Constipation/Diarrhea Flashcards
medical conditions that cause constipation
IBS, anal disorders, MS, CV events, PD, spinal cord tumors, diabetes, hypOthyroidism
nondrug tx for constipation
inc fluids, limit caffiene and alcohol, inc physical activity, inc fiber
what drugs cause constipation
antacids, antidiarrheals, clonidine, colesevelam, anticholinergics, iron, non dhp CCBs, opioids, sucralfate
pts should be refered to physician if constipation persists after how many days of OTC tx
7 days
bulk forming drugs
psyllium (fiber)
drug of choice for constipation in pregnancy
psyllium (fiber)
osmotics
PEG, magnesium hydroxide, glycerin, lactulose
stimulants
senna, bisocodyl
drug of choice for opioid induced constipation
stimulants (senna, bisocodyl) or osmotic
stool softener
docusate
lubricants
mineral oil
metamucil
psyllium
dulcolax
bisacodyl
colace
docusate
drug of choice for constipation with straining
stool softeners (docusate, senna)
mineral oil contraindications
<6y, pregnant, bedridden, elderly, difficulty swallowing
lubiprostone moa
chloride channel activator
lubiprostone contraindication
mechanical bowel obstruction
linaclotide (linzess) contraindications
<6y, mechanical GI obstruction
drug indicated for hospitalized surgery patients to decrease risk of post op ileus
alvimopan
laxatives for wbi should be used with caution in which patients
CVD, reanl insufficiency, taking loops or NSAIDs
alvimopan (entereg) contraindication and max doses
opioid use > 7 consecutive days; 15 doses
constipation drugs only used for OIC
methylnaltrexone, naloxegol, naldemedine
drugs that cause diarrhea
AChE Inhibitors, Mg, antibiotics, antidiabetics, antineoplastics, colchicine, laxatives, misoprostol, mycophenolate, metoclopramide, protease inhibitors, quinidine, roflumilast
most common bacterial cause for diarrhea
e coli
non-drug diarrhea treatment
fluid and electrolyte replacement
antidiarrheal agents
bismuth subsalicylate, loperamide, lomotil
loperamide boxed warning
torsades, cardiac arrest, do not exceed recommended dose
major pepto bismol side effects
black tongue/stool, nausea, bleeding/bruising
lomotil cds class
C-V
dicyclomine warnings
anticholinergic, mild-mod UC
eluxadoline (vibrezi) contraindication
patients without a gallbladder
do not take loperamide for longer than
2 days
Eluxadoline (Vibrezi) MOA
peripherally acting mixed Mu opioid agonist
Methylnaltrexone
Relistor
Naloxegol
Movantik
Prucalopride MOA and warning
5HT4 agonist; suicidal ideation
Imodium bbw and CI
Bbw: cardiac arrest with higher doses
CI: c diff, dysentery, enterocolitis
Lomotil (diphenoxylate/atropine) CI, side effects and max dose
CI: <2y, <6y if tablets
SE: mild euphoria
Max 20 mg/day
drug used to treat constipation that is only available Rx
lactulose
osmoprep boxed warning
nephropathy
first line OIC tx
stimulant laxative
PAMORAs
alvimopan, mathylnaltrexone, naloxegol, naldemedine
amitiza common se
nausea
linaclotide (linzess) MOA
guanylate cyclase C agonist
