CIC

Question 1

Risk factors for CIC? (no need to memorise, just roughly know)

Answer 1

• ↓ fluid intake
• appetite loss (anorexia)
• thyroid problems
• lack of fibre/ bulk-forming foods in diet
• vitamin/ mineral supplements like iron/ calcium pills
• laxative overuse
• low level of physical activity/ prolonged bed rest
• depression
• high level of calcium/ potassium in blood
• cancer growing into large intestine (bowel)/ pressing on spinal cord

Question 2

Drug-induced causes of constipation? (IMPT)

Answer 2

• Pain relievers (esp opioids)
• ChemoTx like vinca alkaloids (vincristine, vinblastine, vinorelbine)
• Antinausea drugs (ondansetron, granisetron)
• Anticonvulsant drugs

Question 3

Non-pharmacoTx of constipation?

Answer 3

Eat more fibre/ natural laxatives, ↑ physical activity

Question 4

Name the 2 types of pharmacoTx for CIC

Answer 4

• Stool softeners
• Laxatives

Question 5

Name examples of stool softeners (2)

Answer 5

Docusate sodium, enemas (phosphate enemas, fleet enemas)

Question 6

Name examples of laxatives (separate into those that do and do not directly promote bowel movement)

Answer 6

Directly promote bowel movement:
sennosides, bisacodyl, glycerine

Do not directly stimulate bowel movement:
psyllium, lactulose, mineral oil

Question 7

What patient population should we not give suppositories/ enemas to?

Answer 7

Patients with low WBC or platelets count due to risk of infection and bleeding a/w these products