Constipation Flashcards
Rome III Criteria ofr constipation must include two or more of what symptoms?
o Straining >25%
o Lumpy or hard stools >25%
o Sensation of incomplete evacuation >25%
o Sensation of anorectal obstruction/blockage >25%
o Manual maneuvers to facilitate defecations >25% (e.g., digital evacuation, support of pelvic floor)
o Fewer than 3 defecations per week
In constipation, Loose stools are rarely present without use of _____
laxatives
to diagnose constipation, there must be Insufficient criteria for ___
IBS
Constipation is often a result of change In what?
diet, exercise, medications, etc
If it is _____ constipation it is a change in bowel without anything else causing ití like IBS, etc.
functional
drug classes that can cause constipation
analgesics
anticholinergics
cation-containing agents
neurally active agents
General Approach to Therapy for constipation
- Patient education
- Diet
- Exercise
what two things should you educate your pt on in regards to their diet for constipation?
o Fiber– Increase in fiber and decrease processed food
o Fluids– Increase fluid intake
should you taper laxative when possible?
yes
Bulk Forming Laxatives- 4 drugs
- Psyllium (Metamucil)
- Methylcellulose (Citrucel)
- Calcium polycarbophil (FiberCon)
- Wheat dextran (Benefiber)
MOA of Bulk Forming Laxatives
hydrophilic colloids that form gels in intestine causing water retention and intestinal distension which increases peristalsis
onset of action for Bulk Forming Laxatives
12-72 hours
Bulk Forming Laxatives ADRs
gas, bloating
drug names of osmotic agents (7)
- Polyethylene glycol (PEG) [Miralax (OTC), Golytely, Nulytely, et al.]
- Magnesium citrate
- Magnesium hydroxide (Milk Of Magnesia)
- Magnesium sulfate
- Lactulose (Enulose)
- Glycerin suppositories
- Sorbitol
Which osmotic agent is Rx only?
- Lactulose (Enulose)
osmotic agents MOA
cause fluid retention in intestine
- Pulling fluid from surrounding tissue into the gut
- More liquid in bowels= stool becomes liquified
do osmotic agents or fiber supplements have a faster onset?
osmotic agents are faster
ADRs of osmotic agents
o Nausea, bloating, cramping, flatulence
o Electrolyte imbalances if used improperly
Surfactants (Stool Softeners) drug name
Docusate sodium (different salt forms) (Colace)
Surfactants (Stool Softeners) MOA
become emulsified in stool and lower surface tension which allows water in
why don’t Surfactants (Stool Softeners) work well as a whole?
Typically do NOT increase stool frequency just consistency
how long can it take for Surfactants (Stool Softeners) to work?
can take weeks to work
Stimulant Laxatives drug names
o Bisacodyl (Correctol, Dulcolax) o Senna (Ex-Lax, Sennokot)
are Stimulant Laxatives OTC?
yes
