51. Bowel Disorder Drugs Flashcards
Infections where patient should not use antidiarrheal drugs
in bacterial or parasitic infections, antidiarrheal drugs cause the organism to stay longer prolonging recovery
Antidiarrheal drug groups (3)
adsorbents, antimotility drugs (anticholinergics & opiates), and probiotics
Adsorbents action (bismuth)
bind bacteria/toxin to surface of adsorbent on wall of GI tract
Anticholinergics (belladonna alkaloids) contra, action and combination
contra in myasthenia gravis. slow peristalsis and drying effect (anticholinergics inhibit PNS); used in combo w adsorbents and opiates
Probiotics action
balance normal flora and suppress growth of diarrhea-causing bacteria (most probiotics are Lactobacillus organisms)
Opiate action as antidiarrheal
reduce motility, reduce associated pain, increase absorption of water/nutrients reducing stool frequency and volume
Indications for antidiarrheal drug groups
Adsorbents in mild cases; anticholinergics/opiates in severe cases; probiotics in antibiotic-induced diarrhea
Main contraindication for antidiarrheal drugs
any major acute GI condition (obstruction, colitis)
AE/interactions of adsorbents (bismuth subsalicylate)
decrease absorption of many drugs; increased bleeding time; if co-admin w Warfarin, increased bleeding time; normal to turn stool/tongue dark; do not take w other salicylates
Diphenoxylate with atropine (opiate) [contra and purpose of atropine]
contra in colitis, toxigenic bacteria. combined w atropine to discourage recreational use (extreme anticholinergic effects in large doses).
Loperamide (opiate) [contra and why available OTC]
contra in colitis, E. coli. no physical dependence so available OTC
Laxative misuse
Widely misused, long-term use can cause laxative dependence, GI damage
Bulk-forming laxatives (cellulose derivatives [methylcellulose, psyllium]) in long-term use
these are only laxatives for long-term use
Emollient laxatives (docusate salts, mineral oil) action
soften stool. docusate salts bring water and fats into stool. mineral oil is lubricant
Hyperosmotic laxatives (glycerin, lactulose PEG-3350) action
increase water content of feces. lactulose reduces blood ammonia lvls. PEG-3350 used before procedures
Saline laxatives (magnesium salts) caution, action
caution in renal function. draw water into colon. mg-based laxatives very potent
Stimulant laxatives (Ducolax, senna) dependence, action
most likely laxative class to cause dependence. induce intestinal peristalsis
IBS drugs
IBS-D (diarrhea) drugs
IBS-C (constipation) drugs
naloxegol used to treat _
opioid-induced constipation
