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Bowel Disorder Drugs Flashcards

1
Q 
Drugs to treat DIARRHEA:
Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lactobacillus

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2
Q 
Drugs to treat CONSTIPATION:
Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Docusate Sodium
Psyllium
Senna, Bisacodyl
Polyethylene Glycol, lactulose

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3
Q 
Drugs to treat Irritable Bowel Syndrome:
Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Diarrhea- Alosetron

Constipation-Lubiprostone

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4
Q 
Drugs to treat Irritable Bowel Disease:
Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Sulfasalazine

Azathioprine

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5
Q

Diarrhea-

Lubiprostone, Alosetron

A

Alosetron

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6
Q

Constipation

Lubiprostone, Alosetron

A

Lubiprostone

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7
Q 
Treat:
CONSTIPATION: These are loosely defined as LAXATIVES
Opioid Induced Constipation (OIC)
Bowel Preparation for Colonoscopy
Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Docusate Sodium,
Psyllium,,Senna,
Bisacodyl,,
Polyethylene Glycol, lactulose

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8
Q

Treat
Constipation

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Docusate (Colace®)- CONSTIPATION

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9
Q

MECHANISM OF ACTION
Reduces surface tension of the oil-water interface of the stool resulting in enhanced incorporation of water and fat allowing for stool softening.

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Docusate (Colace®)- CONSTIPATION

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10
Q

ADVERSE EFFECTS
Avoid in bowel obstruction

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Docusate (Colace®)- CONSTIPATION

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11
Q

Administration
Take with plenty of water!

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Docusate (Colace®) - CONSTIPATION

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12
Q

Treat:
Constipation
Bowel Prep for Procedure

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Senna, Bisacody- CONSTIPATION

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13
Q

MECHANISM OF ACTION
Stimulant laxatives typically induce defecation by stimulating peristaltic activity

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Senna, Bisacody- CONSTIPATION

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14
Q

ADVERSE EFFECTS
Abdominal pain

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Senna, Bisacody- CONSTIPATION

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15
Q

? is E.C.- don’t crush

Senna
Bisacody

A

Bisacody- CONSTIPATION

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16
Q

Nursing Considerations
Avoid in bowel obstruction

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Senna, Bisacody- CONSTIPATION

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17
Q

Mnemonic
ALL MUSH, NO PUSH” Opioid Induced Constipation

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Senna, Bisacody- CONSTIPATION

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18
Q

Senna, Bisacody
Administration
Take ? on empty stomach- Oral pills can take ?+ hours to work, Suppositories should work within an ?

A

Bisacody - CONSTIPATION
12
hour

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19
Q

Senna, Bisacody, Polyethylene Glycol
? dose- Bowel Preparations for Colonoscopy

Low or High

A

High

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20
Q

Senna, Bisacody, Polyethylene Glycol
? dose- opioid induced constipation

Low or High

A

Low

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21
Q

Treat:
Constipation
Bowel Prep for Procedure

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Polyethylene Glycol- Constipation

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22
Q

MECHANISM OF ACTION
An osmotic agent, polyethylene glycol 3350 causes water retention in the stool;

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Polyethylene Glycol- Constipation

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23
Q

ADVERSE EFFECTS
Electrolyte imbalances (can happen with Osmotic agents),
Dehydration
Abdominal pain/N/V

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Polyethylene Glycol, Lactulose - Constipation

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24
Q

Nursing Considerations
Golytely- FINISH the content
Avoid in bowel obstruction

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Polyethylene Glycol, lactulose- Constipation

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25
Q

Increase water intake while using! Can cause dehydration

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Polyethylene Glycol- Constipation

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26
Q

Low dose- opioid induced constipation
High dose- Bowel Preparation for Colonoscopy

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Polyethylene Glycol- Constipation

Senna, Bisacodyl–Constipation

27
Q

Treat:
Hepatic Encephalopathy
Constipation

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lactulose - Constipation

28
Q

MECHANISM OF ACTION
Produces an osmotic effect in the colon with resultant distention promoting peristalsis; reduces blood ammonia concentration to reduce the degree of portal systemic encephalopathy

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lactulose - Constipation

29
Q

ADVERSE EFFECTS
Electrolyte imbalances (can happen with Osmotic agents),
Dehydration
Abdominal pain/N/V

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lactulose, Polyethylene Glycol- Constipation

30
Q

Nursing Considerations
Ammonia levels should decrease
Avoid in bowel obstruction

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lactulose - Constipation

31
Q

Administration
Increase water intake while using! Can cause dehydration
Must give routinely for Hepatic Encephalopathy
Can even give ? if patient is incoherent or not with it

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lactulose - Constipation

rectally

32
Q

Treat:
Constipation

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Psyllium (Metamucil)- Constipation

33
Q

MECHANISM OF ACTION
is a soluble fiber

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Psyllium (Metamucil)- Constipation

34
Q

ADVERSE EFFECTS
Abdominal pain/N/Constipation/Diarrhea
Avoid in Intestinal Obstruction

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Psyllium (Metamucil)- Constipation

35
Q 
Psyllium (Metamucil)- Constipation
Avoid in Intestinal Obstruction
Nursing Considerations
Takes ?-? days to begin working- SLOW
Avoid in bowel obstruction
36
Q

Administration
Increase water intake while using! Slow to work

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Psyllium (Metamucil)- Constipation

37
Q

Treat:
Irritable Bowel Syndrome (in women) with Diarrhea

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Alosetron– Irritable Bowel Syndrome– Diarrhea

38
Q

MECHANISM OF ACTION
is a potent and selective antagonist of a subtype of the serotonin 5-HT3 receptor.

