Inorganic Pharmaceutical Chemistry: Diarrhea Treatment
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Questions and Answers

What is the main purpose of adsorbent-protectives in treating diarrhea?

  • They stimulate excessive peristalsis to enhance bowel movement.
  • They provide a protective coating and bind toxins and bacteria. (correct)
  • They function to directly kill bacteria in the gut.
  • They replace lost fluids and electrolytes in the body.

    • Which of the following correctly identifies a potential cause of acute diarrhea?

  • Bacterial toxins and chemical poisons (correct)
  • Gastrointestinal surgery
  • Chronic inflammatory conditions
  • Absorptive defects

    • How do antispasmodic agents function in the treatment of diarrhea?

  • They provide hydration to counteract fluid loss.
  • They specifically target and kill harmful microorganisms.
  • They increase peristalsis and enhance intestinal movement.
  • They act directly on gut smooth muscles to reduce peristalsis. (correct)

    • Which of the following substances is classified as an adsorbent in gastrointestinal treatment?

    <p>Activated charcoal</p> Signup and view all the answers

    What is a common misconception regarding the treatment of diarrhea with antidiarrheal agents?

    <p>They treat symptoms but not complications of diarrhea.</p> Signup and view all the answers

    What role do antibacterials play in the treatment of diarrhea?

    <p>They are effective only with specific infections in the intestinal tract.</p> Signup and view all the answers

    What can be a serious consequence of diarrhea, particularly for vulnerable populations?

    <p>Dehydration and electrolyte imbalances.</p> Signup and view all the answers

    Which type of diarrhea is often caused by underlying chronic conditions?

    <p>Chronic diarrhea</p> Signup and view all the answers

    What is the primary reason patients on low-sodium diets should avoid sodium-containing saline cathartics?

    <p>They can increase sodium levels.</p> Signup and view all the answers

    What effect does magnesium have when absorbed in the body, particularly in patients with impaired renal function?

    <p>It acts as a central nervous system depressant.</p> Signup and view all the answers

    Which saline cathartic is characterized by having an alkaline solution with a pH of about 9.5?

    <p>Sodium Phosphate</p> Signup and view all the answers

    Why is dried sodium phosphate used instead of the heptahydrate form in certain preparations?

    <p>It reduces the risk of premature reactions.</p> Signup and view all the answers

    What is a common characteristic of Sodium Biphosphate when it is dissolved in water?

    <p>It dissociates into Na+ and H₂PO₄− ions.</p> Signup and view all the answers

    What is the primary force responsible for physical adsorption?

    <p>Van der Waals forces</p> Signup and view all the answers

    Which of the following statements about chemical adsorption is true?

    <p>It can involve the exchange or sharing of electrons.</p> Signup and view all the answers

    How does surface area influence adsorption efficiency?

    <p>A larger surface area allows for more adsorption of substances.</p> Signup and view all the answers

    What effect does polarity have on the adsorption process?

    <p>Polar adsorbents are more efficient for polar molecules.</p> Signup and view all the answers

    What role does pH play in the adsorption process?

    <p>pH affects the solubility of certain compounds, impacting adsorption.</p> Signup and view all the answers

    Which of the following best describes the action of bismuth salts in the gastrointestinal tract?

    <p>They provide protective barriers and adsorb toxins.</p> Signup and view all the answers

    Which of the following is a characteristic of activated charcoal as an adsorbent?

    <p>It demonstrates high surface area and porous structure.</p> Signup and view all the answers

    Which compound is primarily used for its adsorbent properties in the treatment of mild diarrhea?

    <p>Kaolin</p> Signup and view all the answers

    What may result from the chemical interaction of intestinal hydrogen sulfide with bismuth salts?

    <p>Formation of bismuth sulfide and black stools</p> Signup and view all the answers

    Which statement accurately reflects the clinical significance of soluble bismuth cation?

    <p>Its mild astringent and antiseptic effects are questionable.</p> Signup and view all the answers

    What is the primary mechanism of action for activated charcoal as an adsorbent?

    <p>Physical adsorption</p> Signup and view all the answers

    What is a common use for saline cathartics?

    <p>Relieving acute constipation</p> Signup and view all the answers

    Which statement about kaolin is correct?

