Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics > 66: Constipation > Flashcards

66: Constipation Flashcards

1
Q

Constipation

A

-dec freq
-disorder of motility and rectal function
-cramping, bloating
-hard dry stools
-straining, blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gi transit time

A

-mouth to anus
-30-40 hours
-upto 72 hours can still be normal tho

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

movement of water in and out of stool

A

-more time for colon to absorb water from waste
-results in stool becoming hard and difficult to push out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute constipation

A

-noticeable change in normal bowel movement pattern
-less than 3/week
-dry, hard stools
-painful movements
-hard to pass stool
-brought on by change in condition or drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chronic constipation

A

-more than 6 weeks
-may respond to lax but it comes back
-does not respond to diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Common causes of chronic constipation

A

-dietary (poor fluid/calorie intake)
-failure to heed defecation reflex
-impaired physical mobility
-lack of privacy
-inc distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Disease states that slow GI motility

A

-diabetes
-parkinsons
-CNS probs
-MS

-constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Common drug causes of constipation

A

-opioids
-NSAIDs
-Antacids
-strong anticholinergics
-iron
-vearpamil, clonidine, Ca channel blockers
-diuretics
-chronic use of stimulant lax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Refer constipated pt if

A

-symptoms >2weeks
-black/tarry stool
-ab bain or discomfort
-fever
-severe N/V
-family history of IBD or colon cancer
-drastic change in symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Measures to promote bowel movements

A

-ample fluids and fiber (add slowly)
-6-8 glasses of water per day
-prunes, kiwi, psyllium
-do not ignore urge to defecate
-poop first thing in the AM and within 30 min after meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dietary fiber

A

-add slowly over 7-10days to minimize gas
-20-30g/day
-veggies, fruits, beans, whole grains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Prunes

A

-sorbitol
-12g fiber
-dihydrophenylsatin (natural lax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bulk lax products

A

-psyllium (Metamucil)
-Methylcellulose (citrucel)
-Calcium polycarbophil (Fibercon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bulk lax moa

A

-forms emmolient gels that retain water
-swells and stimulates BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bulk lax pros

A

-soften stool better than DOCUSATE
-few side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bulk lax disadvantages

A

-taste
-must drink enough fluids
-gas
-impact on drug absorption
-not ideal if beddridden

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bulk lax admin

A

-mix citrucel w at least 8 oz cold water
-drink immediately
-produce less gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Surfactant / Emoillient product

A

-Docusate (DOSS) 100mg qd or bid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Docusate

A

-surfactant/emmolient lax
-100mg qd or bid
-helps prevent hard stools (hemorrhoids)
-NOT effective for active constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lubricant product for constipation

A

-Mineral Oil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mineral oil

A

-lubricant for constipation
-30-60mL qd
-lubricates lumen and softens stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

mineral oil disadvantages

A

-oily
-only effective in PREVENTION of constipation
-may dec absorption of fat-soluble vitamins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Saline laxative products

A

-MOM
-Mg Citrate
-Saline Enema (rapid onset)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Saline laxatives moa

A

-draws fluid into colon which inc motility
-quick onset (good for acute)
-most economical

25
Q

avoid saline laxatives in

A

renal patients (Na Mg)

26
Q

Hyperosmotic agents for constipation

A

-Sorbitol 30-60mL/qd
-Lactulose 30-60mL/gd
-PEG 17g in H2O qd
-Glycerin suppositories (quick onset)

27
Q

Hyperosmotic agents MOA

A

-draws fluid into colon due to high concentration of sugar, PEG, or glycerin
-softens stool while stimulating BM
-great for chronic

28
Q

Hyperosmotic agents cons

A

-1-3 day onset
-sweet taste
-minor nausea, cramping

29
Q

PEG (miralax)

A

-hyperosmotic for constipation
-17g PO qd
-mix w 4-8oz liquid
-onset in 1-3 days
-well tolerates

30
Q

Stimulant lax products

A

-Senna 2 tabs qd or bid
-bisacodyl (enteric coated) 1-2 tab qd

31
Q

Stimulant lax MOA

A

-locally stimulates enteric nerves
=contraction and mobility
=inc fluid and Na secretion into lumen

