Chapter 40: Antidiarrheal Drugs and Laxatives Flashcards
What is the goal of the small intestine?
absorption of nutrients, enzymes and vitamins
What is the goal of the large intestine?
absorbs water and electrolytes
What does the pancreas secrete?
secretin, high in bicarb that neutralizes the stomach acid in the duodenum and helps prevent ulcers
What is the normal transit time for food to move through the intestine?
24-36 hours
What are the treatments for constipation?
Surgical or nonsurgical, more fiber, more fluid, pharmacological
What are the types of laxatives?
bulk forming, emolient, hyperosmotic, saline, stimulants
What are bulk forming laxatives?
adds bulk, high in fiber, adds water to increase the bulk which distends the bowel and stimulates the nerve that causes bowel movements
What is an example of bulk forming laxatives?
metamucil
What are emollient laxatives?
stool softener and lubricant. Adds water and lubricates the intestinal walls and fecal matter
What are hyperosmotic laxatives?
works only in the large intestine. Increases the water content of the fecal matter, distends the bowel and promotes a bowel movement and increases peristalsis
What are examples of hyperosmotic laxatives?
enemas, polyethylene glycol
What are saline laxatives?
increase the pressure in the intestinal tract which causes water attraction and more water = distention = bowel movement
What are stimulant laxatives?
increase peristalsis due to intestinal nerve stimulation.
What do you need to assess for with use of hyperosmotic and saline laxatives?
Monitor for water and electrolyte loss because water that moves into the bowel comes from the blood stream
What advice do you give pts using laxatives?
take with a full glass of water, keep an eye on fluid and electrolyte levels, document any changes in bowel patterns, avoid giving bismuth to children to avoid Reyes
What position should you a pt in for suppositories?
Laying on their left side, leg up and bent. Continue to lay on your side for 15-30 minutes after to allow for absorption
What is acute vs chronic diarrhea?
Acute: sudden onset, 3 days -2 weeks, caused by meds, bacteria, viruses and usually self limiting
Chronic: longer than 3-4 weeks, symptom of underlying issues like IBD, tumors, immunodeficiency, diabetes, hyperthyroidism, Addisons…
What are the types of Antidiarrheals?
adsorbent, antimotility, and probiotics
What are adsorbent drugs?
Coats the walls of the GI tract, binds to the cause of diarrhea then is eliminated through stool.
What are things to watch out for with adsorbent drugs?
Increase in bleeding, constipation, dark stools, black tongue
What is an example of adsorbent drugs?
pepto bismol
What are antimotility drugs?
slows the peristalsis, dries out the stool, decreases gastric secretions, promotes longer contact with intestinal contents. Can treat bowel spasms, can cause urinary retention, headache, confusion, dry skin, blurred vision
What are probiotics?
good bacteria to replenish the natural flora of the intestine
What are the 2 classes of antimotility drugs?
opioids and anticholinergics
What should you avoid using with antidiarrheals?
other CNS depressants when using opioid based antidiarrheals
What nursing assessments should you look at with antidiarrheals?
Assess if there is an issue causing their diarrhea, bowel movement history, assess fluid and electrolyte levels, ask for what meds they have taken, look at mucous membranes for dehydration
