constipation and diarrhea\ Flashcards
non drug tx for constipation
increase fluid intake
limit caffiene and alcohol
food with fiber
drugs for constipation
bulk forming drugs
osmotics
stimulants
stool softners
lubricants
bulk forming drugs
1st line
pregnancy
MOA absorb water in the intestines soaking up fluid
osmotics
peg
milk of mg
glycerin
lactulose
sodium phos enema
large ions
drawing fluid from intestines
stimulants
senna,
bisacodyl
used to tx chronic opiod
stoolsoftners are given when
docusate
iron suppplement patients
what are some bulk forming drugs
Psyllium (metamucil)
Calcium polycarbophil (fibercon)
methylcellulose (citrucel )
Whear dextrin (benefiber)
what are some key points with bulk forming drugs
adequate fluids are required
AE- flatulence, abdominal cramping, bloaing
what are some osmotics
MGOH (milk of magnesia
polyethylene glycol 3350 (miralax)
Glycerin
lactulose
sodium phosphates(fleet enema)
what are some key points with osmotics
electrolyte impbalance
abdominal cramping
MG care with renal
Glycerin used in children
what are some stimulants
senna (exlax, senokot)
bisacodyl
stool softners
Docusate
other drugs used for constipation
chloride channel activator
guanalate cyclase C agonist
peripherally acting mu opiod receptor antagonist (PAMORAs)
serotonin 5HT4 receptor agonist
Lubiprostone
Amitiza
Chlorine channel activator
AE- nausea
linaclotider
linzess
AE-diarrhea
do not use in pediatric pts
peripherally acting mu opiod receptor antagonists
Alvimopan(entereg)
methylnaltrexone (relistor)
Naloxegol (movantik)
AE- risk of MI with longterm use
5HT4 receptor agonist
prucalopride (motregrity
tegaserod(zelnorm)
AE- suicidal ideation, diarrhea
laxative used for whole bowel irrigation
colonoscopy
polyethylene glycol(colyte, goLytely, Nulytely
sodium phosphates (osmoprep
Sodium sulphate, potassium sulphate and MG sulphate (suprep bowel prep kit
Osmoprep should be avoided in
acute phosphate nephropathy
gastric bypass or stapling surgery
BW- nephropathy
causes of diarrhea
milk -lactose intolerant
IBSD
non drug tx
fluid and electrolyte replacement
oral rehydration solutions
drug tx
bismuth salisylate- peptobismol
loperamide
mu receptor agonist
anti diarrheals
bismuth
loperamide (immodium)
diphenoxylate/atropine (lomotil)
antipasmodic
dicylomine (bentyl)
peripherally acting mu receptor agonist
eluxadoline (viberzi) control
what are the controlled substances used for diarhhea
diphenoxylate/atropine (lomotil)
eluxadoline (viberzi)
other meds for diarrhea
abx- rifaximin (xifaxan)
serotonin receptor antagonist (alosetron (lotronex)
bismuth
salisylate allergy
reyes syndrome
black tongue/stool
tinnitis
nausea
risk of bleeding with anticoag/plat
loperamide
4mg after first loosoe and then 2mg after each loose stool max 8mg/day
constipation
do not use >48 hours
which med can cause anticholinergic effects
dicyclomine
what drugs can cause diarrhea
acetylcholinesterase inhibitor donepezil
antacids with MG
ABX
metformin, GLP
colchicine
laxatives
misprostol
mycophenolate
protease inhibitor
quinidine
roflumilast
MTX, irinetican , flurouracil
metochlopramide , cisapride
what drugs can cause constipation
antacids with Cal aluminum
antidiarrheals
clonidine
colesevelam
anticholinergic
iron
non DHP CCBs
opioids
sucralfate
which drug is for short term use for constipation for ileus sx
alvimopan (enterag)
