Bowel Disorder Drugs Flashcards
diarrhea
the ABNORMAL PASSAGE of stools with INCREASED FREQUENCY, FLUIDITY, & WEIGHT / with increased STOOL WATER EXCRETION
acute diarrhea
- a SUDDEN ONSET in a previously HEALTHY PERSON
- 3 days - 2 weeks
- is SELF-LIMITING
- often is RESOLVED w/o SEQUELAE
chronic diarrhea
- more than 3 - 4 weeks
- asso. with more RECURRING PASSAGE OF DIARRHEA, FEVER, LOSS OF APPETITE, VOMITING, WEIGHT LOSS, or CHRONIC WEAKNESS
what CAUSES ACUTE DIARRHEA?
- BACTERIA
- VIRUSES
- DRUG INDUCED
- NUTRITIONAL FACTORS
- PROTOZOA
what CAUSES CHRONIC DIARRHEA?
- TUMORS
- DM
- ADDISON’s DX
- HYPERTHYROIDISM
- IBS
- AIDS
what are the overall GOALS OF DIARRHEA TREATMENT?
- STOPPING the stool frequency
- relieving the ABDOMINAL CRAMPS
- proper REPLENISHMENT of FLUIDS & ELECTROLYTES
- PREVENTION of WEIGHT LOSS & NUTRITIONAL DEFICITS - MALABSORPTION
what are our antidiarrheals?
- ABSORBENTS
- ANTIMOTILITY DRUGS [ANTICHOLINERGICS & OPIATES]
- PROBIOTICS [INTESTINAL FLORA MODIFIERS/BACTERIAL REPLACEMENT DRUGS]
absorbents MOA
- works on more MILDER CASES of DIARRHEA
- works by COATING the WALLS of the GI TRACT
- binds to the CAUSATIVE BACTERIA/TOXIN - allows it to be eliminated through stool
EXAMPLES:
- BISMUTH SUBSALICYLATE (PEPTOBISMOL)
- ACTIVATED CHARCOAL :0
- ANTILIPEMIC DRUGS; COLESTIPOL & CHOLESTYRAMINE
adverse effects of ABSORBENTS
- INCREASED BLEEDING time
- CONSTIPATION (darker stools)
- CONFUSION
- TINNITUS
- more METALLIC taste
- BLUE TONGUE
drug interactions for ABSORBENTS
- decreases the ABSORPTION of many drugs!
[digoxin, quinidine, hypoglycemic drugs] - increased BLEEDING TIME **caution when given with ANTICOAGULANTS **WARFARIN
- can increase TOXICITY when given with METHOTREXATE
anticholinergics
- treats more SEVERE CASES of DIARRHEA
- works by DECREASING INTEST. MUSC TONE & PERISTALSIS»_space; begins to SLOW DOWN FECAL MATTER MOVEMENT
- peristalsis; reduces the CONTRACTIONS & SM TONE
- gives a DRYING EFFECT & REDUCES GASTRIC SECRETIONS
- often used with ABSORBENTS & OPIATES
example;
BELLADONNA ALKALOIDS
adverse effects of ANTICHOLINERGICS
- URINARY RETENTION/IMPOTENCE
- HEADACHES, dizziness, confusion, ANXIETY, drowsiness
- DRY SKIN/FLUSHING
- BLURRY VISION
- HYPOTENSION/BRADYCARDIA
opiates MOA
- works by DECREASING BOWEL MOTILITY / ANALGESIC for the RECTAL SPASMS
- DECREASES TRANSIT TIME in the BOWEL’ more absorption of fluids & electrolytes
examples;
- PAREGORIC
- OPIUM TINCURE
- CODEINE
- OTC LOPERAMIDE
- DIPHENOXYLATE
opiates ADVERSE EFFECTS
- DIZZINESS/DROWSINESS
- RESP. DEPRESSION
- HYPOTENSION
- URINARY RETENTION/CONSTIPATION
- FLUSHING
probiotics
- used for ANTIBIOTIC-INDUCED DIARRHEA
- ex. LACTOBACILLUS organisms [BACID]
- supplies the MISSING BACTERIA in the GI TRACT
- SUPPRESSES the GROWTH of DIARRHEA-CAUSING ORGANISMS
nursing implications for ANTIDIARRHEALS
- assess Hx of bowel patterns/general state of health
- any diet changes?
- any allergies?
- I&Os?
- MM B/A / during treatment?
- monitor for therapeutic effects
contraindications/cautions for ANTIDIARRHEALS
- DO NOT give BISMUTH SUBSALICYLATE to CHILDREN or TEENS with CHICKENPOX or INFLUENZA - at RISK FOR REYE’s SYNDROME
- DO NOT give ANTICHOLINERGEICS to pts. with HX of:
- NARROW-ANGLE GLAUCOMA
- GI OBSTRUCTION
- MYASTHENIA GRAVIS
- PARALYTIC ILEUS
- TOXIC MEGACOLON
constipation
the ABNORMAL INFREQUENT & DIFFICULT PASSAGE of FECES through the LOWER GI TRACT
- is a SYMPTOM, not a DISEASE
- often due to DISORDER of MOVEMENT within the COLON or RECTUM or DRUGS
how do we treat CONSTIPATION?
