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OTC Therapy > Constipation > Flashcards

Constipation Flashcards

1
Q

What is constipation?

A

<3 bowel movements/week characterized by difficulty passage

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2
Q

How long does ingested food retain in stomach?

A

3hrs

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3
Q

Forceful increase in intra-abdominal pressure, initiated w/ an exhalation attempt against a closed glottis is also know as…

A

Valsalva maneuver

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4
Q

What are some nonpharmacological Tx?

A
  1. Fiber
  2. 2L/day + 300ml for pregnant
  3. Bowel training
  4. Gastrocolic reflexes first thing in the morning and 30 min after meals
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5
Q

Exclusions?

A
  1. <2yrs old

2. Laxative use >7days

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6
Q

What is the first line treatment?

A

Bulk-forming

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7
Q

Psllium, methylcellulose, and calcium polycarbophil are considered…?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Bulk-forming

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8
Q

MOA = dissolves and swells in intestinal fluids leading to peristalsis

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Bulk-forming

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9
Q

AE = flatulence, cramping, esophageal obstruction, acute bronchospasm

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Bulk-forming

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10
Q

Polyethylene glycol and glycerin are considered…?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Hyperosmotic

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11
Q

MOA of Miralax (polyethylene)?

A

Draws water into rectum/bowel

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12
Q

MOA of glycerin?

A

Evacuates lower bowel only

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13
Q

Onset of Miralax?

A

1 to 3 days

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14
Q

Onset of glycerin?

A

15 to 30 min

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15
Q

Indication of Miralax?

A

Short term Tx for age ≥17

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16
Q

Indication of glycerin?

A

Intermittent basis for all age groups

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17
Q

AE of Miralax?

A

Bloating, cramping, flatulence

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18
Q

AE of glycerin?

A

Rectal irritation w/ overdose

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19
Q

Docusate sodium and Docusate calcium are considered…?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Emollients aka stool softeners

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20
Q

MOA = facilitate mixing of aqueous and fatty substances to soften fecal matter

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Emollient

21
Q

Indication = prevent straining and painful defecation

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Emollient & Lubricant

22
Q

AE = diarrhea, mild abdominal cramp

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Emollient

23
Q

Patient counseling = dont use longer than a week + often used with senna for opioid induced constipation

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Emollient

24
Q

Mineral oil is considered…?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Lubricant

25
Q

MOA = coats stool and prevents colonic absorption of fecal water

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Lubricant

26
Q

Avoid use with docusate

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Lubricant

27
Q

Impairs absorption of Vit. A, D, E, K, and oral contraceptives

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Lubricant

28
Q

AE = lipid pneumonia from aspiration + anal pruritis

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Lubricant

29
Q

Patient counseling = dont use longer than a week + take on an empty stomach + dont use on children <6 yrs old + no use in pregnant women + no use in adults with difficulty swallowing

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Lubricant

30
Q

Magnesium citrate, magnesium sulfate, magnesium hydroxide are considered….?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Saline

31
Q

MOA = draws water into intestine to increase intraluminal pressure and intestinal motility

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Saline

32
Q

Indication = acute bowel evacuation

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Saline

33
Q

Patient counseling = only for occasional use and quick onset of action

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Saline

34
Q

What saline formulation should you avoid?

A

Magnesium sulfate aka Epsom salt

35
Q

What is the FDA MedWatch AE of sodium phosphate (in saline)?

A

Acute phosphate nephropathy

36
Q

MOA of Senna?

A

Increase intestinal motility

37
Q

MOA of Bisacodyl?

A

Acts on mucosal nerve plexus + causes contraction of entire colon

38
Q

Indication of use for Senna & Bisacodyl

A

Bowel prep & used with docusate for opioid induced constipation

39
Q

AE of Senna?

A

Urine discoloration

40
Q

Patient counseling of Senna?

A

Dont use longer than a week + take with water

41
Q

Patient counseling of Bisacodyl?

A

Do not crush, do not take within 1 hr of ingesting dairy, antacids, H2RAs, or PPIs

42
Q

Pregnant women should avoid which one?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Stimulants + saline

43
Q

No enemas to be given at what age?

A

<2yrs old

44
Q

Children should avoid…?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Stimulants

45
Q

Elderly should have caution against which kind..?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Stimulants

46
Q

When is opioid induced constipation used?

A

In noncancer and cancer pain

47
Q

MOA of opioid induced constipation?

A

Opioids bind to bowel and CNS receptors + decrease GI motility + drying stool

48
Q

What should you avoid when during an opioid induced constipation?

Bulk-forming
Hyperosmotic
Emollient
Lubricant
Saline
Stimulant
A

Bulk-forming

OTC Therapy (43 decks)

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