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What is treatment for initial non-severe/ severe C. diff infection? What is treatment for initial fulminant C. diff infection?
- Non-severe/severe: oral Vanco 4 times per day for 10 days or FDX BID for 10 days
- Fulminant: Vanco oral or NG tube, or IV or rectally if ileus present.
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True/false: IV vanco is effective for intestinal C. diff
False; IV vanco is for systemic infection, for intestinal C diff infection oral vanco is used
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True/false: Fidaxomicin is a macrolide abx for Oral administration
True
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What is a monoclonal antibody used to treat C diff?
Bezlotoxumab
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When is fecal transplantation recommended?
Patients with multiple recurrences of C diff infections and have failed appropriate abx treatments.
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True/false: cholinergic drugs are used to treat diarrhea
False; it is anticholinergic drugs because anticholinergeic would decrease GI motility and GI secretion, and antispasmodic on GI tract
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Dicyclomine and Hyoscyamine are _______ drugs used to treat diarrhea
Anticholinergic
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True/false: constipation is a side effect of anticholinergic drugs
True; this is why its used to treat diarrhea
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How is opioids used to treat diarrhea?
- Stimulate opioid receptors in GI tract to decrease GI secretion and motility
- Used with atropine to discourage drug abuse
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Loperamide, diphenoxylate/atropine are _______ used to treat diarrhea
Opioids
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MOA of bismuth subsalicylate:
Reacts with gastric HCL to form bismuth oxychloride and salicylic acid which is anti-secretory, anti-inflammatory and antimicrobial
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Which antidiarrheal drug can cause dark stools, black-stained tongue?
Bismuth subsalicylate
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Which antidiarrheal drug can cause elevated anion gap metabolic acidosis?
Bismuth
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5-aminosalicylates is drug used to treat ______
Inflammatory bowel disease
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What are prodrugs of mesalamine (5-ASA)?
- Sulfasalazine
- Olsalazine
- balsalazide
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True/false: 5-ASA given orally as a fast-release formulation is well absorbed from the small intestines but ineffective for ulcerative colitis
True; therefore, to treat ulcerative colitis, this drug needs to be formulated to release downstream of GI tract
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5-ASA is mainly used for _________. And has _____ anti-inflammatory action of GI mucosa
- Ulcerative colitis
- Topical
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What are ADR of 5-ASA?
Headache, nausea, skin rash
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What is the MOA of 5-ASA?
no se
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True/false: Sulfapyridine is a metabolite of sulfasalazine and this can cause side effets in patients with sulfa abx allergies
True
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Oral mesalamine (5-ASA) must be _____-release in order to achieve therapeutic intraluminal levels
Delayed
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