Pharmacology Chapter 34
Dr. Mark is asked to explain the mechanism of adsorbent drugs when they are used in the treatment of simple diarrhea. Which of the following statements should Mark choose? A. The adsorbents work in the intestine to form a complex with irritating substances such as bacteria, digestive enzymes, or toxins and carry them into the feces for elimination. B. The adsorbents remain in the intestine, soak up water, and expand. The water, which is retained, softens the stool, and the swelling action distends the rectum and initiates defecation. C. The adsorbents are a mixture of sodium and magnesium salts. These ions attract water, which causes a more liquid stool to be formed. D. The adsorbents act on the stool to permit water to penetrate the fecal mass. The oily nature of these laxatives eases the passage of the stool through the rectum.
A
Gustav is suffering from mild diarrhea. He consults a doctor who informs him that the underlying cause of the diarrhea is not clear, but it is most likely to be poor dietary habits. The doctor prescribes a liquid suspension and tells him not to take the medicine with meals or other medications. Which of the following drugs is the doctor most likely to have prescribed for Gustav? A. Kaopectate B. Lomotil C. Imodium D. Opium tincture
A
Identify the group in which chronic diarrhea develops readily. A. Children B. Adults C. Elderly D. None of these
A
Select the option in which the classes of laxatives are listed in the increasing order of their onset-of-action times. A. Bowel evacuants, emollients, stool softeners B. Emollients, bowel evacuants, swelling agents C. Osmotic laxatives, emollients, bowel evacuants D. Stimulants, stool softeners, emollients
A
Select the reason why increased dietary fiber is a major component in the management of constipation. A. Fiber increases stool bulk and fluid content and decreases transit time, resulting in an increase in the frequency of defecation. B. Fiber affects the fluid and electrolyte supplements in the stomach and inhibits the sympathetic nervous system, resulting in an increase in the frequency of defecation. C. Fiber decreases the number of microorganisms in the gastrointestinal (GI) tract, decreases the fluid content, and decreases transit time, resulting in a decrease in the frequency of defecation. D. None of these are correct.
A
Which of the following statements is true about the formation of feces? A. Contractions of the small intestine move digested food and chyme toward the colon. B. The rectum removes water and minerals from the residual waste product and compresses the waste into feces for excretion through the anus. C. The small intestine compresses the waste into feces for excretion. D. None of these are correct.
A
Which of the following statements is true of bismuth salts? A. They act within the intestine. B. They are usually administered as intravenous injections. C. They act on mu receptors to stimulate the parasympathetic nervous system. D. They should be administered immediately after meals.
A
Carter consults a doctor as he is suffering from diarrhea. He informs the doctor that he has recently been diagnosed with glaucoma. The doctor should avoid prescribing an anticholinergic to Carter because: A. it leads to irregularly dilated lymphatic channels in the bulbar conjunctiva. B. it may increase intraocular pressure by reducing anterior chamber drainage. C. it inhibits the production of anti-inflammatory cytokine on the ocular surface. D. it results in malignant epithelial lesions
B
Daniel is diagnosed with cancer and is undergoing chemotherapy. He is suffering from bouts of vomiting, usually after the chemotherapy sessions. Which of the following drugs should Daniel's doctor prescribe for the vomiting? A. Diphenoxylate B. Ondansetron C. Loperamide D. Polycarbophil
B
Identify the long-term impact of chronic diarrhea. A. Accumulation of sodium and potassium in the blood B. Dehydration and electrolyte imbalance C. Relaxation of the external anal sphincter due to weakening of impulses from the brain D. All of these
B
Olivia has been suffering from irritable bowel syndrome (IBS) for time now. She has undergone conventional therapy previously and has not responded well to it. Her doctor has prescribed alosetron to treat her. The drug should be discontinued if Olivia displays symptoms of _____. A. craniosynostosis B. ischemic colitis C. hypertension D. psoriasis
B
Select the statement that best describes the involvement of the sympathetic and parasympathetic nervous system in the movement of feces. A. Stimulation of the adrenergic fibers that innervate the intestines increases intestinal motility, whereas stimulation of the cholinergic fibers decreases motility. B. Stimulation of the cholinergic fibers that innervate the intestines increases intestinal motility, whereas stimulation of the adrenergic fibers decreases motility. C. Stimulation of either the cholinergic fibers or the adrenergic fibers that innervate the intestines increases intestinal motility. D. Stimulation of either the cholinergic fibers or the adrenergic fibers that innervate the intestines decreases intestinal motility.
