Constipation Flashcards
First line treatment option
Bulk forming
Why do we like hyperosmotic drugs
It draws water back into the stool so it’s not so hardy
What are our hyperosmotic agents
PEG
Glycerin
What are our bulk forming agents
Methylcellulose
Psyllium
Calcium polycarbophil
What is the function of emollients
“MUSH” stool softner
What are our emollient agents
Docusate
Why are stool softeners (emollients) important
They prevent straining
What is the function of bulk forming agents
They promote peristalsis b/c its how our body naturally moves
What is an adverse event that can occur when taking bulk forming agents? Who is at risk?
Take with 8 oz of water to prevent swallowing difficulties
Pts with swallowing issues and geratics are at risk
What are some drug interactions associated with emollients
Mineral oil
What is constipation
< 3 bowel movements a week with straining and difficult passage of hard, dry stools
What are good agents for ACUTE relief
-Saline laxative (named anything with magnesium)
-Hyperosmotic (Glycerin: because it’s quick)
-Lubricant (mineral oil)
What are interactions/warnings associated with saline laxatives
-Magnesium restricting diets
-Geriatrics
-Renal impairment
-GI surgery Pts
-Magnesium phosphate (HORRIBLE) : contraindicated w/ HF
How do you pick which agent to use for acute relieve
It is patient specific based on contraindications patients may have
Saline laxatives and Hyperosmotics are first line
What are some warnings for mineral oils
<6 years old
Preggers
Geriatrics
Bed ridden
What are the opoid-induced agents
Stimulants( senna,bisacodyl, castor oil)
How is primary constipation characterized
As slower-than-normal GI transit time or defecatory disorder
What are secondary causes of constipation
Systemic, Neurologic, and Psychological disorders and/or structural abnormalities
What can long-standing or untreated constipation lead to
-Hemorrhoids
-Anal fissures
-Rectal prolapse
-Fecal impaction
-Rectal ulcers
How should laxatives be selected
According to health status of patient and drugs MOA
What classifies constipation as self-limiting
Last less than 7 days
Bulk-forming laxatives onset of action times ____
12-24 hours for onset
72 hours for effects
How old must patient be to use PEG formulation
17 years old or older
PEG onset of action times____
12-72 hours for onset
96 hours for effects
Glycerin suppository onset of action times _____
15-30 minutes
Docusate onset of action times_____
12-72 hours
3-5 days for complete effects
Mineral Oil onset of action times _____
6-8 hours
5-15 minutes for effects
Senna and bisacodyl onset of action times___
(both)
6-10 hours
24 hours for effects
Bisacodyl suppositories
15-60 minutes for effects
