antidiarrheals and laxatives Flashcards
what is acute diarrhea?
-sudden onset
-lasts 3 days to 2 weeks
-resolves itself
what is chronic diarrhea?
-lasts for more than 3 to 4 weeks
-other symptoms:
-fever
-loss of appetite
-nausea
-vomiting
-weight loss
-chronic weakness
what are antidiarrheals?
-adsorbents
-anticholinergics and opiates
-probiotics
what do adsorbents do?
-coat the walls of the gastrointestinal tract
-bind to the causative bacteria or toxin, which is then eliminated in the stool
what are examples of adsorbents?
-bismuth subsalicylate (pepto-bismol)
-activated charcoal
-antilipemic drugs colestipol and cholestyramine
what do anticholinergics do?
-decrease intestinal muscle tone and peristalsis of GI tract
-result in slowed movement of fecal matter through the GI tract
-slow peristalsis by reducing the rhythmic contractions and smooth muscle tone of the GI tract
-have a drying effect
-reduce gastric secretions
-used in combination with adsorbents and opiates
what do opiates do?
-decrease bowel motility and reduce pain by relief of rectal spasms
-increases transit time through the bowel, allowing more time for water and electrolytes to be absorbed
what are examples of opiates?
-paregoric
-opium tincture
-codeine phosphate
-loperamide hydrochloride
-diphenoxylate hydrochloride with atropine sulphate
what do probiotics do?
-supply missing bacteria to the GI tract
-suppress the growth of diarrhea causing bacteria
what is an example of a probiotic?
-lactobacillus acidophilus
is what case would you use a adsorbent?
-milder cases of diarrhea
in what case would you use a anticholinergic or opiate?
-more severe cases of diarrhea
in what case would you use a probiotic?
-antibiotic-induced diarrhea
what are some adverse effects of adsorbents?
-increased bleeding time
-constipation, dark stool
-confusion
-tinnitus
-metallic taste
-blue gums or black tongue
what are some adverse effects of anticholinergics?
-urinary retention, sexual dysfunction
-headache, dizziness, confusion, anxiety, drowsiness
-dry skin, flushing
-blurred vision
-hypotension, bradycardia pr tachycardia
what are some adverse effects of opiates?
-drowsiness, dizziness, lethargy
-nausea, vomiting, constipation
-respiratory disease
-hypotension
-urinary retention
-flushing
what are the 5 different kinds of laxatives?
-bulk forming
-emollient
-hyperosmotic
-saline
-stimulant
what do bulk forming laxatives do?
-absorb water to increase bulk
-distend bowel to initiate reflex bowel activity
what are examples of bulk forming laxatives?
-psyllium (metamucil)
-methylcellulose
what do emollient laxatives do?
-stool softeners and lubricants
-promote more water and fat in the stools
-lubricate the fecal material and intestinal walls
what is one example of a stool softener and one lubricant?
-stool softener: docusate salts (colace)
-lubricant: mineral oils
what are some examples of hyperosmotic laxatives?
-polyethylene glycol
-sorbitol, glycerin
-lactulose
what do hyperosmotic laxatives do?
-increase fecal water content
-results in bowel distention, increased peristalsis, and evacuation
what do saline laxatives do?
-increases osmotic pressure within the intestinal tract, causing more water to enter the intestines
-results in bowel distention, increased peristalsis, and evacuation
what are some examples of saline laxatives?
-magnesium hydroxide (milk of magnesia)
-magnesium citrate
what do stimulants laxative do?
-increase peristalsis via intestinal nerve stimulation
what are some examples of stimulant laxatives?
-senna (senokot)
-bisacodyl (dulcolax)
what are some bulk forming laxative indications?
-acute and chronic constipation
-irritable bowel syndrome
-diverticulosis
what are some emollient laxatives indications?
-acute and chronic constipation
-fecal impaction
-facilitation of bowel movements in anorectal conditions
what are some saline laxative indications?
-constipation
-diagnostic and surgical procedures
what are some hyperosmotic laxative indications
-chronic constipation
-diagnostic and surgical procedures
what are some stimulant laxative indications?
-acute constipation
-diagnostic and surgical procedures
what are the adverse effects of bulk forming laxatives?
-impaction
-fluid overload
-electrolyte imbalances
-gas formation
-esophageal blockage
-allergic reaction
what are the adverse effects of emollient laxatives?
-skin rashes
-decreased absorption of vitamins
-electrolyte imbalances
-lipid pneumonia
what are the adverse effects of hyperosmotic laxatives?
-abdominal bleeding
-electrolyte imbalances
-rectal irritation
what are the adverse effects of saline laxatives?
-magnesium toxicity (with renal insufficiency)
-cramping
-electrolyte imbalances
-cramping, diarrhea
-increased thirst
what are the adverse effects of stimulant laxatives?
-nutrient malabsorption
-skin rashes
-gastric irritation
-electrolyte imbalances
-discolored urine
-rectal irritation