B
Select the statement that best describes the reason why antidiarrheals containing atropine should not be used by patients who have glaucoma. A. Anticholinergic drugs may damage the ciliary cells in the eye. B. Anticholinergic drugs may increase intraocular pressure by reducing anterior chamber drainage in patients with glaucoma. C. Anticholinergic drugs may increase the density of the vitreous humor and lead to lowered intraocular pressure. D. None of these are correct.
B
Select the statement that best explains the mechanism of action of the laxative products Ceo-Two and lubiprostone (Amitiza). A. Lubiprostone (Amitiza) releases carbon dioxide gas, which pushes on the wall of the rectum, inducing muscle contractions and stool movement, whereas Ceo-Two opens the chloride channels so that chloride followed by water enters the channels in an attempt to maintain isotonic balance, accelerating transit time and softening the stool. B. Ceo-Two releases carbon dioxide gas, which pushes on the wall of the rectum, inducing muscle contraction and stool movement, whereas lubiprostone (Amitiza) opens the chloride channels so that chloride followed by water enters the channels in an attempt to maintain isotonic balance, accelerating transit time and softening the stool. C. Both lubiprostone (Amitiza) and Ceo-Two open the chloride channels so that chloride followed by water enters the channels in an attempt to maintain isotonic balance, accelerating transit time and softening the stool. D. Ceo-Two releases carbon dioxide gas, which pushes on the wall of the rectum, inducing muscle contractions and stool movement, whereas lubiprostone (Amitiza) stimulates mu receptors in the myenteric plexus to decrease peristalsis, constrict sphincters, and directly affect the circular smooth muscle of the bowel, accelerating the gastrointestinal transit time.
B
Simon is going to travel to another country on a business trip. He is informed by his colleagues that the water supplied in that region is unlikely to be pure and that people who have previously visited the place have suffered from diarrhea. Simon wants to know how he can avoid the onset of diarrhea while on his business trip. Which of the following drugs would you ask Simon to take prophylactically? � A. Lotronex B. Pepto-Bismol C. Imodium D. All of these
B
Which of the following drugs is a serotonin receptor antagonist? A. Atropine B. Granisetron C. Loperamide D. Diphenoxylate
B
Which of the following is the most frequent side effect produced by antidiarrheal drugs? A. Vomiting B. Constipation C. Renal failure D. Hypertension
B
Which of the following statements is true of diphenoxylate? A. It acts only within the intestine. B. It is metabolized by the liver, and the metabolite is excreted into the urine. C. It is used to treat patients suffering from severe colitis. D. It is a serotonin receptor agonist.
B
A patient is being administered opioids to help ease his pain following extensive back surgery. He starts suffering from constipation that is induced by the opioid analgesics. Select the drug that should be used for the treatment of constipation. A. Lubiprostone B. Lactulose C. Methylnaltrexone bromide D. Psyllium hydrophilic
C
Administration of alosetron should be stopped when the patient exhibits symptoms of _____. A. pancreatitis B. gastritis C. ischemic colitis D. dermatomyositis
C
Difenoxen is a _____ receptor agonist. A. serotonin B. glycine C. mu D. gamma-amino butyric acid (GABA)
C
Diphenoxylate works by: A. reducing constriction in sphincters. B. stimulating the parasympathetic nervous system to increase peristalsis. C. stimulating mu receptors in the myenteric plexus. D. increasing the gastrointestinal transit time
C
Identify the correct definition of peristalsis. A. Peristalsis refers to the abnormal involuntary repetitive body movements caused by a distortion of voluntary muscle movement. B. Peristalsis is the process in which water moves across membranes following the movement of sodium ions. C. Peristalsis is a wavelike movement in which circular contraction and relaxation of the intestinal muscles moves contents toward the rectum. D. None of these are correct.
C
Liam consults a doctor as he has been suffering from diarrhea for two days. The doctor prescribes diphenoxylate to decrease peristalsis. Which of the following statements, if true, would indicate that the doctor's prescription is inappropriate for Liam? A. Liam's electrolyte levels have changed. B. Liam suffers from lactose intolerance. C. Liam shows symptoms of liver disease. D. Liam complains of constipation after taking the drug.
