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pharm > antidiarrheals and laxatives > Flashcards

antidiarrheals and laxatives Flashcards

1
Q

what drugs alter the motility of the GI tract

A
  • antidiarrheal and antispasmodic (decrease motility and smooth muscle tone)
  • laxatives (accelerate passage of food through intestine)
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2
Q

antidiarrheal drugs

A
  • opioids
  • adsorbents
  • anticholinergics (antispasmodic)
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3
Q

diarrhea

A

abnormal passage of stools
- increased frequency, fluidity, and weight
- increased stool water excretion

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4
Q

acute diarrhea

A

sudden onset in previously healthy person
- 3 days-2 weeks
- self-limiting
- causes: microbial, drug-induced, nutritional

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5
Q

chronic diarrhea

A
  • more than 3 weeks
  • recurring passage of diarrheal stools, fever, loss of appetite, nausea, vomiting, weight loss, chronic weakness
  • causes: tumour, diabetes, hormonal, IBS
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6
Q

opioids moa

A

activate receptors in GI tract:
- decrease bowel motility (increase bowel transit time and more water/electrolytes can be absorbed)
- decrease secretions and increase fluid absorption

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7
Q

opioids example

A

loperamide
- poorly absorbed
- poor access to CNS

diphenoxylate, paregoric, opium tincture

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8
Q

opioid adverse effects

A

excessive doses:
- drowsiness, sedation, dizziness, lethargy
- nausea, vomiting, anorexia, constipation
- respiratory depression
- bradycardia, palpitations, hypotension
- urinary retention
- flushing, rahs, urticaria

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9
Q

adsorbents

A
  • not fully sure moa
  • coat walls of GI tract
  • bind to bacteria or toxin cause and eliminated through stool
  • inhibit intestinal secretions
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10
Q

adsorbents examples and AE

A
  • bismuth subsalicylate (also used for relief of stomach acid symptoms)
  • AE: constipation, dark stools and tongue, metallic taste, blue gums
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11
Q

client care: antidiarrheal agents

A

do not give bismuth subsalicylate to children <16 or teens with viral infections
- reye’s syndrome

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12
Q

anticholinergic moa

A
  • antagonist at cholinergic receptors
  • decrease diarrheal muscle cramping

example:
- atropine

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13
Q

anticholinergics adverse effects

A
  • CNS excitation: dizziness, confusion, anxiety
  • blurred vision, photophobia, increased intraocular pressure
  • dry mouth, dry skin
  • CV (tachycardia)
  • constipation
  • urinary retention, hesitancy
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14
Q

constipation

A

abnormally infrequent and difficult passage of feces through the lower GI tract
- disorder of movement through intestines or rectum
- cause: diet, drugs, disease

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15
Q

complications of constipation

A
  • hemorrhoids (enlarged rectal veins)
  • anal fissure (cracks in anal lining)
  • fecal impaction (manual removal needed)
  • rectal prolapse (rectal tissue pushed out)
  • lazy bowel
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16
Q

types of laxatives

A
  • bulk forming: 1-3 days
  • osmotic/hyper osmotic (dose dependant)
  • fecal softener (1-3 days)
  • stimulant (6-12 hours)

some available as enema/suppositories

all laxatives lead to softer stools (onset and extent of action varies)

17
Q

laxative use

A
  • do not use if bowel obstruction
  • overuse: atonic colon (reduced muscular activity) and dependency so you require more laxatives
18
Q

bulk forming laxatives

A
  • high fibre substances (non-digestable)
  • absorbs water present in lumen to increase bulk
  • stretches bowel to initiate reflex bowel activity/motility
  • methylcellulose (natural fiber indigestible from plants - drink with water and wash it down so it doesn’t grow and absorb in esophagus - 240mL to avoid esophageal obstruction)
19
Q

osmotic laxatives

A
  • non absorbable compounds or salt solutions that draw water into intestinal lumen (stretches GI wall and causes motility)
  • hyper osmotic compounds and salines
  • can cause substantial water loss and dehydration
  • dramatic and highly effective action (careful leaving the house
  • high doses used for diagnostic and surgical preps for squeaky clean colon (PEG + Na/Mg salines)
20
Q

hyperosmotic compounds

A

increase fecal water content
- bowel distention, increased peristalsis and evacuation
- lactulose

21
Q

salines

A

increase osmotic pressure in intestinal tract, more water enters intestines
- bowel distension, increased peristalsis, evacuation
- magnesium hydroxide

22
Q

fecal softeners (emollients or surfactants

A
  • stool softeners and lubricants
  • promotes more water and fat in the stools (bulky to increase peristalsis)
  • lubricate the fecal material and intestinal walls
  • docusate sodium
23
Q

stimulant

A
  • increases peristalsis via intestinal nerve stimulation
  • increase fluid secretion into intestine
  • senna
24
Q

how to prevent opioid induced constipation

A
  • stimulants and fecal softener
25
Q

client care: laxatives

A
  • high fibre diet, increased fluids and exercise encouraged as alternative to laxative use
  • long term use: decreased bowel tone, dependency
  • do not take if experiencing N&V or abdominal pain

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