Bowel Disorder Drugs Flashcards
Docusate (Colace)
Functional Classification
Laxative, emollient; stool softener
Docusate (Colace)
Mechanism of Action
Increases water, fat penetration in intestine; allows for easier passage of stool
Docusate (Colace)
Uses
Prevention of dry, hard stools
Docusate (Colace)
Contraindications
Hypersensitivity, obstruction, fecal impaction, nausea/vomiting
Docusate (Colace)
Side Effects
EENT: bitter taste, throat irritation
GI: nausea, anorexia, cramps, diarrhea
INTEG: rash
Docusate (Colace)
Nursing Considerations
ASSESS:
- CAUSE OF CONSTIPATION; identify whether fluids, bulk, or exercise missing from lifestyle; constipating products
- Cramping, rectal bleeding, nausea, vomiting; if these occur, product should be discontinued
Glycerin
Functional Classification
Laxative, hyperosmotic
Glycerin
Uses
Constipation
Glycerin
Contraindications
Hypersensitivity
Lactulose
Functional Classification
Laxative; ammonia detoxicant (hyperosmotic)
Lactulose
Chemical Classification
Lactose synthetic derivative
Lactulose
Mechanism of Action
Prevents absorption of ammonia in colon by acidifying stool; increases water, softens stool
Lactulose
Uses
Chronic constipation, portal-systemic encephalopathy in patients with hepatic disease
Lactulose
Contraindications
Hypersensitivity, low-galactose diet
Lactulose
Side Effects
GI: Nausea, Vomiting, Anorexia, Abdominal Cramps, diarrhea, flatulence, distention, belching
META: hypernatremia
Lactulose
Nursing Considerations
ASSESS:
- STOOL: amount, color, consistency
- CAUSE OF CONSTIPATION; determine whether fluids, bulk, or exercise is missing from lifestyle; use of constipating products
- HEPATIC ENCEPHALOPATHY: blood ammonia level (30-70mg/100ml); may decrease ammonia level by 25%-50%; clearing of confusion, lethargy, restlessness, irritability if portal-systemic encephalopathy
- Blood, urine electrolytes if product used often; may cause diarrhea, hypokalemia, hyponatremia
- I&O ratio to identify fluid loss
- Cramping, rectal bleeding, nausea, vomiting; if these symptoms occur, product should be discontinued
Loperamide (Imodium)
Functional Classification
Antidiarrheal
Loperamide (Imodium)
Chemical Classification
Piperidine derivative
Loperamide (Imodium)
Mechanism of Action
Direct action on intestinal muscles to decrease GI peristalsis; reduces volume, increases bulk; electrolytes not lost
Loperamide (Imodium)
Uses
Diarrhea (cause undetermined), travelers’ diarrhea, chronic diarrhea, to decrease amount of ileostomy discharge
Loperamide (Imodium)
Contraindications
Hyper-sensitivity, pseudomembranous colitis, constipation, dysentery, GI bleeding/obstruction/perforation, ileus, vomiting
Loperamide (Imodium)
Side Effects
CNS: dizziness, drowsiness, fatigue
GI: Nausea, Dry Mouth, Vomiting, Constipation, abdominal pain, anorexia, TOXIC MEGACOLON, bacterial enterocolitis, flatulence
INTEG: rash
MISC: hyperglycemia
SYST: ANAPHYLAXIS, ANGIOEDEMA, TOXIC EPIDERMAL NECROLYSIS
Loperamide (Imodium)
Nursing Considerations
ASSESS:
- STOOLS: volume, color, characteristics, frequency; bowel pattern before product; rebound constipation
- Electrolytes (K, Na, Cl) if receiving long-term therapy
- Skin turgor q8hr if dehydration is suspected; fluid replacement
- Response after 48hr; if no response, product should be discontinued
- Dehydration, CNS problems in children, those with hepatic disease
- Abdominal distention, toxic megacolon; may occur with ulcerative colitis
Psyllium
Functional Classification
Bulk laxative
Psyllium
Chemical Classification
Psyllium colloid
Psyllium
Mechanism of Action
Bulk-forming laxative
Psyllium
Uses
Chronic constipation, ulcerative colitis
Psyllium
Contraindications
Hypersensitivity, intestinal obstruction, abdominal pain, nausea, vomiting, fecal impaction
Psyllium
Side Effects
GI: Nausea, Vomiting, Anorexia, Diarrhea, cramps, intestinal esophageal blockage
Psyllium
Nursing Considerations
ASSESS:
- Blood, urine electrolytes if used often
- I&O ratio to identify fluid loss
- CONSTIPATION: cause of constipation; fluids, bulk, exercise missing; bowel sounds, distention, usual bowel function; color, consistency, amount
- Cramping, rectal bleeding, nausea, vomiting; product should be discontinued
Docusate (Colace)
Chemical Classification
Anionic Surfactant