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Questions and Answers
What is the primary micro-organism responsible for causing 90% of all ulcers?
What is a common side effect associated with taking Flagyl in combination with alcohol?
What type of drugs are Lomotil and Paregoric classified as?
Which of the following is an effect of absorbents like Kaopectate?
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What should be avoided due to a risk of salicylate toxicity when taking Pepto-Bismol?
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Which type of medication primarily functions to decrease bowel motility in diarrhea?
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What is the primary purpose of synthetic prostaglandins in treating GI disorders?
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Which class of medications is used to reduce gastric acid secretion in GI disorders?
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What is a common antibiotic used in the treatment of gastric ulcers?
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What is the mechanism of action of opioid anti-diarrheals?
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Which type of laxative is known to stimulate intestinal contractions?
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What is a potential side effect of using magnesium-based antacids?
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How should antacids be administered in relation to other medications?
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Which of the following medications is generally used as an anti-cholinergic for GI disorders?
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What are the common side effects associated with high doses of metoclopramide (Reglan)?
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Which type of laxative must be followed with a full glass of water to avoid forming a 'glue'-like substance?
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Which of the following medications is utilized in the treatment of ulcers and GERD by blocking acid production?
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What is a potential consequence of laxative abuse as highlighted in the content?
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Which laxative type is most suitable for evacuating the colon prior to medical procedures?
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What is the action of Syrup of Ipecac as an emetic?
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What effect does atropine/scopolamine (found in Donnatal) produce?
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Which laxative can cause urine to turn reddish upon use?
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Study Notes
Antibiotics and Anticholinergics
- Ciprofloxacin (Cipro) is frequently prescribed as an antibiotic.
- Belladonna alkaloids include atropine and scopolamine, both classified as anticholinergics.
Laxatives
- Types of laxatives include bulk-forming, stool softeners, irritants/stimulants, osmotic, and saline.
- Bulk-forming laxatives: Examples include Fibercon and Metamucil; must be taken with a full glass of water to prevent becoming gummy.
- Stool softeners: Includes Colace (docusate sodium) and Surfak (docusate calcium); softens stool for easier passage.
- Irritant/Stimulant laxatives: Such as Dulcolax (bisacodyl, in tablet or suppository form) and Senekot (sennosides), which may cause urine to appear reddish.
- Saline laxatives: Magnesium hydroxide (Milk of Magnesia) is used cautiously in patients with renal disease and typically works in about six hours. Magnesium citrate is used for colon evacuation.
- Osmotic laxatives: Include lactulose (used for portal-systemic encephalopathy) and polyethylene glycol (GoLYTELY) used for bowel cleansing until clear.
Cautions with Laxatives
- Avoid using laxatives if experiencing nausea, vomiting, or abdominal pain.
- Laxative and cathartic abuse can lead to dependence or be associated with eating disorders.
Miscellaneous Gastrointestinal Drugs
- GI stimulants: Metoclopramide (Reglan) increases GI motility and prevents nausea; though it may cause CNS irritability and Parkinsonism with high doses or prolonged use.
- Gastric acid pump inhibitors: Medications like Prilosec (omeprazole), Nexium (esomeprazole), and Prevacid (lansoprazole) are effective against ulcers, erosions, and GERD; may need a 4-8 week course.
Emetics
- Emetic agents induce vomiting, used primarily in cases of poisoning or drug overdose.
- Syrup of Ipecac is the most common emetic, which irritates the GI tract when taken orally but should not be given if the person is unconscious.
Anti-Ulcer Medications
- Antibiotics such as Pepto-Bismol (bismuth sub-salicylate), metronidazole (Flagyl), and tetracycline are effective against Helicobacter pylori, responsible for many ulcers.
- Treatment often involves combinations like "Helidac" (tetracycline, Flagyl, Pepto-Bismol).
Side Effects and Precautions
- Be aware of allergic reactions, superinfections (especially yeast), and GI disturbances.
- Avoid alcohol when taking Flagyl due to potential acute illness; drink plenty of water to stay hydrated.
- Pepto-Bismol may cause black stools/tongue and has salicylate toxicity signs like tinnitus.
Anti-Diarrheal Medications
- Includes opioids, anticholinergics, anti-spasmodics, and bulk-forming agents.
- Opioids such as Lomotil (diphenoxylate HCL and atropine sulfate) and Paregoric (camphorated opioid) require careful regulation and storage.
- Loperamide HCL (Imodium-A-D) is available OTC and has a low potential for abuse.
Anti-Diarrheals (continued)
- Absorbents like Kaopectate attract toxins and bacteria for more formed stools; Pepto-Bismol also acts as an anti-inflammatory.
- Treatment may be administered after each loose bowel movement, monitoring stool consistency.
Gastrointestinal Disorders
- Common GI disorders include GERD, ulcers (gastric and duodenal), nausea/vomiting, constipation, and diarrhea.
GI Drug Categories
- Categories include antacids, anti-ulcer drugs, anti-diarrheals, laxatives, emetics, and anti-emetics.
Antacids
- Comprised of aluminum, magnesium, calcium, and sodium compounds; commonly used as OTC options.
- Neutralize hydrochloric acid, beneficial for peptic ulcer disease and GERD.
- Each type may cause either constipation (aluminum/calcium) or diarrhea (magnesium).
Antacid Administration
- Antacids can interact with other medications; it’s best to take them two hours apart.
- Caution in patients with cardiovascular or renal issues concerning magnesium or sodium content due to fluid retention risk.
- Monitor for signs of epigastric pain, stool color changes, and edema.
Patient Teaching on Antacids
- Common antacids include Amphogel, MOM, calcium carbonate, and Maalox.
- Instructions include thorough chewing of tablets and following with water, taking doses after meals and bedtime, and reporting any constipation or diarrhea.
Anti-Ulcer Medications (continued)
- Key classes include H-2 receptor antagonists, mucosal barriers, synthetic prostaglandins, proton pump inhibitors, antibiotics, and anticholinergics.
- H-2 blockers include cimetidine (Tagamet), ranitidine (removed from the market), famotidine (Pepcid), and nizatidine (Axid).
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Description
This quiz covers essential information about various types of laxatives and anticholinergic medications like ciprofloxacin and belladonna alkaloid. Test your understanding of bulk forming, stool softeners, irritants, and stimulant laxatives as well as their proper usage and precautions. Ideal for students in pharmacology or nursing courses.