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Alosetron– Irritable Bowel Syndrome– Diarrhea

39
Q

BOXED WARNING
Constipation- resulting in hospitalizations, surgery, death (bowel ischemia, toxic megacolon)

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Alosetron– Irritable Bowel Syndrome– Diarrhea

40
Q

Ischemic colitis
Narrow Therapeutic Index

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Alosetron– Irritable Bowel Syndrome– Diarrhea

41
Q

Nursing Considerations
REMS DRUG!

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Alosetron– Irritable Bowel Syndrome– Diarrhea

42
Q

Came to market in 2000
Pulled off market in 2001
Brought back in 2002 as a REMS drug. THE FIRST TIME THE FDA HAS DONE THIS

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Alosetron– Irritable Bowel Syndrome– Diarrhea

43
Q

Treat:
Irritable Bowel Syndrome with Constipation in women at least 18 years old

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lubiprostone- Irritable Bowel Syndrome- Constipation

44
Q

Irritable Bowel Syndrome Constipation

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lubiprostone- Irritable Bowel Syndrome- Constipation

45
Q

MECHANISM OF ACTION
A chloride channel activator that acts locally on the apical membrane of the gastrointestinal tract to increase intestinal fluid secretion and improve fecal transit.

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lubiprostone- Irritable Bowel Syndrome- Constipation

46
Q

ADVERSE EFFECTS
Small percentage of patients develop dyspnea
Abdominal pain/Nausea/Diarrhea/Vomiting/Flatulence
Intestinal Obstruction

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lubiprostone- Irritable Bowel Syndrome- Constipation

47
Q

Nursing Considerations
Opioid Induced Constipation’

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lubiprostone- Irritable Bowel Syndrome- Constipation

48
Q

Avoid in diverticulitis, diarrhea, bowel obstruction

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lubiprostone- Irritable Bowel Syndrome- Constipation

49
Q

Administration
Administer with Food! Increase water intake while using!

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Lubiprostone- Irritable Bowel Syndrome- Constipation

50
Q

Treat:
Irritable Bowel Disease
Ulcerative Colitis
Rheumatoid Arthritis

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Sulfasalazine- Irritable Bowel Disease:

51
Q

MECHANISM OF ACTION
5-aminosalicylic acid (5-ASA ormesalamine) is the active component of ? ; Functions a prostaglandininhibitor

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Sulfasalazine- Irritable Bowel Disease:

52
Q

ADVERSE EFFECTS
Blood dyscrasias/Aplastic anemia(similar to sulfamethoxazole)
Sulfa allergy/ SUN sensitivity/SJS (all sulfa drugs!)
Check the Liver

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Sulfasalazine- Irritable Bowel Disease:

53
Q

Nursing Considerations
Should not use in Sulfa allergy or Aspirin/Salicylate allergy
Similar to Sulfamethaxozole (monitor CBC)

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Sulfasalazine- Irritable Bowel Disease:

54
Q 
?- Irritable Bowel Disease:
Mnemonic 
5- ASA
A Bowel (treats IBD)
Arthritis (Rheumatoid Arthritis)
Aplastic anemia
AST
ALT
Sulfa allergy, SUN sensitivity, SJS
Aspirin like- Reye Syndrome
A

Sulfasalazine- Irritable Bowel Disease:

55
Q 
Sulfasalazine- Irritable Bowel Disease:
Mnemonic 
5- ASA
A -
A-
A-
A-
A-
S-
A-
A 
Mnemonic 
5- ASA
A Bowel (treats IBD)
Arthritis (Rheumatoid Arthritis)
Aplastic anemia
AST
ALT
Sulfa allergy, SUN sensitivity, SJS
Aspirin like- Reye Syndrome
56
Q

Administration
Take with food or water

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Sulfasalazine- Irritable Bowel Disease:

57
Q

Treat:
Irritable Bowel Disease/ Ulcerative Colitis/ Rheumatoid Arthritis
Crohn’s Disease
TRANSPLANTS

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Azathioprine - Irritable Bowel Disease:

58
Q 
MECHANISM OF ACTION
Purine antagonist (inhibits DNA synthesis). Lack of DNA= Bone Marrow Suppression.

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Azathioprine - Irritable Bowel Disease:

59
Q

ADVERSE EFFECTS
N/V, Anorexia
Hepatotoxicity
Bone marrow Suppression

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Azathioprine - Irritable Bowel Disease:

60
Q

Nursing Considerations
Monitor CBC-
Check LFTs

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Azathioprine - Irritable Bowel Disease:

61
Q

Azathioprine - Irritable Bowel Disease:

Notify patients immunosuppressant’s are slow (can take ? months)

62
Q

Avoid giving with allopurinol (increased risk for toxicity)

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Azathioprine - Irritable Bowel Disease:

63
Q

Administration
Give with food

Lubiprostone
Docusate Sodium
Psyllium
Azathioprine
Senna, Bisacodyl
Lactobacillus
Polyethylene Glycol, lactulose
Alosetron
Sulfasalazine
A

Azathioprine - Irritable Bowel Disease:

Phamacology (13 decks)

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