CHAPTER 21

Lower Gastrointestinal Tract

PART 7 Learning Objectives Pronunciations After completing this chapter, you should be able to Anorectal (ay-noh-REK-tul) 1. Define the following: Anthraquinone (an-thruh-kwuh- nohn) • Lower gastrointestinal tract Anti-inflammatory (AN ti-in-FLAM- • Duodenal ulcer muh-TOR-ee) Antipruritics (an-tee-proo-RIT-ik) • Appendicitis Ascaris lumbricoides (lum-bri-COY- • Gastroenteritis des) • Colonoscopy Campylobacter (KAM-pi-loh-bak-ter) 2. Review the anatomy and normal physiology of the lower gastrointestinal tract Cecum (SEE-kum) Clostridium difficile (klo-STRID-ee-um 3. Identify the causes, risk factors, and clinical presentation for diarrhea, constipation, dif-uh-SEEL) hemorrhoids, inflammatory bowel disease, irritable bowel syndrome, flatulence, and Colonoscopy (koh-luh-NOS-kuh-pee) parasitic infections Defecation (def-ih-KAY-shun) 4. Review the treatment goals for diarrhea, constipation, hemorrhoids, inflammatory Duodenum (doo-OD-eh-num) bowel disease, irritable bowel syndrome, flatulence, and parasitic infections Fibromyalgia (FYE-broh-mye-AL-juh) 5. List the nonpharmacologic, pharmacologic, and alternative treatment for diarrhea, Gastroenteritis (GAS-troh-en-ter- IE-tis) constipation, hemorrhoids, inflammatory bowel disease, irritable bowel syndrome, Hyperalgesia (hye-per-AL-jee-zhuh) flatulence, and parasitic infections Ileocecal (ill-ee-oh-SEE-kal) 6. Discuss the therapeutic effects, drug properties, dosages, and routes of administra- Ileum (ILL-ee-um) tion for each class of medications listed above, and list their most common side Jejunum (jee-JOO-num) effects and drug interactions Lactobacillus acidophilus (lak-toh- buh-SILL-us ass-ih-DOF-ill-us) Megacolon (MEG-uh-coh-lun) Melanosis coli (mel-uh-NOH-sis kO-lI) Pancreatitis (pan-kree-uh-TAHY-tis) Protozoa (proh-tuh-ZOH-uh) Protozoal (proh-tuh-ZOH-ul) Pyloric sphincter (pie-LOR-ik SFINGK- ter) Ricinoleic (RYE-sin-oh-lay-ik) Rotavirus (ROH-tuh-vahy-ruhs) Salmonella (sal-muh-NEL-uh) Sigmoidoscopy (sig-moi-DOS-kuh- pee) Ulcerative colitis (UL-ser-uh-tiv koh- LYE-tis) Vermiform appendix (VER-mih-form ah-PEN-diks) Workbook for Understanding Pharmacology for Pharmacy Technicians 78

Matching I Generic Names a. adalimumab f. mesalamine Match each brand name to its generic name and indication b. alosetron g. natalizumab (Constipation = C, Diarrhea = D). For additional study, note the regulatory status (RX or OTC). c. balsalazide h. olsalazine d. certolizumab i. simethicone Generic Regulatory e. infliximab j. sulfasalazine Brand Names Names Indication Status 1. Benefiber Indications 2. Colace K = Flatulence 3. Dulcolax L = Inflammatory bowel disease 4. Enulose M = Irritable bowel syndrome 5. Ex-Lax 6. Haley’s M-O True or False 7. Imodium For additional study, try to change the false statements to 8. Konsyl make them true. 9. Kristalose 1. The most important treatment for acute diarrhea 10. Lomotil is beginning an antidiarrheal medication. 11. Maltsupex 2. The pharmacist may recommend loperamide liquid as an OTC diarrhea treatment for a 12. Metamucil 6-month-old infant who cannot swallow the 13. Miralax capsules. 14. Pepto Bismol 3. Patients who are allergic to aspirin may also be 15. Senokot allergic to bismuth subsalicylate. 4. Lomotil (diphenoxylate/atropine) is a controlled Generic Names substance. a. bisacodyl g. methylcellulose b. bismuth subsalicylate h. polyethylene glycol 5. The pharmacist may recommend a probiotic c. diphenoxylate/atropine i. psyllium preparation such as Lactobacillus as an OTC d. docusate j. senna diarrhea treatment for a child. e. lactulose k. sorbitol/magnesium/ 6. Patients taking opioid medication for cancer f. loperamide mineral oil pain often require antidiarrheal medications to maintain regular bowel function. Matching II 7. Stool softeners, such as docusate, stimulate defecation by drawing water into the bowel and Match each brand name to its generic name and indication. promote local irritation, stimulating evacuation. Brand Names Generic Names Indication 8. Hemorrhoids are frequently treated with stool 1. Asacol softeners as well as with local agents applied to the painful area. 2. Azulfidine 3. Cimzia 9. Irritable bowel syndrome is a form of inflam- matory bowel disease. 4. Colazal 10. Patients who are allergic to sulfonamides (sulfa) 5. Dipentum are likely to also be allergic to mesalamine. 6. Humira 7. Lotronex 8. Mylicon 9. Pentasa 10. Remicade 11. Rowasa 12. Tysabri