    <p>Kaolin binds toxins through physical and chemical adsorption.</p> Signup and view all the answers

    What distinguishes saline cathartics from laxatives?

    <p>Laxatives are typically milder than saline cathartics.</p> Signup and view all the answers

    What role does pectin play when combined with kaolin in treatment products?

    <p>It promotes stability and adsorption.</p> Signup and view all the answers

    For what condition should cathartics be particularly avoided?

    <p>Temporary diarrhea</p> Signup and view all the answers

    Which of the following acids can dissolve bismuth subnitrate?

    <p>Hydrochloric acid</p> Signup and view all the answers

    Activated clays and adsorbents are commonly used to manage what condition?

    <p>Mild diarrhea of short duration</p> Signup and view all the answers

    What is a contraindication of kaolin-containing products?

    <p>Interference with drug absorption</p> Signup and view all the answers

    What is the primary use of bismuth subnitrate?

    <p>As an astringent-protective in Milk of Bismuth</p> Signup and view all the answers

    What effect does bismuth subnitrate have on tragacanth?

    <p>Precipitates it into a hard mass</p> Signup and view all the answers

    What is the approximate formula for bismuth sub carbonate?

    <p>[(BiO)₂CO₃]₂·H₂O</p> Signup and view all the answers

    Bismuth sub carbonate is primarily used as what in pharmaceuticals?

    <p>An antacid</p> Signup and view all the answers

    What is the main chemical reaction that produces bismuth hydroxide from bismuth nitrate in Milk of Bismuth?

    <p>Bi(NO₃)₃ + 3NH₄OH → Bi(OH)₃ + 3NH₄NO₃</p> Signup and view all the answers

    What characteristic reaction does bismuth sub carbonate display when interacting with nitric acid?

    <p>It dissolves with copious effervescence</p> Signup and view all the answers

    Why is sodium biphosphate or trisodium phosphate recommended for use with tragacanth?

    <p>They supply negative ions to stabilize the colloid</p> Signup and view all the answers

    What type of powder is bismuth subnitrate described as?

    <p>A white, slightly hygroscopic powder</p> Signup and view all the answers

    Study Notes

    Inorganic Pharmaceutical Chemistry

    • Gastrointestinal agents commonly used to treat mild diarrhea
    • Diarrhea is a symptom, not a disease.
    • Factors that impair digestion and absorption lead to increased bulk in the intestinal tract, stimulating peristalsis and causing diarrhea.
    • Diarrhea can be acute or chronic, with different causes.
    • Dehydration and electrolyte imbalances are complications of diarrhea, particularly for young and elderly individuals.
    • Antidiarrheal agents treat symptoms and occasionally causes, but not complications.
    • Most antidiarrheal products contain adsorbent-protectives, antispasmodics, and possibly antibacterial agents.
    • The ideal antispasmodic agent directly acts on smooth muscles of the gut to decrease peristalsis and increase segmentation.
    • Antibacterials are effective when there's an intestinal infection.
    • Adsorbent-protectives bind toxins, bacteria, and viruses, and also provide a protective mucosal coating.
    • Some adsorbent-protectives include bismuth salts, special clays, and activated charcoal.

    Mechanism of Adsorption

    • Adsorption: substance (adsorbate) adheres to the surface of another substance (adsorbent).
    • Activated charcoal, kaolin, and specific clays act as adsorbents in the gut.

    Types of Adsorption

    • Physical Adsorption: occurs due to Van der Waals forces, which are weak and non-specific, leading to reversible adsorption.
    • Chemical Adsorption: involves stronger chemical bonds between adsorbent and adsorbate, possibly irreversible, with electron exchange or sharing.

    Factors Affecting Adsorption

    • Surface Area and Porosity: Adsorbents like activated charcoal have high surface areas and porous structures, crucial for adsorbing substances.
    • Polarity: Adsorption is influenced by the polarity of molecules. Polar adsorbents bind polar molecules, and non-polar adsorbents bind non-polar substances.
    • pH Sensitivity: The surrounding environment's pH affects adsorption efficiency. For example, bismuth salts' solubility and adsorption vary with pH.

