidiarrheal is __

loperamide

loperamide has a __ duration of action than diphenoxylate

longer

__ may cause colonic secretory diarrhea

excess bile salts

bile salt binding agents include

cholestyramine, colestipol, colesevelam

octreotide is a __ mimetic

somatostatin

octreotide may __ insulin secretion

inhibit

acute watery travelers diarrhea treatment includes

bismuth subsalicylate and doxycycline

dysentery is treated with

antibiotics

giardiasis is treated with

metronidazole