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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
Increase water intake while using! Can cause dehydration ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Polyethylene Glycol- Constipation
26
Low dose- opioid induced constipation High dose- Bowel Preparation for Colonoscopy ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Polyethylene Glycol- Constipation | Senna, Bisacodyl--Constipation
27
Treat: Hepatic Encephalopathy Constipation ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Lactulose - Constipation
28
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 ```
Lactulose - Constipation
29
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 ```
Lactulose, Polyethylene Glycol- Constipation
30
Nursing Considerations Ammonia levels should decrease Avoid in bowel obstruction ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Lactulose - Constipation
31
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 ```
Lactulose - Constipation | rectally
32
Treat: Constipation ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Psyllium (Metamucil)- Constipation
33
MECHANISM OF ACTION is a soluble fiber ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Psyllium (Metamucil)- Constipation
34
ADVERSE EFFECTS Abdominal pain/N/Constipation/Diarrhea Avoid in Intestinal Obstruction ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Psyllium (Metamucil)- Constipation
35
``` Psyllium (Metamucil)- Constipation Avoid in Intestinal Obstruction Nursing Considerations Takes ?-? days to begin working- SLOW Avoid in bowel obstruction ```
1-3 days
36
Administration Increase water intake while using! Slow to work ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Psyllium (Metamucil)- Constipation
37
Treat: Irritable Bowel Syndrome (in women) with Diarrhea ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Alosetron-- Irritable Bowel Syndrome-- Diarrhea
38
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 ```
Alosetron-- Irritable Bowel Syndrome-- Diarrhea
39
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 ```
Alosetron-- Irritable Bowel Syndrome-- Diarrhea
40
Ischemic colitis Narrow Therapeutic Index ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Alosetron-- Irritable Bowel Syndrome-- Diarrhea
41
Nursing Considerations REMS DRUG! ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Alosetron-- Irritable Bowel Syndrome-- Diarrhea
42
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 ```
Alosetron-- Irritable Bowel Syndrome-- Diarrhea
43
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 ```
Lubiprostone- Irritable Bowel Syndrome- Constipation
44
Irritable Bowel Syndrome Constipation ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Lubiprostone- Irritable Bowel Syndrome- Constipation
45
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 ```
Lubiprostone- Irritable Bowel Syndrome- Constipation
46
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 ```
Lubiprostone- Irritable Bowel Syndrome- Constipation
47
Nursing Considerations Opioid Induced Constipation’ ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Lubiprostone- Irritable Bowel Syndrome- Constipation
48
Avoid in diverticulitis, diarrhea, bowel obstruction ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Lubiprostone- Irritable Bowel Syndrome- Constipation
49
Administration Administer with Food! Increase water intake while using! ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Lubiprostone- Irritable Bowel Syndrome- Constipation
50
Treat: Irritable Bowel Disease Ulcerative Colitis Rheumatoid Arthritis ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Sulfasalazine- Irritable Bowel Disease:
51
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 ```
Sulfasalazine- Irritable Bowel Disease:
52
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 ```
Sulfasalazine- Irritable Bowel Disease:
53
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 ```
Sulfasalazine- Irritable Bowel Disease:
54
``` ?- 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 ```
Sulfasalazine- Irritable Bowel Disease:
55
``` Sulfasalazine- Irritable Bowel Disease: Mnemonic 5- ASA A - A- A- A- A- S- 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
Administration Take with food or water ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Sulfasalazine- Irritable Bowel Disease:
57
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 ```
Azathioprine - Irritable Bowel Disease:
58
``` 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 ```
Azathioprine - Irritable Bowel Disease:
59
ADVERSE EFFECTS N/V, Anorexia Hepatotoxicity Bone marrow Suppression ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Azathioprine - Irritable Bowel Disease:
60
Nursing Considerations Monitor CBC- Check LFTs ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Azathioprine - Irritable Bowel Disease:
61
Azathioprine - Irritable Bowel Disease: | Notify patients immunosuppressant's are slow (can take ? months)
6 months
62
Avoid giving with allopurinol (increased risk for toxicity) ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Azathioprine - Irritable Bowel Disease:
63
Administration Give with food ``` Lubiprostone Docusate Sodium Psyllium Azathioprine Senna, Bisacodyl Lactobacillus Polyethylene Glycol, lactulose Alosetron Sulfasalazine ```
Azathioprine - Irritable Bowel Disease:

Phamacology (13 decks)

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