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C7- Lower GI Medications Flashcards

1
Q

Adults- criteria for constipation

A

Fewer than three BM per week
Lumpy or hard stools for more than 25% of BM
Straining During more than 25% of BM

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2
Q

Infants and Children- Criteria for Constipation

A

Pebble-like, hard stools for a majority of BM for at least 2 wks
Firm stools 2X/week or less for at least 2 weeks

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3
Q

Constipation Causes- D.O.P.E.D.

A

D- drugs
O- obstruction
P- pain
E- endocrine
D- depression

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4
Q

Constipation contraindications

A

Abdominal pain
Possible appendicitis
Diverticulitis
Ulcerative colitis
Pregnancy/lactation

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5
Q

Constipation Contributing factors

A

Insufficient water intake
Fecal impaction
Bowel obstruction
Chronic laxative use
Neurological disorders
Ignoring the urge to defecate
Lack of exercise
Some drugs
anticholinergics
narcotics
certain antacids

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6
Q

Indications for Laxatives

A

Painful elimination
Cardiovascular disease
Elderly with weakened abdominal or perineal muscles
Correcting constipation from opioid use or prolonged bedrest

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7
Q

How are laxatives classified?

A

By response

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8
Q

Group 1 laxatives

A

Produce watery stools (osmotic)
Magnesium salts
Sodium salts
Castor oil
Polyethylene glycol
electrolyte solution

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9
Q

Group 1 Laxative response time

A

2-6 hours

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10
Q

Laxatives- Group 2

A

Produce Semi-fluid stool
osmotic in low doses
Magnesium salts
Sodium salt
Polyethylene glycol
Stimulant laxatives
bisacodyl
Senna

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11
Q

Group 2 laxative response time

A

6-12 hours

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12
Q

Laxatives- Group 3

A

Bulk forming laxatives
methyl cellulose
psyllium
polycarbophil
Surfactant Laxatives
Docusate sodium
Docusate Calcium
Others
lactulose
lubiprostone

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13
Q

Group 3 laxatives response

A

1-3 Days

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14
Q

Bulk forming laxatives - Generic Name

A

Psyllium (powder in water)

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15
Q

Bulk forming laxatives action

A

Similar to dietary fiber (swell in water)
Increase intestinal volume

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16
Q

Bulk forming laxatives- Indications

A

Preferred agent for temporary relief
works within 12-72 hours

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17
Q

Bulk forming laxatives- administration

A

Should be accompanied by a full glass of water

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18
Q

Bulk forming laxatives- Side effects

A

Esophageal obstruction
Intestinal obstruction

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19
Q

Do not give laxatives with this condition

A

Undiagnosed abdominal pain

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20
Q

Emollient laxatives:

A

Docusate

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21
Q

Emollient laxatives- Action

A

Allow water and fat to penetrate into stool

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22
Q

Emollient laxatives- Administration

A

Should be accompanied by a glass of water

HOLD MEDICATION FOR LOOSE STOOLS

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23
Q

Emollient laxatives- results show signs of improvement (how long)

A

12-72 hours

24
Q

Osmotic Laxatives-

A

Polyethylene glycol
Magnesium hydroxide (milk of mag)

25
Osmotic Laxatives- action
Osmotic action draws water into the intestinal lumen
26
Osmotic Laxatives- adverse effects
Fluid loss Mg++ accumulation Na+/Fluid retention
27
Osmotic Laxatives- in a large volume
GoLytely for colonoscopies
28
Stimulant laxatives:
Bisacodyl Senna
29
Stimulant laxatives- RISK?
Frequently abused laxative
30
Stimulant laxatives- Action
Stimulate nerves to increase intestinal motility
31
Stimulant laxatives- Uses
Opioid induced constipation Slow intestinal transit
32
Stimulant laxatives- nursing teaching
May discolor urine
33
Laxative abuse causes:
Belief that daily and bountiful BM is a requisite of good health
34
Laxative abuse consequences:
Diminished Defecator reflexes reliance on laxatives electrolyte imbalances Dehydration colitis
35
Laxative abuse treatment:
Cessation of laxative use educate on normal bowel function fix with diet
36
Diarrhea
3+ loose/liquid stools per day
37
Diarrhea Cautions
Fluid and electrolyte imbalance monitor I/O
38
Diarrhea Management
Diagnose and treat underlying condition Replacement fluids/electrolytes Relief of cramping Reducing passage of unformed stools
39
Antidiarrheal Medications (Adsorbents):
Bismuth Salicylate (Pepto-Bismol)
40
Antidiarrheal Medications (Antimotility agents)
Loperamide Opiates and opiate-related agents
41
Antidiarrheal Antimotility agents: (action)
Slow peristalsis
42
Antidiarrheal combinations:
Diphenoxylate with atropine narcotic and anticholinergic drug reduces GI motility
43
Probiotics:
Restore normal flora
44
Adsorbents Action
Coats walls of GI tract and binds to causative bacteria or toxin (trouble maker) Decreases flow of fluids Reduces inflammation of intestine
45
Adsorbents- Cautions
Allergy to aspirin Children contains aspirin Anticoagulant use DO NOT USE
46
Adsorbents- Side effects
Black/dark tongue Dark stools Bleeding Tinnitus
47
Antimotility agents- Anticholinergic
Diphenoxylate with atropine (lomotil)
48
Antimotility agents- Contraindications (when you should not take)
Glaucoma Paralytic ileus
49
Antimotility agents: Side effects
(Anticholinergic) dry mouth urinary retention drowsiness
50
Antimotility agents: Opioid like
Loperamide (Imodium)
51
Antimotility agents: loperamide (Contraindication)
Not for children <2yo
52
Antimotility agents: Loperamide (precaution)
Use as directed higher doses cause lethal heart rhythms
53
Antimotility agents: Loperamide (side effects)
CNS depression
54
Diarrhea Nursing implications- Assessment
Monitor for therapeutic effect assessment patient condition b4 therapy and regularly after fluid and electrolyte balance hydration status stool frequency and consistency
55
Diarrhea Nursing Implications- Planning (outcomes)
Patient will have regular formed BM Adequate fluid balance will be maintained
56
Diarrhea Nursing implications (Implementation)
Correct fluid and electrolyte disturbances before starting the drug

Nursing Pharmacology (11 decks)

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