Constipation

Question 1

What are your recommendation for treatment of constipation for a child under 2 years of age .

Answer 1

Increase fluid in formula

Practice baby exercise

Glycerin suppository 1g - insert in the rectom reliefs will be seen in less than 30 min .

If constipation continue refer to doctor

Question 2

Treatment for constipation for children over 2 years

Answer 2

Increase water in take
Increase fiber
Prone juice - list 1

Fleet enima pediatric -list 2
Lactulose -list 2
Glycerin suppository 1g

Prescription : Skilax Drops list 4

Avoid
Saline laxative

Question 3

Constipation in elderly

Answer 3

Increase in fiber intake

Exercise

Mojo herbs

Senokot pads - tea

Bennefiber one sachets in a full glass of water and drink for short duration and use as long term for prevention

Fleet enema

Glycerin suppository 2 g

Lactulose

Question 4

Laxative in pregnancy and what to avoid

Answer 4

Glycerin suppository 3g

Avoid
Any laxative that absorb systematic

Mineral oil .. decrease absorption of fat soluble vitamins

Caster oil - may cause premature labour

Stimulant laxative - Senokot and dulcolax

Question 5

What are your counseling points on epsome salt ( Mg So4)

Answer 5

Should not use daily
Or given to children under 6 years

Question 6

Patient counseling on Mineral Oil

Answer 6

Should not be given to children
Under 6 , elderly or pregnant women or patients taking anti coagulants

Question 7

Counseling points on laxative

Answer 7

Should not be use for more than a week
Once regular bowel movement return discontinue using laxative

Question 8

What’s the MOA for stool softener and give examples

Answer 8

Colase - docusate sodium

It’s a Sergactant - it decrease the oil surface of the feces causing water to penetrates the feces making it softer

Should not use with mineral oil , as it increase its absorption

Question 9

MOA for osmotic diuretic and example and dose

Answer 9

Loctullose ( disaccharide ) 15 ml two or 3 times a day

Pull water inside the colon cause softening of stool

Side effects cramping, flatulence , bleaching

Question 10

What is the MOA of lubricant laxative give example and side effects

Answer 10

Mineral oil 10 - 15 ml tid on empty stomoch

Coat stool make it easy to pass

Prevent movement to water from colon to blood

SE: causes aspiration pneumonia in elderly
Increase absorption of fat soluble vitamin
Leakage from the anal

Question 11

Mode of action of hyperosmotic laxative

Answer 11

Glycerin suppository

Pull water in intestine

Question 12

MOA of stimulant laxatives side effects , caution and use

Answer 12

Bisacodyl ( dulcolax) 5 mg 1 to 2 times a day
10 mg suppos
Skilax drops —- Na Picosulphate ( prodrug )

Sanna tablet

or senokot

It stimulate the NERVE in the colon which result in contraction of walls of colon it also increase salt secretion anywhere sodium goes water follows

Unlike senokot that can be given in children > 2 yrs Bisacodyl cannot be given in children less than 6

Use for opioid induce chronic constipation

S/E
Fluid and electrolyte mal absorption

Caution : PEOPLE WITH RECTAL BLEEDING OR RETAL OBSTUCTION

CAN CAUSE DISCOLORATION OF URIN .

Question 13

MOA of saline laxative /SE

Answer 13

Na is a saline .. that is in the intestine .. anywhere Na is water follows .

Increase water soften the stool

Fleet Enema .. adult and pediatric

Question 14

How long does it take each laxative to work

Answer 14

( glycerin sup) - 15 to 30 min
Lubricant 6-8 hours
Stimulant 6 to 12 hours
Bulk 12 hrs to 1 day
Osmotic And Emolent. 1-3 day

Question 15

Tap water enema

Answer 15

An injection of plain water into the rectum in order to stimulate a bowel movement

Normally administer before a medical procedure

Question 16

Soap sud enema

Answer 16

It’s a combination of distilled water and a small amount of soap. The soap mildly irritates your bowels, which helps to stimulate a bowel movement.

Can cause colitis / proctitis ( inflammation of the rectum )