- SURGICAL TREATMENTS
- NONSURGICAL TREATMENTS;
dietary (more fiber)
behavioral (more exercise/activity)
pharmacologic
what are our TYPES OF LAXATIVES?
- BULK FORMING
- EMOLLIENTS (STOOL SOFTENERS/LUBRICANTS)
- HYPEROSMOTIC
- SALINE
- STIMULANTS
bulk-forming laxatives indications
- ACUTE & CHRONIC CONSTIPATION
- IBS
- DIVERTICULOSIS
emollients indications
- ACUTE & CHRONIC CONSTIPATION
- FECAL IMPACTION
- facilitation of BM in ANORECTAL CONDITIONS
hyperosmotic laxatives indications
- CHRONIC CONSTIPATION
- DIAGNOSTIC and SURGICAL PREP
saline indications
- CONSTIPATION
- DIAGNOSTIC and SURGICAL PREP
stimulant laxatives indication
- ACUTE CONSTIPATION
- DIAGNOSTIC and SURGICAL PREP
laxatives MOA
- are HIGH in FIBER
- ABSORBS WATER to increase more bulk
- DISTENDS the BOWEL to initiate more REFLEX BOWEL ACTIVITY
what are our BULK FORMING LAXATIVES?
- PSYLLIUM (METAMUCIL)
- METHYLCELLULOSE (CITRUCEL)
adverse effects of bulk forming laxatives
- can cause IMPACTION
- FLUID or ELECTROLYTE IMBALANCES
- ESOPHAGEAL BLOCKAGE
emollient MOA
- promotes more WATER & FAT in the STOOLS
- is able to LUBRICATE the FECAL MATERIAL and INTESTINAL WALLS
emollient examples
- STOOL SOFTENERS
- DOCUSATE SALTS
[COLACE, SURFAK] - LUBRICANTS; MINERAL OIL
adverse effects - emollients
- SKIN RASHES
- a DECREASED ABSORPTION of VITAMINS
- ELECTROLYTE IMBALANCES
- LIPID PNEUMONIA
hyperosmotic MOA
- increases the FECAL WATER CONTENT
- results;
BOWEL DISTENTION
INCREASED PERISTALSIS - EVACUATION
what are our HYPEROSMOTIC LAXATIVES?
- POLYETHYLENE GLYCOL (PEG)
- SORBITOL/LACITITOL/GLYCERIN
- LACTULOSE **also used to reduce increased serum ammonia levels
adverse effects of HYPEROSMOTIC LAXATIVES
- ABDOMINAL BLOATING
- ELECTROLYTE IMBALANCES
- RECTAL IRRITATION
saline MOA
- increases the OSMOTIC PRESSURE within the INTESTINAL TRACT»_space; causes more WATER to enter the intestines
- results;
BOWEL DISTENTION
INCREASED PERISTALSIS
EVACUATION
what are our SALINE laxatives?
- MAGNESIUM HYDROXIDE (MILK of MAGNESIA)
- MAGNESIUM CITRATE
adverse effect of SALINE LAXATIVES
- MAGNESIUM TOXICITY (renal insufficiency)
- CRAMPING
- ELECTROLYTE IMBALANCES
- DIARRHEA
- INCREASED THIRST
stimulant laxatives MOA
- INCREASED PERISTALSIS via INTESTINAL NERVE STIMULATION
stimulant laxative examples
- SENNA (SENOKOT)
- BISACODYL (DULCOLAX)
adverse effects of stimulant laxatives
- NUTRIENT MALABSORPTION
- SKIN RASHES
- GASTRIC IRRITATION
- ELECTROLYTE IMBALANCES
- DISCOLORED URINE
- RECTAL IRRITATION
nursing implications for LAXATIVES
- Hx of symptoms, elimination patterns, allergies
- fluid & electrolytes?
- do not take when having active N&V/abdominal pain
long term use of laxatives
can result in a DECREASED BOWEL TONE - can lead to LAXATIVE DEPENDENCY
how much water should be taken with LAXATIVES?
- LAXATIVE TABS; 6 -8 oz of water
- BULK-FORMING LAXATIVES; 240 mL (8 oz) of water
bisacodyl should be given with?
- WATER
- can cause interactions when given with MILK, ANTACIDS, or JUICES
drugs for IBS-D
- Alosetron (Lotronex)
- Rifaximin (Xifaxan)
- Eluxadoline (Viberzi)
drugs for IBS-C
- Lubiprostone (Amitiza)
- Linacotide (Linzess)
