Constipation

Question 1

Examples of bulk forming laxatives?

Answer 1

Isphagula Husk
Methylcellulose
Sterculia

Question 2

Examples of osmotic laxatives?

Answer 2

Lactulose, Macrogol

Question 3

Examples of Stimulant laxatives?

Answer 3

Bisacodyl
Sodium Picosulfate
Senna
Docusate
Glycerol

Question 4

Examples of Stool softeners?

Answer 4

Liquid Paraffin, Docusate, Glycerol

Question 5

First line short duration of constipation?

Answer 5

Bulk forming such as Isphagula

Question 6

Second line if stools remain hard?

Answer 6

Osmotic laxative such as:
Lactulose or Macrogol

Question 7

Chronic constipation first line?

Answer 7

Bulk forming such as Isphagula

Question 8

If stools remain hard what do you do?

Answer 8

Add or change to OSMOTIC such as Macrogol or even Lactulose

Question 9

If after 6 months of chronic constipation, bulk forming or osmotic hasn’t worked?

Answer 9

Prucalopride can be used (WOMAN ONLY)

Question 10

Faecal impaction - Hard stools treatment?

Answer 10

Macrogol + Stimulant once softened

Question 11

Faecal Impaction - Soft stools treatment?

Answer 11

Half the problem is gone as is already soft sooo just:

• Stimulant

Question 12

If faecal impaction still there what to use?

Answer 12

Rectal Bisacodyl and/or Glycerol used if still there

Question 13

Opiod induced first line? And why?

Answer 13

Osmotic and stimulant

Stimulant needed as Opiod induced will slow the peristalsis (intestine muscles) so needs STIMULATION to increase it

Question 14

Opiod induced second line?

Answer 14

Naloxegol

Question 15

What Laxative to avoid in Opiod induced constipation?

Answer 15

AVOID BULK FORMING LAXATIVES

will cause obstruction in peristalsis

Question 16

First line laxative in pregnancy?

Answer 16

Lactulose

Question 17

Second line laxative in pregnancy?

Answer 17

If bulk doesn’t work,
Use Bisacodyl or Senna

*DO NOT USE SENNA NEAR TERM

Question 18

First line step in pregnancy constipation

Answer 18

Dietary and lifestyle always first before laxatives!

Question 19

Which laxative to not use near term?

Answer 19

Senna

Question 20

Children constipation first line?

Answer 20

Macrogol

Question 21

If not working what is second line in child’s constipation?

Answer 21

Stimulant

Question 22

How long does it take bulk forming laxatives to work?

Answer 22

2-3 days

Question 23

How long does it take osmotic laxatives to work?

Answer 23

2-3 days

Question 24

How long does it take stimulant laxatives to work?

Answer 24

6-12 hours

Question 25

Quickest acting laxative???

Answer 25

Docusate Enemas (5-20mins)

Question 26

Which laxative to avoid in Anal seepage? Granulomatous, disease of GI tract, lipoid pneumonia on aspiration?

Answer 26

Liquid Paraffin - a stool softener

Question 27

Which stimulant laxative causes red urine as a side effect?

Answer 27

Co-danthramer or Co-danthrusate due to carcinogenicity