    Bismuth-Containing Products

    • Utilization of bismuth salts as antidiarrheals is mainly based on tradition.
    • Bismuth subcarbonate is used as an antacid.
    • Bismuth salts are water-insoluble, but a small amount dissolves, acting as a mild astringent and antiseptic.
    • Intestinal hydrogen sulfide interacts with bismuth salts to form bismuth sulfide, causing black stools.
    • Bismuth compounds provide dual action: they adsorb toxins and bacteria while creating a protective intestinal barrier.

    Bismuth Subnitrate

    • A white, slightly hygroscopic powder, insoluble in water and alcohol, but soluble in acids.
    • Assayed in terms of bismuth trioxide.
    • Incompatibility with tragacanth, which can be overcome by adding sodium biphosphate or trisodium phosphate.
    • May inhibit pepsin.
    • Used as a component of Milk of Bismuth, where it acts as a mild astringent-protective.

    Milk of Bismuth

    • Contains bismuth hydroxide and bismuth subcarbonate suspended in water.
    • Produced by converting bismuth subnitrate to bismuth nitrate, then treated with ammonium carbonate and ammonia solution.
    • Classified as an astringent and antacid.

    Bismuth Subcarbonate

    • White or pale yellowish-white powder, odorless and tasteless.
    • Stable in air but affected by light, insoluble in water and alcohol, but soluble in acids.
    • Assayed in terms of bismuth trioxide.

    Nonofficial Bismuth Compounds

    • Bismuth Subgallate
    • Bismuth Subsalicylate
    • Bismuth Ammonium Citrate

    Activated Clays and Other Adsorbents

    • Clays with excellent adsorbent properties are used industrially and clinically for mild, short-duration diarrhea.

    Kaolin

    • Native hydrated aluminum silicate, powdered and free from gritty particles.
    • Soft, white, or yellowish-white powder, with an earthy taste.
    • Binds toxins and bacteria through physical and chemical adsorption.
    • Insoluble in water, acids, and alkali hydroxides.
    • Often used with pectin (Kaopectate®, Kao-Con®) as an adsorbent.
    • Reported to interfere with intestinal absorption of lincomycin.

    Activated Charcoal

    • Used as an adsorbent for diarrhea and as an antidote for specific poisoning.
    • Works primarily through physical adsorption.
    • Highly porous, effectively binding large organic molecules such as toxins, chemicals, and drugs.

    Saline Cathartics

    • Agents that accelerate and increase bowel evacuation.
    • Laxatives are mild cathartics.
    • Widely used, but often abused and overpromoted.
    • Properly used to:
      • Ease defecation with painful hemorrhoids or rectal disorders.
      • Avoid straining and pressure in patients with hernias.
      • Reduce blood pressure during defecation in patients with hypertension or other circulatory diseases.
      • Relieve acute constipation.
      • Remove solid material before certain roentgenographic studies.
    • Sodium-containing saline cathartics are not suitable for long-term use in low-sodium diets.
    • Magnesium salts should be restricted for those with impaired renal function due to magnesium absorption and CNS depressant effects.

    Official Saline Cathartics

    • Sodium Biphosphate:
      • Colorless crystals or white crystalline powder, odorless, slightly deliquescent, acid to litmus.
      • Dissolves in water, dissociating into ions.
      • Used as urinary acidifier and cathartic (Phospho-Soda, Vacuetts, and Sal Hepatica).
    • Sodium Phosphate:
      • Colorless or white granular salt, effervesces in moist air, solutions are alkaline.
      • Freely soluble in water, poorly absorbed in intestines.
      • Used as a saline cathartic (Fleet Enema, Phospho-Soda).
    • Dried Sodium Phosphate:
      • Nearly anhydrous white powder, absorbs moisture readily, freely soluble in water, insoluble in alcohol.
      • Used as a saline cathartic in Effervescent Sodium Phosphate, a mixture with carbonates, tartaric acid, and citric acid.
      • Dried form prevents premature reactions and ensures a pleasant flavor.

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    Description

    This quiz covers gastrointestinal agents used to treat mild diarrhea, exploring the causes, symptoms, and treatment options. Learn about the role of antidiarrheal agents and how they help manage diarrhea-related complications. Test your knowledge on the various types of agents and their mechanisms of action in the gastrointestinal system.

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