Constipation and Diarrhea Flashcards
What drugs are constipating?
What are your bulk forming agents?
What are your osmotics?
Aluminum antacids, anticholinergic drugs or drugs with similar properties (TCA’s, antihistamines, urge incontinence, antispasmodics, phenothiazines), Non-DHP calcium channel blockers(especially verapamil), clonidine, colesevelam, iron, opioids, sucralfate.
Psyllium (metamucil), Calcium polycarbophil(FiberCon), Methylcellulose (Citrucel). Can cause gas, bloating, take 2 hours before or after other drugs.
Magnesium hydroxide (Milk of magnesia), PEG 3350 (Miralax), Glycerin, Lactulose, Electrolyte imbalance, magnesium, renal impairment.
What to know about stimulants?
What are your emollients?
What osmotics to use for whole bowel irrigation and what to know?
Senna (Ex-Lax, Senokot), Bisacodyl (Dulcolax). Cramping, Chronic opioid use.
Docusate sodium (Colace), preferred when you don’t want to strain, use when stool hard/dry.
PEG (Calyte, Gavilyte, Moviprep, Golytely, Nulytely, Trilyte, Plenvu). Sodium phosphate (fleet enema, osmoprep), Sodium sulfate, potassium sulfate, and magnesium sulfate (suprep bowel kit) Nephropathy BBW for OsmoPrep, Acute phosphate nephropathy, gastric bypass or stapling surgery. Clear liquid diet, red or blue or purple food coloring, and solid or semi solid foods.
How does Lubiprostone work?
How does linaclotide work?
What is your PAMORA?
Activates chloride channels, CIC, OIC, IBS-C.
Linzess, agonist of guanylate cyclase C, CIC and IBS-C, diarrhea side effect.
Alvimopan (Entereg), maximum of 15 doses, MI, therapeutic dose of opioids for >7 days it is CI’d.
What drugs cause diarrhea?
What to know about Bismuth Subsalicylate?
What to know about loperamide?
Antacids with magnesium, antibiotics, antineoplastics, colchicine, laxatives, metoclopramide, misoprostol, quinidine.
Pepto-Bismol. Salicylate allergy, use with other salicylates, coagulopathy, black/bloody stool CI’s. Black tongue/stool, tinnitus, aspirin therapy, anticoagulants. Children and teens recovering from viral infections like flu and chickenpox should not use this due to Reye’s syndrome.
Imodium A-D, 4 mg PO after first diarrhea, then 2 after with each loose stool, Max 16 mg/day, OTC max is 8 mg/day. Children <2 years, acute dysentery, pseudomembranous colitis, bacterial enterocolitis, don ot self treat for more than 48 hours.
What to know about Diphenoxylate/Atropine?
What to know about Dicyclomine?
What to know about Eluxadoline?
Lomotil, C-V, Max 20 mg/day, pediatric patients <6 years of age cannot use tablets, Tablets not recommended for children <13.
Bentyl, Anticholinergic, so watch for patients >65, toxic megacolon or paralytic ileus. Dizziness, dry mouth, nausea, blurred vision.
C-4, Patients without a gallbladder CI’d, mu opioid receptor agonist.
