Anti-Diarrhoeals and Constipation Treatment

Question 1

Name some antidiarrhoeals

Answer 1

Loperamide

Codeine

Morphine

Question 2

Describe how loperamide works

Answer 2

Binds to Mu receptors in the myenteric plexus

This causes decreased tone of longitudinal and circular smooth muscle to reduce peristalsis but also to increase segmental contraction to increase contact time with enterocytes

Also decreases colonic mass movement by supressing gastrocolic reflex

Question 3

Describe how codeine and morphine work and when they are used

Answer 3

Bind to and activate mu and delta receptors to cuause similar effects to loperamide

Add in after loperamide

Question 4

Name some side effects of opioid receptor agonists

Answer 4

Paralytic ileus

Nausea

Vomiting

Sedation

Addiction

Question 5

Name the types of laxatives

Answer 5

Osmotic mush - retain fluid or draw fluid in

Stimulants

Bulk forming

Stool forming

Enemas - osmotic and stimulants

Question 6

Name some osmotic mush diuretics and describe how they work

Answer 6

Lactulose - draws fluid in. PO

Movicol/macrogols - retain fluid they came with. PO

Question 7

Name some side effects and contraindications of lactulose

Answer 7

Side effects - abdominal pain, diarrhoea, nausea, vomiting

Contraindications - lactose intolerance, takes time to act

Question 8

Name some side effects and contraindications of movicol/macrogol

Answer 8

Contraindications - GI obstruction, perforation, paralytic ileus, IBD

Side effects - GI upset, anal discomfort, headache, nausea, vomiting

Question 9

Name some drugs used to treat constipation that come under the stimulant push category

Answer 9

Bisacodyl

Sodium picosulphate

Senna

Co-danthromer

Docusate sodium

Glycerine

Question 10

Describe how senna works, how it is given and some contraindications

Answer 10

Senna increases intestinal motility. Either PO or PR

Contraindications - intestinal obstruction

Question 11

Name some side effects of senna

Answer 11

Diarrhoea

Electrolyte/fluid imbalance

GI discomfort

Skin reactions

Question 12

Describe how glycerine works, and how it is given

Answer 12

Glycerine works by lubricating the bowel. Given PR

Question 13

Name some side effects of glycerine

Answer 13

Diarrhoea

Hypokalaemia

Nausea

GI discomfort

Question 14

Describe how co-danthromer works, how it is given and some contraindications

Answer 14

Co-danthromer is a stool softener and helps to stimulate the bowel

Given PO

Contraindications - acute IBD, acute surgical abdominal conditions, intestinal obstruction

Question 15

Name some side effects of co-danthromer

Answer 15

Abdominal cramps

Hypokalaemia

Skin reactions

Question 16

Name some bulk forming treatments for constipation

Answer 16

Ispaghula husk

Methylcellulose

Question 17

Name some stool softening drugs used to treat constipation

Answer 17

Sodium docusate

Glycerine suppository

Arachis oil

Liquid paraffin

Question 18

Describe how sodium decusate works, how it is given and some contraindiactions

Answer 18

Sodium decusate softens stool

Given PR or PO

Contraindications - intestinal obstruction

Question 19

Name some side effects of sodium decusate

Answer 19

Abdominal cramps

Nausea

Rash