Constipation Flashcards

1
Q

Medical conditions that can cause constipation

A

IBS, anal disorders (fissures, fistulae, rectal prolapse), MS, PD, spinal cord tumors, DM, hypothyroidism

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2
Q

Constipation is defined as infrequent bowel movements (less than ___ per week)

A

3 per week

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3
Q

Non-drug tx are preferred for constipation. List them.

A

Inc fluid intake (64oz daily), limiting caffeine and alcohol intake, inc physical activity

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4
Q

Drugs that can cause constipation

A
Antacids (aluminum and calcium containing)
Clonidine
Colesevelam
Diphenhydramine
Baclofen
Amitriptyline 
Iron
Verapamil
Sucralfate
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5
Q

If constipation is not improved after ___ days, consult a PCP

A

7 days

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6
Q
Which OTC to recommend for constipation?
Most adults -->
Iron-induced -->
Opioid-induced -->
Preg -->
Fast relief -->
A

Most adults –> fiber
Iron-induced –> decussate (stool softener)
Opioid-induced –> Senna or bisacodyl (Stimulants)
Preg –> fiber
Fast relief –> glycerin suppository (adult/children); bisacodyl (adult)

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7
Q

Psyllium

A

Metamucil

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8
Q

Calcium polycarbophil

A

FiberCon

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9
Q

Methylcellulose

A

Citrucel

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10
Q

Wheat dextrin

A

Benefiber

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11
Q

First-line tx in most constipation cases and DOC in pregnancy. MOA: absorb water in the intestine, soaking up fluid and adding bulk to the stool=INC perstalsis and DEC stool transit time

A

Bulk-forming

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12
Q

Contain large ions or molecules that are poorly absorbed. Draw fluid into the bowel lumen through osmosis which distends the colon and INC peristalsis

A

Osmotics

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13
Q

Directly stimulate neurons in the colon, causing peristaltic activity

A

stimulants

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14
Q

emollients that reduce the surface tension of the stool oil-water interface allowing more water and fat to mix with the stool (commonly used by those with iron supplements)

A

Stool softeners

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15
Q

coat the bowel and stool with a waterproof film. keeps moisture in the stool and makes defecation easier (ex: mineral oil)

A

lubricants

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16
Q

Magnesium hydroxide, PEG, glycerin, lactulose, sodium phosphates, lactitol, sorbitol are examples of

A

Osmotics

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17
Q

Milk of magnesia

A

magnesium hydroxide

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18
Q

Miralax

A

PEG 3350

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19
Q

Fleet liquid glycerin supp, Pedia-Lax

A

Glycerin

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20
Q

Constulose, Enulose, Generlac

A

Lactulose (Rx)

21
Q

Fleet Enema

A

Sodium phosphates

22
Q

Pizensy

A

Lactitol (Rx)

23
Q

Senna and bisacodyl are examples of

A

Stimulants

24
Q

Brand: Ex-Lax, Senokot

A

Generic: Senna

25
Q

B: Senna S, Senokot S

A

G: Senna + docusate

26
Q

Dulcolax

A

bisacodyl enteric coated tablet, suppository

27
Q

When do you take stimulant oral products?

A

bedtime to induce a BM the following morning

28
Q

Docusate sodium is an example of

A

Emollient (stool softener)

29
Q

Colace

A

docusate sodium

30
Q

What drug is preferred when straining should be avoided? (post MI, postpartum, hemorrhoids)

A

Docusate sodium/stool softeners

31
Q

Mineral oil is an example of

A

Lubricant

32
Q

A chloride channel activator that acts on chloride channels in the gut, leading to increased fluid and peristalsis

A

Lubiprostone

33
Q

A guanylate cyclase C agonist that increases Cl and bicarb secretion into the lumen of the intestine, inc speed of GI transit and reduce abdominal pain

A

Linaclotide

34
Q

a peripherally acting mu-opioid receptor ANTAGONIST that dec constipation

A

Alvimopan

35
Q

Amitiza

A

Lubiprostone – think nausea & OIC

36
Q

Linzess

A

Linaclotide

37
Q

Trulance

A

Plecanatide

38
Q

Alvimopan, methylnaltrexone, naloxegol are examples of

A

peripherally acting mu opioid receptor atagonists

39
Q

Entereg

A

alvimopan

40
Q

Relistor

A

Methylnaltrexone

41
Q

Movantik

A

Naloxegol

42
Q

A sodium/hydrogen exchanger (NHE3) inhibitor

A

tenapanor/isbrela

43
Q

Prucalopride and tegaserod are examples of

A

serotonin 5h4 receptor agonists

WARNINGS: suicide ideation

44
Q

What laxative that is used for whole bowel irrigation has a boxed warning for nephropathy

A

OsmoPrep

45
Q

What laxative has a contraindication to acute phosphate nephropathy, gastric bypass or stapling surgery

A

OsmoPrep

46
Q

Colyte, GoLytely, NuLytley

A

Polyethylene glycol electrolyte solution

47
Q

Osmoprep

A

Sodium phosphates

48
Q

Suprep Bowel Prep kit

A

Sodium sulfate, potassium sulfate, and magnesium sulfate