Constipation and Diarrhea Flashcards
Signs and symptoms of dehydration in children
Dry mouth and tongue Sunken and/or dry eyes Sunken fontanelle Decreased urine output (dry diapers for several hours) Dark urine Fast heart beat Thirst (drink extremely eagerly) Absence of tears when crying Decreased skin turgo Unusual Lethargy Weight Loss
Bulk-forming laxatives-
contains methylcellulose, polycarbophil, and psyllium. Dosage form includes tablets, capsules, powders to be mixed with water or other liquid, and fiber few, wafters, or gummies.
methylcellulose, polycarbophil, and psyllium.
Usually onset of action is 12-24 hours, onset may be delayed up to 72 hours
Treatment generally for 1) patients on low-fiber diet 2) postpartum women 3) older adults 4) patients with colostomies, irritable bowel syndrome, or diverticular disease
Patients with intestinal obstruction, intestinal ulcerations, stenosis, or disabling adhesions should not take bulk-forming products.
Hyperosmotic agent-
includes polyethylene glycol 3350 and glycerin. Product contain large, poorly absorbed ions, or molecules that draw water into the colon and rectum through osmosis to stimulate a bowel movement.
polyethylene glycol 3350 and glycerin
Glycol 3350 is only for patients 17 years of age and older. Dosage is generally 17g (1 capsule or 1 packet) mixed in with water once daily as needed. Produce bowel movement in 12-72 hours, onset may take up to 96 hours.
Effective for short term treatment.
Adverse effects are bloating, abdominal discomfort, cramping, and flatulence. Glycerine is available as a suppository for lower bowel evacuation. Effective in 15-30min.
Emollient agent
stool softeners. Docusate. Time onset of 12-72 hours, and may take up to 3-5 days to effect laxation. Generally combined with a stimulant laxative for opioid-induced constipation.
Lubricant agent-
Mineral oil is the only non prescription lubricant. Onset of action 6-8hours after oral administration and 5-15 after rectal administration. Major concern is lipid pneumonia resulting from aspiration into the lungs after an oral dose. Should not be taken lying down or in patient with aspiration. Not for younger than 6 years, pregnant women, and bedridden or older adults, or people with difficulty swallowing. Don’t recommend it.
Saline laxative-
Magnesium citrate, Magnesium hydroxide, dibasic sodium phosphate, monobasic sodium phosphate, and magnesium sulfate. available in liquid or solid for oral and liquid for rectal. For occasional constipation in healthy people. Takes about 30min to 6 hour for effect. Adverse effects, abdominal cramping, nasua, vomiting and dehydration.
Stimulant agent-
anthraquinones or diphenylmethanes. Primarily in the colon to increase intestinal motility either by local irritation of the mucosa or by a more selective actions on the intramural nerve plexus of intestinal smooth muscle. Onset of action for bisacodyl is 6-10 hours after oral administration. Bisacodyl suppositories usually take effect 15-60 minutes after administration.
Diarrhea
Diarrhea- more than 3 bowel movements in the day
Causes- pathogenic, antibiotics, noravirus
Diarrhea non pharm
Non-Pharm= ORS- Oral Rehydration Solution, mild to moderate dehydration
Referee within 72 hours if nothing gets fixed
Loperamide-
produces antidiarrheal effects by stimulating peripheral micro-opioids receptors on the intestinal circular muscles to slow intestinal motility. 6 years < older. Used generally for traveler’s diarrhea. Duration of use 48 hours
bismuth subsalicylate
bismuth subsalicylate- Duration of use 48 hours. Black tarry stool Reacts with hydrochloric acid in the stomach to form bismuth oxychloride and salicylic acid, which is insoluble and poorly absorbed from the GI Tract. 12years
Lactase
Lactase- may be taken with milk or other dairy product to prevent osmotic diarrhea
