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Fall 2014 - Pharm GI/ENT > Constipation > Flashcards

Constipation Flashcards

1
Q

Causes of Constipation

A
  • frequently caused by inadequate intake of dietary fiber
  • also influenced by misconceptions about adequate frequency of stooling
  • GI, metabolic/endocrine, pregnancy, neurogenic, psychogenic, drug-induced
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2
Q

Examples of GI Constipation

A
  • IBS
  • diverticulitis
  • hernias
  • volvulus
  • stricture
  • Hirshsprung’s dz
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3
Q

Examples of Metabolic/Endocrine Constipation

A
  • hypothyroidism
  • pheochromocytoma
  • hypercalcemia
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4
Q

Pregnancy Induced Constipation

A

-secondary to depressed gut motility, inadequate diet and water intake

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5
Q

Examples of Neurogenic Constipation

A
  • CVAs
  • CNA or spinal injury
  • Parkinson’s
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6
Q

Examples of Psychogenic Constipation

A
  • improper toilet training

- occupational (eg truck drivers)

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7
Q

Examples of Drug-Induced Constipation

A
  • analgesics (opiates)
  • anticholinergics
  • iron supplements
  • aluminum and calcium containing antacids
  • also CCBs, diuretics, clonidine, phenothiazines, TCAs
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8
Q

3 Options for Therapeutic Management of Constipation

A
  1. dietary modification
  2. increase exercise and fluid intake
  3. drug therapy
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9
Q

Dietary Modification for Constipation

A
  • fiber: undigestable vegetable material –> increases stool bulk, increases retention of stool water, increases rate of transit through the GI tract
  • results in increasing frequency of stooling
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10
Q

Dietary Sources of Fiber

A

-beans, whole grains, fruits, veggies, bran cereals

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11
Q

Fiber Products for Constipation

A

psyllium (Metamucil, Perdiem)
methylcellulose (Citrucel)
polycarbophil (Mitrolan)

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12
Q

Bulk-Forming Drugs MOA

A
  • nondigested plant cell wall absorbs water into feces

- softens stool

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13
Q

Bulk-Forming Drugs Generics

A
  • psyllium
  • methylcellulose
  • polycarbophil
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14
Q

Bulk-Forming Drugs Trade Names of:

  • psyllium
  • methylcellulose
  • polycarbophil
A
  • psyllium: (Metamucil, Perdiem)
  • methylcellulose: (Citrucel)
  • polycarbophil: (Mitrolan)
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15
Q

Bulk-Forming Drugs Efficacy

A

-best option for prevention of chronic constipation

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16
Q

Bulk-Forming Drugs Safety/AEs

A
  • well tolerated

- flatulence, impaction possible

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17
Q

Emollients MOA

A
  • stool softeners

- facilitate mixing of aqueous and fatty materials

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18
Q

Emollients Generics

A
  • docusate sodium

- docusate potassium

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19
Q

Emollients Trade Names of:

  • docusate sodium
  • docusate potassium
A
  • docusate sodium: Colace

- docusate potassium: Kaopectate

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20
Q

Emollients Efficacy

A

more effective for prevention of constipation

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21
Q

Emollients Safety/AEs

A
  • very safe

- diarrhea or abdominal cramps possible

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22
Q

Disaccharides MOA

A
  • metabolized to low molecular weight acids
  • increase peristalsis
  • osmotic agent
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23
Q

Disaccharides Generics

A
  • sorbitol

- lactulose

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24
Q

Lactulose Trade Name

A

-cephulac

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25
Disaccharides Efficacy
- very effective for chronic constipation | - may also be used to decrease serum ammonia
26
Disaccharides Safety/AEs
- expensive - flatulence, belching - cramps - N/V/D
27
Glycerin MOA
lubricant and osmotic effect
28
Glycerin Trade Name
- Fleet | - Babylax
29
Glycerin Efficacy
- mild action | - ideal for children and infants
30
Glycerin Safety
very safe
31
Lubricants MOA
- coats stool and allows easier passage - decreases absorption of water - lubricant
32
Lubricant Generics
-mineral oil
33
Lubricant Trade Names
- agoral | - kondremul
34
Lubricant Efficacy
-effective for impaction and temporary relief
35
Lubricant Safety
- may decrease absorption of fat soluble vitamins with prolonged use - risk of aspiration if given at bedtime
36
What is the purpose of treating a hepatic encephalopathy patient with lactulose?
-purposely inducing diarrhea to decrease serum ammonia levels and reverse the encephalopathy sxs
37
Diphenylmethane Derivatives MOA
-stimulation of gut motility
38
Diphenylmethane Derivatives Generic
Bisdacodyl PO
39
Bisacodyl Trade Name
Dulcolax
40
Bisacodyl Dose
10 mg PO x1 (also PR)
41
Diphenylmethane Derivatives Efficacy
-very effective for tx of acute constipation, prevention of opioid-induced constipation
42
Diphenylmethane Derivatives AEs
abd cramping possible
43
Anthraquinone Derivatives MOA
stimulant
44
Anthraquinone Derivatives Generics
- senna | - casantranol
45
Anthraquinone Derivatives Efficacy
- senna moderately effective | - casanthranol also in combo with docusate
46
Anthraquinone Derivatives AEs
abd cramping possible
47
Polyethylene Glycol MOA
osmotic
48
Polyethylene Glycol Trade Name
Miralax
49
Polyethylene Glycol AEs/Safetu
- appears better tolerated than other laxatives | - more costly
50
PEG Solution Trade Name
- Go-Lytely | - CoLyte
51
PEG Solution Efficacy
effective for whole bowel irrigation and prep for surgery
52
PEG Solution Safety
- reserve for refractory constipation | - requires 4L oral administration over 3 hours
53
Saline Cathartics MOA
- osmotic retention of fluid in intestine | - also increases peristalsis
54
Saline Cathartics Generics
- magnesium hydroxide | - magnesium citrate
55
Saline Cathartics Trade Name (for magnesium hydroxide)
Milk of Magnesia
56
Saline Cathartics Efficacy
reserve for bowel evacuation
57
Saline Cathartics Safety
- may result in electrolyte disturbances | - abdominal cramping and HTN possible
58
How long for bulk-forming drugs to take effect?
1-3 days
59
How long for emollient drugs to take effect?
1-3 days
60
How long for diphenylmethane derivative drugs to take effect?
6-12 hours
61
How long for disaccharide drugs to take effect?
1-3 days
62
How long for polyethylene glycol to take effect?
1-6 hours
63
How long for glycerin drugs to take effect?
1-3 days
64
How long for anthraquinone derivative drugs to take effect?
6-12 hours
65
How long for saline cathartic drugs to take effect?
1-6 hours
66
How long for lubricant drugs to take effect?
1-3 days

Fall 2014 - Pharm GI/ENT (14 decks)

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