(Chapter 53 Antidiarrheal drugs and laxatives)

Question 1

Antidiarrheal drugs

Answer 1

• Drugs that counter or combat diarrhea, also called adsorbent
• Coat the walls of the gastrointestinal (GI) tract and bind to the causative bacteria or toxin, which is then eliminated through the stool
• intestinal flora modifiers (known as probiotics)
• Adverse effects include Increased bleeding time, Constipation, dark stools, Confusion, twitching, Hearing loss, tinnitus, metallic taste, blue gums

Question 2

Constipation

Answer 2

A condition of abnormally infrequent and difficult passage of feces through the lower GI tract

• It is a symptom, not a disease
• Different types are Bulk-forming, Emollient, Hyperosmotic, Saline, Stimulant

Question 3

Diarrhea

Answer 3

Abnormal passage of stools with increased frequency, fluidity, and weight, or with increased stool water excretion
- Can be acute (lasts a couple days and then goes away) or chronic (lasts for more than 3 weeks)

Question 4

Laxatives

Answer 4

Drugs that promote bowel evacuation, such as by increasing the bulk of the feces, softening of the stool, or lubricating the intestinal wall
- All laxatives can cause an electrolye imbalance

Question 5

Antimotility drugs: anticholinergics

Answer 5

• An antidiarrheal drug
• Decrease intestinal muscle tone and peristalsis of GI tract
• Slow the movement of fecal matter through the GI tract
• Adverse effects include Urinary retention, hesitancy, impotence, headache, dizziness, confusion, dry skin, rash, blurred vision, hypotension

Question 6

Antimotility drugs: opiate

Answer 6

• A antidiarrheal drug
• Decrease bowel motility and relieve rectal spasms
• Decrease transit time through the bowel, allowing more time for water and electrolytes to be absorbed
• Reduce pain by relieving rectal spasms
• Adverse effects include CNS depression, drowsiness, sedation, nausea, vomiting, respiratory depression

Question 7

Nursing implications for Antidiarrheals

Answer 7

• Obtain thorough history of bowel patterns, general state of health, and recent history of illness or dietary changes, and assess for allergies
• Do NOT give bismuth subsalicylate (Pepto-Bismol) to children or teenagers with chickenpox because of the risk of Reye’s syndrome (swelling of the brain and liver).
• Assess fluid volume status, intake and output, and mucous membranes before, during, and after initiation of treatment

Question 8

Bulk forming laxatives

Answer 8

• Are high in fibre
• Absorb water to increase bulk
• Distend bowel to initiate reflex bowel activity
• Start the process slowly to avoid gas and bloating
• Example is metamucil
• Acute constipation
• Adverse effects include impaction, fluid overload, electrolyte imbalance

Question 9

Emollient laxatives

Answer 9

• Are also referred to as stool softeners and lubricants
• Promote more water and fat in the stools
• Lubricate the fecal material and intestinal walls
  Include:
  Stool softeners: docusate salts (Colace)
• Acute constipation
• Adverse effects include rashes, decreased absorption of vitamins

Question 10

Hyperosmotic laxatives

Answer 10

• Increase fecal water content
• Result in bowel distention, increased peristalsis, and evacuation
  Include:
  polyethylene glycol (PEG) and lactulose
• ## Chronic constipation and diagnostic and surgical bowel preps

Question 11

Saline laxatives

Answer 11

• Increase osmotic pressure within the intestinal tract, causing more water to enter the intestines
• Result in bowel distention, increased peristalsis, and evacuation
• Examples include Epsom salts, milk of magnesia, and sodium phosphate
• Used for the removal of worms

Question 12

Stimulant laxatives

Answer 12

• Increase peristalsis via intestinal nerve stimulation
• Include castor oil, senna, biscodyl
• Acute constipation and diagnostic and surgical bowel preps

Question 13

Nursing Implications of laxatives

Answer 13

• Obtain a thorough history of presenting symptoms, elimination patterns, and allergies
• Assess fluid and electrolytes before initiating therapy
• Patients should not take a laxative or cathartic if they are experiencing nausea, vomiting, or abdominal pain
• A healthy, high-fibre diet and increased fluid intake should be encouraged as an alternative to laxative use
• Long-term use of laxatives often results in decreased bowel tone and may lead to dependency
• All laxative tablets should be swallowed whole, not crushed or chewed, especially if enteric coated
• Drink lots of water