BM Pharm Flashcards
Bismuth subsalicylate (Pepto-bismol)
adsorbent; chewable form of aspirin made of activated charcoal
Bismuth subsalicylate MOA
coats the walls of the GI tract; binds the causative agent for elimination
SE for bismuth subsalicylate
inc bleeding time, constipation, dark stools and darkened tongue
Antimotility drugs
Loperamide (imodium) and diphenoxylate with atropine (Lomotil)
Antimotility drugs MOA
made with anticholinergic and antiperistalsis agents; slow peristalsis by dec rhythmic contractions muscle contraction of GI tract and decrease gastric secretions
loperamide specific function
Slows peristalsis
NC for antimotility
Can be used with adsorbants and opiates
anticholinergics
NOT OTC; causes drying effect and SE of urinary retention, headache, dizzy, anx, drowsiness, bradycardia, hypotension, dry skin, flushing
Probiotics
made from bacterial cultures, mostly lactobacillus and sacchryobaccilus organisms (Bacid, Culturelle)–make up the majority of normal flora of gut
Sacchyaromyces boulardii (Florastor)
Probiotic used for C. diff
MOA of probiotics
replenish bacteria and restore normal flora
Constipation tx char
Personalized based on age, severity, contributing factors
psyllium (Metamucil)
Bulk-forming med that acts similar to dietary fiber by absorbing water into the intestine, increasing bulk and distends bowel to initiate reflex bowel activity and bowel movement
Which constipation med can be used long-term?
Bulk-forming–Metamucil/psyllium
psyllium SE
impaction above strictures, fluid/electrolyte imbalance, gas formation, esophageal blockage
Psyllium NC
take with lots of water, CI for intestinal obstruction and fecal impaction
docusate sodium (Colace)
PO emollient that lubricates fecal material and walls and promotes fat abs into fecal mass
Why is docusate sodium given?
prevent opioid-induced constipation
Mineral oil
PO and rectal, enema, emollient for fecal impaction that lubricates the intestines
SE of emollients
skin rashes, dec abs of vitamins
Hyperosmotic meds
Glycerin, lactulose, and polyethylene glycol
Glycerin
mild drug given often to kids as a suppository
Lactulose
digested in colon, creating hyperosmotic enviro that draws water in; dec blood ammonia levels
Lactulose indications
liver disease and hepatic encephalopathy
Polyethylene glycol indications (golightly)
before diagnostic or surgical bowel procedures; very potent–total cleansing
Hyperosmotic MOA
inc water content in feces, promotes distension, peristalsis, and evacuation
Hyperosmotics SE
ab bloating, rectal irritation, electrolyte imbalance
Saline laxatives
magnesium salts and sodium salts; inc osmotic pressure and draw water into colon
Saline laxatives SE
mag toxicity (with preexisting renal probs), electrolyte imbalance, cramping, diarrhea
Saline laxatives NC
be careful with renal disease–hypermagnesemia
Stimulant laxatives
induce intestinal peristalsis; work on GI tract; bisacodyl (Ducolax) and senna (Senokot)
bisacodyl (Ducolax)
given PO and rectum, OTC
senna (Senokot)
given PO, OTC; may cause urine discoloration
Stimulant lax SE
nutrient malabsorption, gastric irritation, electrolyte imbalance
Stimulant lax NC
most likely to cause dependence
Types of laxatives
Bulk forming, emollients, stimulant saline, and hyperosmotics
