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Pharmacology NURS251 > Ch.3 Antidiarrheal Drugs & Laxatives > Flashcards

Ch.3 Antidiarrheal Drugs & Laxatives Flashcards

1
Q

What is the clinical definition of diarrhea?

A

Abnormal passage of stools with increased frequency, fluidity, and weight or with increased water in stool. Consists of 3 or more loose/liquid stools per day

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2
Q

What are 2 types of clinical diarrhea?

A
  1. Acute
  2. Chronic
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3
Q

What is acute diarrhea?

A
  • Diarrhea with sudden onset in a healthy person
  • Lasts 3 days to 2 weeks
  • Self-limiting
  • Resolves without sequelae (consequences)
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4
Q

What is chronic diarrhea?

A
  • Diarrhea that lasts more than 3 to 4 weeks
  • Associated w/ recurring passage of diarrheal stools, fever, loss of appetite, nausea, vomiting. weight loss, and chronic weakness
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5
Q

What are some causes of acute diarrhea?

A
  • Bacteria
  • viruses
  • drugs (drug induced disease)
  • Nutritional factors
  • protozoa
  • syndromes
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6
Q

What are some causes of chronic diarrhea?

A
  • tumours
  • diabetes
  • addisons
  • IBS
  • AIDS
  • hyperthyroidism
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7
Q

What are the goals of diarrheal treatment?

A
  • Stop stool frequency
  • alleviate abdominal cramps
  • replenish fluid & electrolytes
  • prevent weight loss and nutritional deficits from malabsorption
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8
Q

What are the 3 types of antidiarrheal drugs?

A
  1. Adsorbents
  2. Antimotility (anticholinergic & opiates)
  3. Probiotics
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9
Q

what is the MOA of adsorbents?

A

coat walls of GI, then bind to causative bacteria/toxin, which is then eliminated through stool.

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10
Q

What is an ex. of an adsorbent drug>

A

bismuth subsalicytate (pepto-bismol)

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11
Q

What is the MOA of antimotility: anticholinergic drugs?

A

Decrease intestinal muscle tone and peristalsis of GI tract, resulting in slower movement of feces through the GI
- also slow peristalsis by reducing rhythmic contractions and smooth muscle tone of GI

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12
Q

What is an ex. of an anticholinergic drug?

A

Belladona alkaloids

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13
Q

what are some side effects of anticholinergics?

A
  • have a drying effect
  • reduce gastric secretions
  • used in combo w. adsorbent and opiates
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14
Q

What is the MOA of antimotility: opiates?

A

decrease bowel motility and reduce pain by relief of rectal spasms. Increase transit time through bowel letting more water and electrolytes absorb.

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15
Q

what are some ex. of opiate drugs?

A
  • codeine phosphate
  • loperamide HCL
  • Diphenyloxylate HCL w/ atropine sulphate
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16
Q

What are probiotic drugs?

A
  • intestinal flora modifiers and bacterial replacement drugs
  • bacterial cultures of lactobacillus organisms work by supplying missing bacteria to GI and suppressing growth of diarrhea-causing bacteria
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17
Q

what is an ex. of a probiotic drug?

A

lactobacillus acidophilus

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18
Q

What are indications of when to use a certain type of antidiarrheal?

A

Adsorbents: mild diarrheal cases
Anticholinergics & opiates: more severe cases where there is a bacterial infection/IBS
Probiotics: when it is an antibiotic-induced diarrhea

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19
Q

What are some side effects of adsorbents?

A
  • longer bleeding time
  • constipation, dark stools
  • confusion
  • tinnitus
  • metallic taste
  • blue gums/black tongue
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20
Q

what are some side effects of anticholinergics?

A
  • Urinary retention, sexual dysfunction
  • headache, dizziness, confusion, anxiety, drowsiness
  • dry skin, flushing
  • blurry vision
  • hypotension, brady & tachycardia
21
Q

what are some side effects of opiates?