32
Q

Stimulant lax pros

A

-6-12 h onset
-works in pt w motility disorders
-DOC for OIC

33
Q

stimulant lax cons

A

-risk of nausea and cramping
-avoid long-term use in pts w normal GI motility

34
Q

Bisacodyl suppositories

A

-stimulant lax
-10mg PR
-quick onset

35
Q

Newer lax

A

-Lubiprostone
-Linaclotide
-Plecanatide
-Lactitol

36
Q

Lubiprostone

A

-24mcg BID wf + water
-activates chloride channels
-N/D, HA
-$$$

37
Q

Linaclotide

A

-145mcg qd 30 min before first meal
-inc chloride and bicarbonate secretions
-diarrhea
-$$$

38
Q

Plecanatide

A

-3mg qd
-inc chloride and bicarbonate secretions
-diarrhea
-$$$

39
Q

Lactitol

A

-20g qd
-osmotic
-do NOT admin w other meds

40
Q

Chloride channels

A

-allow water to pass into lumen

41
Q

Options to relieve acute constipation within 1 hour

A

-Enema
-Bisacodyl or Glycerin suppository
-fleets is RAPID

42
Q

Options to relieve acute constipation within 3-6 hours

A

-citrate of magnesia
-larger doses of PEG

-also used for GI prep

43
Q

Options to relieve acute constipation within 24 hours

A

-bisacodyl or Senna tablets (stimulant)

44
Q

Options to relieve acute constipation within 48 hours

A

-Milk of Magnesia
-PEG
-hyperosmotic

45
Q

Chronic constipation step therapy

A
  1. relieve acute (dietary mods)
  2. Bulk lax and fluids
  3. PEG, lactulose or sorbitol
  4. Short-term stimulant then maintence agent
  5. Lubiprostone, linaclotide, prucalopride, plecanatide (CIO)
46
Q

Follow up constipation

A

-1-2 days for acute
-1-2 weeks chronic

-stool freq
-episodes of diarrhea
-deitary changes
-any SE from meds

47
Q

Tx of constipation in spinal cord injury

A

-routine use of bowel stimulants
-usually suppositories

48
Q

Tx of constipation in pregnancy

A

-diet, fiber, docusate
-senna in more severe cases

49
Q

Tx of constipation in diabetics

A

-prokinetic agents (metoclopramide, prucalopride)
-stimulants

50
Q

Tx of constipation in pts on opioids

A

-stimulants
-then add docusate, lactulose, or PEG prn
-AVOID bulk lax
-opioid antagonists if those dont work

51
Q

Opioid antagonists for constipation in pt on opioids

A

-Methylnaltrexone
-Naloxegol

52
Q

Methylnaltrexone (Relistor)

A

-mu opioid antagonist
-dose based on weight
-8-12mg SC every other day
-BM within 30 min
-$$$

53
Q

Naloxegol (Movantik)

A

-opioid receptor antagonist
-25mg PO qd, half if CrCl <60ml/min
-1 hr prior to 1st meal or 2 hrs after meal (empty tummy, high-fat meal increases rate and extent of aabsorption)
-tablet can be crushed
-$$$

54
Q

Preps for GI procedures

A

-hyperosmotics
-saline lax

-clear liquid diet
-drink lots of fluids
-day before

55
Q

Oral prep agents

A

-PEG
-SAS prep
-OsmoPrep, Visicol
-Suprep
-Suclear
-Prepopik

56
Q

PEG for GI procedure prep

A

-Nulytely, Golytely, HalfLytely, Colyte
-2-4L
-8 oz q10min
-fridge
-add crystal lite for flava

57
Q

SAS Prep

A

-day before procedure
-clear liquids all day
-1 bottle miralax into 2 bottles gatorade
-fridge
0drink extra 8 oz clear fluid every hour
-4 5mg bisacodyl at noon
-at 2pm drink miralax 8oz every 10-20min over 1 hour
-wait 30 min then drink second bottle at same rate

58
Q

Other commercial prep agents

A

-not used bc risk of CVD, renal and electrolyte abnormalities
-osmoprep, suprep, suclear, prepopik

59
Q
A

Therapeutics (78 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions