bowel drugs

Question 1

bismuth subsalicylate

Answer 1

adsorbent
coat walls, bind agent for elim
SE: increased bleeding, constipation, dark stools and tongue, same as aspirin
activated charcoal
drug overdose

Question 2

loperamide (otc, no SE)
diphenoxylate (Rx)

Answer 2

antimotility - slowed peristalsis, D: drying effect - reduce gastric secretions
due to anticholinergic: urinary retention, HA, dizzy, anx, drowsy, brady, hypot, dry skin, flush
used alone or in combo with adsorbents

Question 3

lactobacillius
saccaromyces (c. diff)

Answer 3

probiotics
otc or Rx strength

Question 4

psyllium

Answer 4

bulk forming laxatives
absorb water into intestine, distend bowel to initiate activity and movement
long term use! contraindicated for intestinal obstruction or fecal impaction
SE: impaction, less fluid/e, gas, esophageal blockage - take with lots of water
no systemic affects

Question 5

docusate sodium
mineral oil

Answer 5

emollient
prevent water from leaving intestine
SE: skin rashes, decreased absorption of vits
DS: lubricate feces and walls, promote fat absorption, given prophylactically - opioids
MO: lubricate intestines, fecal impaction, PO and PR

Question 6

glycerin
lactulose
polyethylene glycol

Answer 6

hyperosmotic
increase H2O content in feces, promote distention, peristalsis, and evacuation
SE: abd bleeding, rectal irritation, e imbalance
G: children - suppository
L: reduce blood ammonia levels (use with liver disease and hepatic encephalopathy), work in colon
PG: before diagnostic or surgical bowel, total cleansing

Question 7

Mg salts (Mg citrate, Mg hydroxide, Mg sulfate)
Na salts

Answer 7

saline
increase osmotic pressure and draw water into colon
SE: Mg toxicity (e imbalance), cramp, diarrhea
work within 3-6 hours
Mg OTC, Na usually enema

Question 8

Bisacodyle
Senna

Answer 8

c or whole bowel evac - work on entire GI tract
SE: nutrient malabsorption, gastric irritation, e imbalance
B: PO and PR OTC