Constipation

Question 1

First line treatment option

Answer 1

Bulk forming

Question 2

Why do we like hyperosmotic drugs

Answer 2

It draws water back into the stool so it’s not so hardy

Question 3

What are our hyperosmotic agents

Answer 3

PEG
Glycerin

Question 4

What are our bulk forming agents

Answer 4

Methylcellulose
Psyllium
Calcium polycarbophil

Question 5

What is the function of emollients

Answer 5

“MUSH” stool softner

Question 6

What are our emollient agents

Answer 6

Docusate

Question 7

Why are stool softeners (emollients) important

Answer 7

They prevent straining

Question 8

What is the function of bulk forming agents

Answer 8

They promote peristalsis b/c its how our body naturally moves

Question 9

What is an adverse event that can occur when taking bulk forming agents? Who is at risk?

Answer 9

Take with 8 oz of water to prevent swallowing difficulties

Pts with swallowing issues and geratics are at risk

Question 10

What are some drug interactions associated with emollients

Answer 10

Mineral oil

Question 11

What is constipation

Answer 11

< 3 bowel movements a week with straining and difficult passage of hard, dry stools

Question 12

What are good agents for ACUTE relief

Answer 12

-Saline laxative (named anything with magnesium)
-Hyperosmotic (Glycerin: because it’s quick)
-Lubricant (mineral oil)

Question 13

What are interactions/warnings associated with saline laxatives

Answer 13

-Magnesium restricting diets
-Geriatrics
-Renal impairment
-GI surgery Pts
-Magnesium phosphate (HORRIBLE) : contraindicated w/ HF

Question 14

How do you pick which agent to use for acute relieve

Answer 14

It is patient specific based on contraindications patients may have

Saline laxatives and Hyperosmotics are first line

Question 15

What are some warnings for mineral oils

Answer 15

<6 years old
Preggers
Geriatrics
Bed ridden

Question 16

What are the opoid-induced agents

Answer 16

Stimulants( senna,bisacodyl, castor oil)

Question 17

How is primary constipation characterized

Answer 17

As slower-than-normal GI transit time or defecatory disorder

Question 18

What are secondary causes of constipation

Answer 18

Systemic, Neurologic, and Psychological disorders and/or structural abnormalities

Question 19

What can long-standing or untreated constipation lead to

Answer 19

-Hemorrhoids
-Anal fissures
-Rectal prolapse
-Fecal impaction
-Rectal ulcers

Question 20

How should laxatives be selected

Answer 20

According to health status of patient and drugs MOA

Question 21

What classifies constipation as self-limiting

Answer 21

Last less than 7 days

Question 22

Bulk-forming laxatives onset of action times ____

Answer 22

12-24 hours for onset
72 hours for effects

Question 23

How old must patient be to use PEG formulation

Answer 23

17 years old or older

Question 24

PEG onset of action times____

Answer 24

12-72 hours for onset
96 hours for effects

Question 25

Glycerin suppository onset of action times _____

Answer 25

15-30 minutes

Question 26

Docusate onset of action times_____

Answer 26

12-72 hours
3-5 days for complete effects

Question 27

Mineral Oil onset of action times _____

Answer 27

6-8 hours
5-15 minutes for effects

Question 28

Senna and bisacodyl onset of action times___

Answer 28

(both)
6-10 hours
24 hours for effects

Bisacodyl suppositories
15-60 minutes for effects