C
Select the correct information to give to a patient who is not aware that there is a difference between acute and chronic diarrhea. A. Acute diarrhea is associated with the production of loose stools in otherwise healthy individuals that lasts less than 7 days; diarrhea that lasts more than 10 days is defined as chronic and is accompanied by weight loss, muscle weakness, and electrolyte imbalance B. Acute diarrhea is associated with the production of loose stools in otherwise healthy individuals that lasts less than 10 days; diarrhea that lasts more than 15 days is defined as chronic and is accompanied by weight loss, muscle weakness, and electrolyte imbalance. C. Acute diarrhea is associated with the production of loose stools in otherwise healthy individuals that lasts less than 14 days; diarrhea that lasts more than 30 days is defined as chronic and is accompanied by weight loss, muscle weakness, and electrolyte imbalance. D. Acute diarrhea is associated with the production of loose stools in otherwise healthy individuals that lasts less than 3 days; diarrhea that lasts more than 7 days is defined as chronic and is accompanied by weight loss, muscle weakness, and electrolyte imbalance.
C
Select the statement that best describes the adverse effects of osmotic laxatives. A. Osmotic laxatives form a complex with vitamins, minerals, and other drugs, thereby impairing systemic absorption of these substances. B. Osmotic laxatives are serotonin antagonists that could lead to ischemic colitis and serious complications of constipation. C. Osmotic laxatives cause a large amount of water to be lost with the feces and could lead to dehydration if overused. D. None of these are correct.
C
Using your knowledge of the treatments for constipation, explain to a patient how laxatives and cathartics stimulate defecation. A. Both laxatives and cathartics produce a mild, gentle stimulus for defecation. B. Cathartics produce a mild, gentle stimulus for defecation, whereas laxatives produce a more intense action on the bowel. C. Laxatives produce a mild, gentle stimulus for defecation, whereas cathartics produce a more intense action on the bowel. D. Both laxatives and cathartics produce an intense action on the bowel, causing defecation.
C
Which of the following drugs forms a complex with the irritants in the stomach and moves them to the feces? A. Lotronex B. Lomotil C. Kaopectate D. Motofen
C
Explain the mechanism of action of emollients that are used as laxatives. A. They work by releasing carbon dioxide gas that pushes against the rectum wall and induces muscle contraction and stool movement. B. They soak up water and soften the stool, which results in a swelling action that distends the rectum and initiates defecation. C. They consist of a mixture of sodium and magnesium salts that attract water, which results in the formation of a more liquid stool. D. They penetrate the fecal mass and ease the passage of the stool through the rectum due to their oily nature.
D
Identify the causes of constipation. A. Poorly developed toilet habits and diets low in fiber B. Stressful situations that result in sympathetic stimulation and decrease intestinal motility C. Emotional disturbances that alter the parasympathetic control of the intestines D. All of these
D
Identify the mechanism used in the classification of diarrheas. A. Increased motility in the gastrointestinal (GI) tract B. Increased secretory functions C. Increased osmolality in the intestine D. All of these
D
Select the group of drug agents that contribute to increased intestinal motility, resulting in diarrhea. A. NSAIDs, antacids, chemotherapy medications B. Antiarrhythmic and blood pressure medications C. Antibiotics and laxatives D. All of these
D
Select the true statement related to the treatment of diarrhea with difenoxen (Motofen). A. Side effects including nausea, vomiting, and hypotension are seen with larger doses such as 40 to 60 mg. B. Difenoxen is a mu receptor agonist that stimulates mu receptors in the myenteric plexus to decrease peristalsis and constrict sphincters, and it directly affects the circular smooth muscle of the bowel, prolonging gastrointestinal transit time. C. At therapeutic doses of up to 20 mg per day, difenoxen can produce weak opiate effects, including euphoria. D. All of these are correct.
D
Toxic doses of diphenoxylate could produce respiratory depression and coma similar to _____ overdose. A. ephedrine B. barbiturate C. psychogenic D. opiate
D
Which of the following drugs that are used to treat diarrhea needs to be absorbed into the circulation to work? A. Ephedrine B. Bismatrol C. Kaopectate D. Motofen
D
