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HLST220: Pharmacology > Chapter 82: Laxatives > Flashcards

Chapter 82: Laxatives Flashcards

1
Q

laxative are used to

A

ease or stimulate defication
- soften the stool
- increase stoole volume
- hasten fecal passage through the intestine
- facilitate evacuation from the rectum
- misuse comes from misconceptions of what constitutes normal bowel function

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2
Q

laxative effect

A
  • production of soft, formed stool over 1 or more days
  • relativelty mild
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3
Q

Catharsis

A
  • prompt, fluid evaculation of bowel
  • fast and intense
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4
Q

what is the function of the colon

A
  • absorbs water and electrolytes
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5
Q

delayed transport through colon causes

A

excessive fluid absorption and hear stool

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6
Q

what is normal bowel elimination

A

varies widely (2-3 times per day to 2 times per week)

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7
Q

proper bowel movement is dependent on

A

dietary fibre

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8
Q

benefits of fibre

A
  • absorbs water (softens feces and increases size)
  • can be digested by colonic bacteria whose growth can increase fecal mass
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9
Q

what is the frequent cause of constipation

A

low fibre diet

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10
Q

what is potimal fibre intake per day

A

20-60 g

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11
Q

constipation can be cuased by

A

variety of disease or drugs, poor diet, dysfunction of pelvic floor and anal sphincter or slow intestinal transit

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12
Q

what are the factors that can cause intestinal slowdown

A
  • dehydration
  • inadequate amounts of fibre
  • ignoreing urge to deficate
  • lack of physical activity
  • irritable bowel syndrome
  • changes in lifestyle or outine, includinf pregnancy, aging and travel
  • illness
  • frequent use or misuse of laxiatives
  • specific diseases, such as stroke, diabetes, thryroid disease, and parkinson disease
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13
Q

constipation

A

type 1-2

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14
Q

normal

A

type 3-4

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15
Q

diarrhea

A

type 5-7

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16
Q

contradictions to laxative use

A
  • abdominal pain, nausea, cramps, symptoms of appenndicitis, regional enteritis, diverticulitis, or ulcerative colitis
  • acute surgical abdomen
  • fecal impaction or bowel obstruction
  • habitual use/abuse
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17
Q

laxatives should be used with caution is

A

pregnancy and lactation

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18
Q

Classification of Laxatives

A
  • Bulk-forming laxatives (psyllium [metamucil] _
  • surfactant laxatives (docusate sodium [Colace] )
  • stimulant laxatives (Bisacodyl [dulcolax])
  • osmotic laxatives (polyethylene Glycol [restoralax])
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19
Q

Group I

A

act rapidly (2-6 hours) and give stool a watery consistency; useful for preparing bowel for diagnostic procedures or surgery

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20
Q

Group II

A

intermediate latency (6-12 hours)
- produce semifluid stool

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21
Q

Group III

A

act slowly (1-3 days) to produce a soft, formed stool; uses include treating chronic constipation and preventing straining at stool

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22
Q

Bulk Forming Laxatives include

A

psyllium [metamucil]
- mehtylcellulose [entroce; solution]
- polycarbophil [Prodiem]
- inulin [Benefibre]

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23
Q

Bulk Forming Laxatives MOA

A

swell with water to form a gel that softens and increases fecal mass

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24
Q

Bulk forming laxatives is often used in the treatment of

A

diverticulosis and IBS

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25
Q

Bulk forming laxatives adverse effects

A

minimal
- esophageal obstruction if swallowed without sufficent fluids; intestinal obstruction

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26
Q

Surfactant Laxatives are also called

A

stool softeners

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27
Q

Surfactant Laxatives MOA

A

lowers surface tension, which facilitates penetration of water into feces.
Act on intestinal wall to
- inhibit fluid absorption
- stimulate secretion of water and electrolytes into intestinal lumen

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28
Q

surfactant laxatives promote

A

more water and fat in the stools

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29
Q

Surfactant laxatives examples

A

Docusate salts [sodium and calcium] (colace)

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30
Q

how long does it take for Docusate salts [sodium and calcium] (colace) to produce a soft stool

A

several days

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31
Q

surfactant laxative require

A

adequate fluids

32
Q

Stimulant laxative is used for

A

treatment of medication related constipation and slow intestinal transit constipation

33
Q

Stimulant laxatives MOA

A

stimulate intestinal motility and increase amounts of water and electrolytes in intestinal lumen

34
Q

stimulant laxatives include

A

Bisacodyl (Dulcolax)
- senna/sennosides (senokot preperations; Ex-Lax)
- cascara sagrada

35
Q

osmotic laxatives low doeses work in

A

6-12 hours

36
Q

high doses of osmotic doses see results in

A

2-6 hours

37
Q

Polyethylene glycol (PEG) [Restoralax]

