Antidiarrheals & Laxatives
Define laxative effect
Production of a soft form stool over one or more drugs
Difference in opportunistic infections and primary infections
Opportunistic: immunocompromised
Primary: immunocompetent
What is the role of histamine?
Attaches to receptor to cause itching, increased mucus production, sneezing, congestion
Stimuli that produce the reflex of vomiting (name at least 5)
- motion sickness
- surgery
-pregnancy
-pain
-shock
-side effect of medication
-food tolerance
-viral & bacterial infections
-radiation
-disturbances of the middle ear
What is the mechanism of action for benzodiazepines
boosts the action of GABA and allows more chloride ions to enter the neuron making it more resistant to excitation of neurons
Non pharm measures for diarrhea
clear liquids, bland food, oral hydration solutions, tea
Action of polyenes
Polyenes bind to ergosterol in the cell membrane on fungi and form aqueous pores that promote leakage of intracellular ions and disrupt the membrane
Pathophysiology if upper respiratory system
nasal cavity, nares, pharynx, larynx
Predisposing factors of peptic ulcers (name at least 3)
- hyplori
-hypersecretion
-genetic reasons
-hydrochloric acid/ pepsin
-environmental reasons (alcohol, NSAIDS)
-mechanical disturbances (food can't pass)
What is maximal efficacy?
The point at which increasing a drugs dosage no longer increases therapeutic response
Types of antidiarrheals and their action
-Opiate and opiate related agents: most effective, activate opioid receptors, GI tract, decrease intestinal motility, and decrease fluid secretion into the small intestine and increase absorption of fluid and salt
- Absorbents: coat wall of GI tract, absorb bacteria or toxins
Action of azoles
Increases permeability and leakage by interfering with ergosterol formation
What histamine class is not for nasal congestion
1st gen
Adverse reaction for calcium carbonate
acid rebound
What is catharsis
prompt fluid evacuation of bowel; fast and intense
What do laxatives do?
Promote soft stool, reduce painful elimination, and decrease straining. Can be used as bowel prep as well.
Action of antimetabolics
Selectively penetrates the fungal cell which disrupts fungal DNA and RNA synthesis
What drug class has the anticholinergic rhyme: "can't see, can't spit, can't pee, can't ****"
1st
Are PPIs for short term use or long term use
short term
Contradictions of laxatives
-undiagnosed abdominal pain
-inflammatory disorders of GI tract -spastic colon
-bowel obstruction
-pregnancy (stimulants)
-painful abdomen
Types of laxatives and their action
-Stimulants: stimulate motility by irritating sensory nerves and increases amount of water and electrolytes in the intestinal lumen to produce watery stool
-Osmotics: hyperosmolar salts pull water into colon and increase water in feces to cause intestinal lumen stretch, this stimulates peristalisis and defecation produced semi-formed watery stool
-Bulk Forming: absorb water into intestines, increase bulk and peristalsis, promote formed, soft stools
-Emollients: lower surface tension, promote water accumulation in intestine and stool
-Chloride channel activators: activate chloride channels in lining of small intestine which increases intestinal fluid secretion and motility
Action of echinocandins
Inhibits biosynthesis of essential components of fungal cell wall which interferes with growth and reproduction of candida
What patient teaching would you give to a patient taking oxymetazoline
rebound congestion
What patient teaching would you give to a patient taking sucralfate?
1 hr before meals
do not take antacids within 30 minutes of this medication
Adverse effects of azoles
dysrythmias, hepatotoxicity, nephrotoxicity