Chapter 1 BNF (Constipation and Bowel Cleansing) Flashcards
Stimulant laxative?
Bisacodyl glycerol senna docusate danthramer sodium picosulfate
stool softeners?
liquid paraffin
bulk forming?
sterculia
isphagula
methylcellulose
osmotic laxatives?
lactulose
macrogol
magnesium
Other laxatives?
Prucalopride
lubiprostone
methylnaltrexone
naloxegol
whats best for small hard stools in fibre-deficient diets?
bulk forming
BULK FORMING: onset and counselling points?
onset: 24hrs but 2/3 days for full effect
points: plenty of fluid to avoid obstruction
OSMOTIC: onset and advuce ?
2/3 days, 48hours for lactulose
drink plenty fluid
whats best for soft stools difficult to pass and incomplete emptying?
stimulant
STIMULANT: onset and advice?
glycerol suppositories: 15-30 minutes. rest; 6-12 hours
advice: senna urine yellow
1 week use, abuse
take at night to pass stool in morning
which laxative is reserved for terminally ill patients and why?
dantron due to its genotoxic and carcinogenic effects
which two laxatives are used when two laxatives have been trialed at their highest dose for 6 months?
prucalopride (women only )
Lubiprostone
Opioid induced constipation treatment
osmotic or docusate
+
stimulant
or methylnaltrexone/naloxegol
which osmotic laxative is preferred in long term constipation?
macrogol
whats first line for constipation in children?
macrogol
add stimulant
add lactulose or faecal softeners