GI Patient Cases

GI Patient Cases - Gastrointestinal Physiology: Patient...

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Gastrointestinal Physiology: Patient Cases Jack Wood, Ph.D. Cari Brackett, Pharm. D.
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Case #1: “I’m having horrible constipation A 68-y-o woman presents to her doctor complaining of severe constipation. She states “I’ve never had this problem before”, and asks for a prescription to relieve her symptoms. The doctor complies and gives her a prescription for 2 days worth of medication
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QUESTIONS: 1. What is an osmotic laxative ? 2. What is a stimulant laxative? 3. What is a ClC-2 channel opener ?
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QUESTIONS: 1. What is an osmotic laxative ? 2. What is a stimulant laxative? 3. What is a ClC-2 Channel Opener? Amitiza ® (Lubiprostone)
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Interestingly: This patient takes 8 different medications. She was given a new medication 2 weeks ago for high blood pressure. The new medication is verapamil .
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Verapamil ! A “calcium channel antagonist” ! Inhibits voltage-dependent calcium channels in smooth muscle ! Prevents interaction between actin and myosin in smooth muscle
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Verapamil ! Use to inhibit vascular smooth muscle contraction ! This lowers blood pressure ! Might it also explain this patient’s symptoms of constipation? If so, how?
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QUESTIONS: 1. What is an L-type calcium channel ? 2. What is an L-type channel blocker? 3. What is the function of voltage-activated calcium channels in gastrointestinal smooth muscle?
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Case #2: “I’m having stomach cramps and diarrhea An 18-y-o woman presents to her doctor complaining of severe belly pains and diarrhea. She states “I’ve had this problem for two years but it’s getting worse”.
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Case #2: “I’m having stomach cramps and diarrhea She notes that symptoms are worse when she exercises, is stressed, or eats too quickly. A gastroenterologist examined her last year and told her that she has “irritable bowel syndrome” She is now limiting her exercise and her social life because of her G.I. symptoms.
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Case #2: “I’m having stomach cramps and diarrhea The doctor offers her reassurance and gives her a prescription for a medication called, Domperidone, which is available across the border in Canada.
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GI Patient Cases - Gastrointestinal Physiology: Patient...

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