34 Drugs used to treat constipation and diarrhea

Question 1

causes of constipation

Answer 1

-improper diet: too little fiber, or too little fluid, lacking fruits and veg
-lack of exercise, sedentary habits
-medications such as morphine, codeine, oxycodone, anticholinergic agents

Question 2

Diarrhea: enzyme deficiencies- pt’s w/ deficiencies of digestive enzymes (ex: lactase or amylase) have difficulty with this

Answer 2

digesting certain foods. Diarrhea usually develops because of irritation from undigested food

Question 3

Basic assessment: assessing pt and notice inelastic skin turgor, sticky oral mucous membranes, excessive thirst, a shrunken and deeply furrowed tongue, crushed lips, weight loss, deteriorating vital signs, soft or sunken eyeballs, delayed capillary filling, high urine specific gravity, or no urine output, and possible mental confusion, report this

Answer 3

dehydration

Question 4

Lab studies indicating problems of malabsorption, dehydration and fluid, electrolyte, and acid-base balance show an increase in these

Answer 4

hemoglobin, hematocrit

Question 5

pt education: medications: when opioids are used regularly this should be given and taken for how long

Answer 5

stool softeners; take as long as opioids are taken

Question 6

Laxatives: stimulant laxatives: act directly where, causing what

Answer 6

intestine, causing an irritation that promotes peristalsis and evacuation

Question 7

Laxatives: stimulant laxatives: orally act within how many hours; rectally act within how many min

Answer 7

6-10 hours; 60 to 90 min

Question 8

Laxatives: osmotic laxatives: what kind of compound; which ones have an onset of action of 24 -48 hrs; which is 15-30 min

Answer 8

-hypertonic- draws water into the intestine from surrounding tissues;
-lactulose and lactitol onset of action 24 -48 hrs
-glycerine (rectal suppository) 15 - 30 min

Question 9

Laxatives: stimulant laxatives: names

Answer 9

bisacodyl, sennosides A and B

Question 10

Laxatives: osmotic laxatives: names

Answer 10

lactulose, PEG, glycerin, lactitol

Question 11

Laxatives: lubricant laxatives: why could preg and geriatric pt use this

Answer 11

there is little cramping accompanying their use

Question 12

Laxatives: bulk-forming laxatives: for whom would this be the drug of choice

Answer 12

someone who is incapacitated and needs a laxative regularly

Question 13

Laxatives: stool softeners: used prophylactically how

Answer 13

to prevent constipation or straining at stool

Question 14

pt recovering from MI or abdominal surgery would use this

Answer 14

stool softener

Question 15

Peripheral opioid antagonists

Answer 15

methylnaltrexone, naloxegol, and naldemedine

Question 16

Pts with advanced illness, receiving palliative care who have not responded well to laxative therapy, would use this for their opioid-induced constipation

Answer 16

peripheral opioid antagonists

Question 17

Pt has undiagnosed abdominal pain or inflammation of the GI tract (possible gastritis, appendicitis, or colitis) should a laxative be prescribed

Answer 17

no

Question 18

SAE of laxatives on GI

Answer 18

abdominal tenderness; failure to defecate or defecation of only a small amount may indicate the presence of an impaction; also symptoms of an acute abdominal condition

Question 19

Drug interactions of the laxative Psyllium (Metamucil); why can’t psyllium and salicylates, nitrofurantoin, or digoxin be taken at the same time; how can they be taken

Answer 19

psyllium may inhibit absorption;
take salicylates, nitrofurantoin, or digoxin at least 1 hour before or 2 hours after psyllium

Question 20

Antidiarrheal agent uses; when to use

Answer 20

-diarrhea is of sudden onset, lasted > 2-3 days, is causing significant fluid and water loss. Young children and elderly should start antidiarrheal therapy earlier
-Post-GI surgery pts who develop diarrhea can use agents to retain fluids and electrolytes

Question 21

Pt’s with inflammatory bowel disease that develop diarrhea can use

Answer 21

antidiarrheal agents, adrenocorticosteroids or sulfonamides may be used to control the underling bowel disease

Question 22

SAE of antidiarrheal agents; indications

Answer 22

prolonged or worsened diarrhea- indicates that toxins are present and antidiarrheal agent is causing retention of the toxins. Refer to hcp