Anesthesia
Pharmacology: Gastrointestinal Pharmacology Practice Questions
Choose the correct answer for each question.
May be helpful in managing colonic secretory diarrhea:
Cholestyramine (Questran)
Colestipol (Colestid)
Colesevelam (Welchol)
A & B
B & C
A & C
A, B & C
Diarrhea resulting from excess fecal bile acids may be reduced by colestipol.
True
False
Adverse effect(s) associated with cholestyramine and other bile salt-binding resin administration.
Flatulence
Constipation
Both
Neither
Adverse effect(s) associated with cholestyramine and other bile salt-binding resin administration.
Fecal impaction
Bloating
Both
Neither
Important clinical issue(s) associated with use of bile salt-binding resins.
In patients with limited circulating bile acid pools, use of bile salt binding agents may worsen fat malabsorption.
Cholestyramine and colestipol themselves may bind to drugs and decrease their absorption; this concernsuggests that cholestyramine and colestipol should not be administered within a couple hours of other agents.
Both
Neither
Colesevelam administration, by contrast to cholestyramine and colestipol, does not appear to significantly alter absorption of other drugs.
True
False
Cholestyramine is effective in treating diarrhea associated with either distal
ileum resection or after cholecystectomy since this diarrhea is classified as "bile salt-induced."
True
False
In some patients with extensive ileal resection (>100 cm) bile salt depletion may occur with subsequent inadequate micellar formation needed for fat absorption. In this condition, steatorrhea may develop and cholestyramine use tends to worsen the diarrhea.
True
False
Crofelemer (mystesi, fulyzaq):
Purified Proanthocyanidin, a botanical extract
Used in managing diarrhea associated with antriretroviral therapy for HIV/AIDS.
Both
Neither
Crofelemer:
Approved for diarrhea associated with antriretroviral therapy; not approved for infectious or other diarrheas.
Inhibits cyclic AMP stimulated
Cl- channel and Ca2+ activated Cl- channels at the luminal side of the enterocyte; these actions decrease water loss associated with luminal chloride secretion.