A
  • drowsiness, dizziness, lethargy
  • nausea, vomiting, constipation
  • resp. depression (IMPORTANT)
  • hypotension
  • urinary retention
  • flushing
22
Q

what is the clinical definition of constipation?

A

abnormally infrequent and difficult passage of feces through lower GI. Disorder of movement through colon/rectum that can be cause by variety of diseases or drugs

23
Q

is constipation a symptom or disease

A

a symptom

24
Q

what are the treatments that can be done for constipation?

A
  • surgical(rarely)
  • nonsurgical
25
Q

what are the nonsurgical treatments for constipation?

A
  • dietary (ex. fibre supplements)
  • behavioral ( increased physical activity)
  • pharmacological
26
Q

what are the 5 types of laxatives?

A
  • bulk forming
  • emollient (stool softeners, lubricant laxatives)
  • hyperosmotic
  • saline
  • stimulant
27
Q

What is the MOA for bulk forming laxatives?

A
  • high fibre
  • absorb water to increase bulk
  • distend bowel to initiate reflex bowel activity
28
Q

what is an example of a bulk forming laxative?

A

psyllium (Metamucil)

29
Q

What is the MOA for emollient laxatives?

A
  • stool softeners and lubricants
  • promote more water and fat in stools
  • lubricate fecal material and intestinal walls
30
Q

what are some examples of emollient laxatives?

A
  • stool softeners: docusate salts (colace)
  • lubricants: mineral oil
31
Q

what is the MOA for hyperosmotic laxatives?

A
  • increase fecal water content
  • results in bowel distention, increased peristalsis, and evacuation
32
Q

what are some examples of hyperosmotic laxatives?

A
  • polyethylene glycol
  • glycerin
  • lactulose (also used to reduce elevated serum ammonia levels)
33
Q

What is the MOA of saline laxatives?

A
  • increases osmotic pressure within the intestinal tracts causing more water to enter intestines
  • results in distention, increased peristalsis, and evacuation
34
Q

what are some examples of saline laxatives?

A
  • magnesium hydroxide (milk of magnesia)
  • magnesium citrate
35
Q

what is the MOA of stimulant laxatives?

A
  • increase peristalsis via intestinal nerve stimulation
36
Q

what are examples of stimulant laxatives?

A
  • senna (senokot)
  • bisacodyl (dulcolax)
37
Q

when to use bulk forming laxatives?

A
  • acute & chronic constipation
  • IBS
  • diverticulosis
38
Q

When to use emollient laxatives?

A
  • acute & chronic constipation?
  • fecal impaction
  • facilitation of bowel movements in anorectal condition
39
Q

when to use hyperosmotic laxatives?

A
  • chronic constipation
  • diagnostic and surgical procedures
40
Q

when to use saline laxatives?

A

constipation
- diagnostic and surgical procedures

41
Q

when to use stimulant laxatives?

A
  • acute constipation
  • diagnostic and surgical procedures
42
Q

side effects of bulk forming

A
  • impaction’
  • fluid overload
  • electrolyte imbalance
  • gas formation
  • esophageal blockage
  • allergic reaction
43
Q

side effects of emollient laxatives

A
  • skin rashes
  • decreased absorption of vitamins
  • electrolyte imbalances
  • lipid pneumonia
44
Q

side effects of hypersomotic

A
  • bloating
  • electrolyte imbalance
  • rectal irritation
45
Q

side effects of saline laxatives

A
  • magnesium toxicity (with renal insufficiency)
  • cramping
  • electrolyte imbalance
  • cramping, diarrhea
  • increased thirst
46
Q

side effects of stimulant laxatives

A
  • nutrient malabsorption’
  • skin rashes
  • gastric irritation
  • electrolyte imbalances
  • discoloured urine
  • rectal irritation
47
Q

what adverse effect do ALL laxatives have?

A

Electrolyte imbalance

48
Q
A

Pharmacology NURS251 (2 decks)

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