Constipation Flashcards

1
Q

Bulk laxatives MOA

A

fibre replacement. They swell in the fluids by attracting water and form gels that promote healthy bowel movements.

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2
Q

Bulk laxative drugs

A

ispaghula husk (fybogel)

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3
Q

Dosing for ispaghula husk

A

1 sachet BD

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4
Q

side effects of ispaghula husk

A

abdominal cramps, constipation

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5
Q

counselling points for ispaghula husk

A
  1. do not leave it to stand as it will solidify
  2. should not be taken before going to bed
  3. space apart 2 hours from other medications
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6
Q

onset of action of ispaghula husk

A

12-72 hours

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7
Q

Osmotic laxative drugs

A
  • lactulose

- phospho-soda oral solution

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8
Q

osmotic laxative MOA

A

draws water into colon causing distention and increasing motility

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9
Q

Dosing for phospho-soda oral solution

A

PO 20ml OD dilute with 1/2 glass cold water then 1 full glass of cold water

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10
Q

side effects of phospho-soda oral solution

A
  • abdominal pain

- diarrhoea

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11
Q

contraindications of phospho-soda oral solution

A
  • renal problems

- heart failure

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12
Q

counselling points for phospho-soda oral solution

A
  • take 30min before meal or bedtime
  • drink enough water
  • if nothing happens 6 hours after 1st dose, take another dose
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13
Q

onset of action of phospho-soda oral solution

A

30min to 3 hours

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14
Q

Lactulose dosing

A

PO 15ml BD can increase to 30ml

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15
Q

side effects of lactulose

A

abdominal cramps, flatulence, nausea and vomitting

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16
Q

contraindication of lactulose

A

patients requiring low galactose diet

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17
Q

counselling points for lactulose

A
  • take with meals to reduce GI discomfort
  • mix with juice, water, milk
  • drink plenty of water
  • suitable for diabetics
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18
Q

onset of action of lactulose

A

24-48 hours

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19
Q

Enema MOA

A

increases bulk volume and water content of stools

20
Q

Enema drugs

A

fleet enemas

21
Q

dosing for fleet enemas

A

PR 1 bottle

22
Q

side effects of fleet enema

A

abdominal cramps, local irritation

23
Q

contraindication of fleet enema

A
  • severe kidney disease
24
Q

counselling points for fleet enema

A
  1. counsel patient on how to administer enema

2. not for frequent use as it can cause trauma to rectum

25
onset of action for fleet enema
2-5mins
26
Lubricant laxatives Drug
liquid paraffin
27
Liquid paraffin MOA
softens the faecal contents by coating them and preventing colonic absorption of water
28
dosing of liquid paraffin
PO 10-30ml at night or when required
29
side effects of liquid paraffin
- abdominal cramp - diarrhoea - nausea and vomitting - anal seepage of liquid paraffin
30
contraindication for liquid paraffin
- pregnancy - children less than 6 - bedridden patients - elderly - patients who cannot swallow
31
counselling points for liquid paraffin
- do not use for more than 1 week - do not administer with food or meals - prolonged administration can lead to decrease absorption of lipid-soluble vitamins (ADEK)
32
onset of action of liquid paraffin
6-8 hours
33
stimulant laxatives drugs
- bisacodyl | - senna/sennosides
34
Biscodyl MOA
- produces contraction of the entire colon
35
Senna/sennosides MOA
stimulates colonic motility
36
Dosing for bisacodyl
5-15mg at night for tablets PR 10mg at night or suppository
37
side effects of bisacodyl
abdominal cramps
38
contraindications for bisacodyl
intestinal obstruction
39
Counselling points for bisacodyl
- swallow tablet whole do not crush - do not administer within an hour of antacids or dairy products - should not be used for more than 1 week - counsel on administration of suppository
40
Onset of action for bisacodyl
tabs: 6-12 hours suppository: 15-60mins
41
Dosing for senna/sennosides
PO 2 tablets at night
42
side effects for senna/sennosides
abdominal cramps
43
Counselling points for senna/sennosides
- taken with or without food - administer 2 hours before or after other meds - urine may discolor to red or yellowish brown - should not be used for more than a week
44
onset of action for senna/sennosides
6-12 hours
45
which drug has the fastest onset of action?
phospho-soda oral solution with the onset of action of 30min - 3 hrs