Antidiarrheals and Laxatives Flashcards

1
Q

What are the classes of antidiarrheals?

A

Adsorbents
Antimotility
Flora modifiers

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2
Q

What is the mechanism of action and drug effect of adsorbents?

A

Binds to the causative bacteria/toxin, which is then eliminated through the stool

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3
Q

What are the indications for adsorbents?

A

Mild diarrhea

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4
Q

What are examples of adsorbents?

A
Activated charcoal
Bismuth subsalicylate (Pepto-Bismol)
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5
Q

What are the nursing implications for bismuth subsalicylate (Pepto-Bismal)?

A

Linked with Reyes syndrome

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6
Q

What are the adverse effects of adsorbents?

A
Increased bleeding time
Constipation
Confusion in elderly
Hearing loss, tinnitus
Dark stools and tongue
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7
Q

What is the mechanism of action of antimotility (anticholinergics)?

A

Decrease intestinal muscle tone and peristalsis of GI traact

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8
Q

What is the drug effect of antimotility (anticholinergics)?

A

Slows movement of fecal matter through GI tract

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9
Q

What are examples of antimotility (anticholinergics)?

A

Belladonna alkaloids (Donnatal)

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10
Q

What is the mechanism of action and drug effect of antimotility (opiates)?

A

Decrease bowel motility
Decrease transit time through the bowel, allowing more time for water and electrolytes to be absorbed
Reduces pain by relief of rectal spasms

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11
Q

What are some antimotility (opiates)?

A

Loperamide (Imodium)

Diphenoxylate/Atropine (Lomotil)

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12
Q

What are the adverse effects of antimotility (opiates)?

A
Drowsiness, sedation, dizziness, lethargy
Respiratory depression
Hypotension
Nausea, vomiting, constipation
Flushing
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13
Q

What is the mechanism of action and drug effect of flora modifiers?

A

Replenishes “good” GI tract bacteria that are often destroyed by antibiotics
Suppresses growth of diarrhea-causing bacteria

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14
Q

What are some flora modifiers?

A
L. acidophilius (Lactinex, Bacid)
Lactobacillus GG (Culturelle)
Bifidus regularis (Dannon Activa yogurt)
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15
Q

What are the nursing implications for antidiarrheals?

A

Obtain thorough history of bowel patterns, general state of health, history of recent illness, dietary changes, and travel
Assess for contraindications (bowel obstruction, bacterial/parasite infection)
DO NOT give bismuth subsalicylate to children or teenagers with chickenpox/influenza because risk Reye’s syndrome

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16
Q

What are the classes of laxatives?

A

Bulk-forming laxatives
Surfactant laxatives
Osmotic laxatives
Stimulant laxatives

17
Q

What is the mechanism of action and drug effect of bulk forming laxatives?

A

Absorbs water, swelling to a bulky substance that distends the wall of the colon which elicits a defecation reflex
Act in manner similar to naturally occurring dietary fiber

18
Q

What are some bulk forming laxatives?

A

Psyllium (Metamucil)

Methylcellulose (Citrucel)

19
Q

What is the mechanism of action and drug effect of surfactant laxatives?

A

Allows penetration of water into hardened fecal mass to soften it
DOES NOT promote peristaltic activity
Considered a “stool softener” and not a true laxative

20
Q

What are examples of surfactant laxatives?

A
Docusate salts (Colace)
Mineral oil (lubricant)
21
Q

What is the mechanism of action and drug effect of osmotic laxatives?

A

Increased osmotic pressure draws water from tissues into colon
Bowel distention stimulates stretch receptors of colon which induces peristalsis and evacuation

22
Q

What are some osmotic laxatives?

A

Magnesium citrate
Lactulose
Polyethylene glyco (Golytely, Moviprep, Miralax)

23
Q

What is the mechanism of action and drug effect of stimulant laxatives?

A

Stimulates peristalsis via direct intestinal nerve stimulation

24
Q

What are some stimulant laxatives?

A

Senna (Senekot)

Bisacodyl (Dulcolax)

25
Q

What are nursing implications for stimulant laxatives?

A

This laxative class is most likely to cause dependence

26
Q

What are nursing implications for laxatives?

A

Obtain thorough history of present symptoms, elimination patters, and allergies
Assess fluid and electrolytes before initiating therapy
Contact physician if experience severe abdominal pain, muscle weakness, cramps, dizziness (possible fluid/electrolyte loss)
Alternative to laxative use: healthy, high-fiber diet and increased fluid intake and activity
Long-term use of laxatives result in decreased bowel tone (dependency)
Take tablets with water