Antidiarrheal Drugs and Laxatives

Question 1

Acute diarrhea

Answer 1

Sudden onset. 3 days to 2 weeks

Question 2

Chronic Diarrhea

Answer 2

More than 3 to 4 weeks

Question 3

Causes of acute diarrhea

Answer 3

Bacteria, viruses, drugs, Nutrition, Protozoa

Question 4

Causes of chronic diarrhea

Answer 4

Tumour, Diabetes, Addison’s disease, Hyperthyroidism, IBS, AIDS

Question 5

4 types of antidiarrheals

Answer 5

Adsorbents(milder cases), Antimotility drugs(more severe cases) (anticholinergics and opiates), Probiotics (antibiotic-induced diarrhea)

Question 6

Adsorbents MOA

Answer 6

Coat the walls of the GI tract and bind to causative bacteria, which is then eliminated through the stool.

Question 7

Anticholinergics MOA

Answer 7

Decreases intestinal muscle tone and decreases peristalsis of the GI tract. Has a drying effect and reduces gastric secretion

Question 8

Opiates MOA

Answer 8

Decreases bowel motility and reduces pain by relief of rectal spasms. Increases transit through the bowel, allowing more time for water and electrolytes to be absorbed

Question 9

Probiotics MOA

Answer 9

Supplies missing bacteria to the GI tract and suppresses the growth of diarrhea-causing bacteria

Question 10

Adsorbents adverse effects

Answer 10

Increased bleeding time, constipation and dark stools, confusion, tinnitus, metallic taste, blue gums or black tongue

Question 11

anticholinergics adverse effects

Answer 11

urinary retention, sexual dysfunction, headache, dizziness, confusion, anxiety, drowsiness, dry skin, flushing, blurred vision, hypotension

Question 12

Opiates adverse effects

Answer 12

Drowsiness, dizziness, lethargy, nausea, vomiting, constipation, respiratory depression, hypotension, urinary retention, flushing

Question 13

Bismuth subsalicyclate is not to be given to ______

Answer 13

children or teens with chicken pox & the flu due to the risk of Reye’s syndrome (swelling of the brain and liver)

Question 14

5 types of laxatives

Answer 14

Bulk-forming, emollient, hyperosmotic, saline, stimulant

Question 15

Bulk-forming MOA

Answer 15

Absorb water to increase bulk. Distend bowel to initiate reflex bowel activity

Question 16

Emollient (lubricant and softener) MOA

Answer 16

Promote more water and fat in the stools. Lubricate the fecal matter and intestinal walls.

Question 17

Hyperosmotic MOA

Answer 17

Increases fecal water content, results in bowel distension, increased peristalsis and evacuation

Question 18

Saline MOA

Answer 18

Increases osmotic pressure within intestinal tract, causing more water to enter the intestines

Question 19

Stimulants MOA

Answer 19

Increase peristalsis via intestinal nerve stimulation

Question 20

Bulk-forming uses

Answer 20

Acute and chronic constipation, IBS and diverticulosis

Question 21

Emollient uses

Answer 21

Acute and chronic constipation, fecal impaction, facilitation of bowel movements

Question 22

Hyperosmotic uses

Answer 22

Chronic constipation, diagnostic and surgical procedures

Question 23

Saline uses

Answer 23

Chronic constipation, diagnostic and surgical procedures

Question 24

Stimulant uses

Answer 24

Acute constipation, diagnostic and surgical procedures

Question 25

Bulk forming adverse effects

Answer 25

impaction, fluid overload, electrolyte imbalances, gas formation, esophageal blockage

Question 26

Emollient adverse effects

Answer 26

Skin rashes, decreased absorption of vitamins, electrolyte imbalances, lipid pneumonia

Question 27

Hyperosmotic adverse effects

Answer 27

Abdominal bloating, electrolyte imbalances, rectal irritation

Question 28

Saline adverse effects

Answer 28

Magnesium toxicity, cramping, electrolyte imbalances, cramping, diarrhea, increased thirst

Question 29

Stimulant adverse effects

Answer 29

Nutrient malabsorption, skin rashes, gastric irritation, electrolyte imbalances, discoloured urine, rectal irritation

Question 30

Patients should take all laxative tablets with _______

Answer 30

180 to 240 mL of water.

Question 31

Patients should take bulk-forming laxatives as directed by the manufacturer with at least ________

Answer 31

240 mL of water

Question 32

Name an adsorbent

Answer 32

bismuth subsalicyclate (Pepto-bismol)

Question 33

Name 3 opiates

Answer 33

codeine phosphate, loperamide hydrochloride, diphenoxylate hydrochloride with atropine sulphate

Question 34

What is an example of a probiotic

Answer 34

Lactobacillus acidophilus

Question 35

When are adsorbents indicated to be used

Answer 35

In milder diarrhea cases

Question 36

When are anticholinergics and opiates indicated to be used

Answer 36

In more severe diarrhea cases

Question 37

When are probiotics indicated to be used

Answer 37

During antibiotic-induced diarrhea

Question 38

What is an example of a bulk-forming laxative?

Answer 38

psyllium (Metamucil)

Question 39

What is an example of a stool softener and a lubricant (emollients) laxative?

Answer 39

Docusate salts (colace) and mineral oil

Question 40

What are 3 examples of hyperosmotic laxatives?

Answer 40

Polyethylene glycol, glycerin, lactulose

Question 41

What are 2 examples of saline laxatives?

Answer 41

Magnesium hydroxide (milk of magnesia), Magnesium citrate

Question 42

What are two examples of stimulant laxatives?

Answer 42

Senna (senokot), bisacodyl (dulcolax)

Question 43

All laxative tablets should be___________, not ___________, especially if enteric coated.

Answer 43

Swallowed whole, not crushed or chewed