A
  • non absorbing compound that retains water in the intestinal lumen causing fecal mass to soften and swell
38
Q

Glycerin suppository onset

A

15-60 mins

38
Q

Polyethylene glycol (PEG) [Restoralax] onset

A

48-96 hours

39
Q

Polyethylene glycol (PEG) [Restoralax] can also be used for

A

catharsis

39
Q

Lactulose onset

A

24-48 hours

40
Q

osmotic laxatives examples

A
  • Polyethylene glycol (PEG) [restoralax]
  • glycerin suppository
  • lactulose
  • magnesium hydroxide [milk of magnesium]
41
Q

osmotic laxatives adverse effects

A
  • dehydration
  • acute renal failure
  • sodium retention: exacerbated heart failure, hypertension, edema
42
Q

Glycerin suppository

A

softens and lubricates hardened impacted feces and may also stimulate rectal contration

43
Q

Glycerin suppository onset

A

occurs about 30 mins after insertion

44
Q

Mineral oil use

A
  • especially useful when administered by enema to treat fecal impaction
45
Q

mineral oil adverse effects

A
  • lipid pneumonia
  • anal leakage
46
Q

mineral oil is available in

A

oral liquid, enema, oral jelly

47
Q

precalopride [resotran] MOA

A
  • binds with serotonin receptors in the colon and activities the release of Ach
  • increases tone and motility
48
Q

precalopride [resotran] is used for

A

chronic constipation in females who have other therapies

49
Q

precalopride [resotran] side effects

A

headache, nausea and vomiting

50
Q

Linaclotide [Constella] indication

A
  • chronic idiopathic constipation and IBS-C in adults
51
Q

Linaclotide [Constella] adverse effects

A

diarhea and abdominal pain

52
Q

Laxatives should be administered

A

30 minutes before the first meal of the day

53
Q

Methylnaltexone [relistor] is indicated for

A

opiod induced constipation in palliative care in patients who have other therapies

54
Q

Methylnaltexone [relistor] side effects

A

abdominal pain. diarrhea, flatulence, nausea, dizziness

55
Q

Methylnaltexone [relistor] negatives

A

expensive, protect from light

56
Q

Methylnaltexone [relistor] onset

A

30mins-4houra

57
Q

what are the types of bowel cleansing products for colonoscopy

A
  • sodium phosphate (oral fleet or fleet enema)
  • polyethylene glycol (PEG)
58
Q

sodium phosphate (oral fleet or fleet enema)

A
  • hypertonic with body fluid
  • can cause dehydration and electrolyte disturbances
  • possibility or renal damage
59
Q

Polyethylene Glycol - Electrolyte solutions adminstration

A

typically 4L
- must ingest 250-500ml every 10 mins for 2-3 hours.
- 2L evening before; 2L day or colonoscopy

60
Q

hwo do you know if a patient is fully cleansed

A

BM becomes clear yellow liquid

61
Q

Polyethylene Glycol - Electrolyte solutions onset

A

commences within 1 hour

62
Q

Polyethylene Glycol - Electrolyte solutions most common adverse effect

A

nausea, bloating, and abdominal discomfort

63
Q

Polyethylene Glycol - Electrolyte solutions tips

A
  • drink through straw, rinse with mouthwash, non red candy, dimenhydrinate if nausea, chew gum, refrigerate solution
64
Q

laxative abuse causes

A
  • bowel movements occur daily
  • weight loss
65
Q

Polyethylene Glycol - Electrolyte solutions consequences

A
  • diminished defectory reflexes, leading to further reliance on laxatives
  • electrolyte imbalance, dehydration, colitis
66
Q

bulk forming use

A
  • acute and chronic constipation
  • IBS
  • diverticulosis
67
Q

Surfactant use

A
  • acute and chronic constipation
  • softening of fecal impaction; movements in anorectal
  • facilitation of bowel condition s
68
Q

osmotic laxative use

A
  • chronic constipation
  • diagnostic and surgical preps
69
Q

stimulant laxative use

A
  • acute constipation
  • diagnostic and surgical bowel preps
70
Q

adverse effects of bulk forming laxatives

A
  • impaction
  • fluid overload
  • electrolyte imbalances
  • esophageal blcokage
71
Q

surfactant laxatives adverse effects

A
  • skin rashes
  • decreased absorption of vitamins
  • electrolyte imbalances
72
Q

osmotic laxatives adverse effects

A
  • abdominal bloating
  • electrolyte imbalances
  • rectal irritation
73
Q

stimulant laxatives adverse effects

A
  • nutrient malabsorption
  • skin rashes
  • rectal irritation
  • electrolyte imbalances
  • gastric irritation
  • rectal irritation
74
Q

laxative drug interaction

A

bulk forming laxative concurrently with other medications

HLST220: Pharmacology (46 decks)

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