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Naplex 2025 > Constipation & Diarrhea > Flashcards

Constipation & Diarrhea Flashcards

1
Q

What is Constipation?

A
  • Infrequent bowel movements [< 3/week] or difficulty passing
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2
Q

What is Chronic Idiopathic Constipation (CIC)?

A
  • Constipated for several weeks
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3
Q

What are some medical conditions that could cause constipation/

A
  • IBS (constipation-predominant)
  • Anal Disorders (fissures, fistules, prolapse)
  • Multiple Sclerosis
  • Cerebrovascular Events
  • Parkinsons
  • Pregnancy
  • Spical Cord Tumors
  • Diabetes
  • Hypothyroidism
  • DRUGS
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4
Q

What are some non-pharm treatments for constipation?

A
  • Increase fluids (eight 8 oz daily)
  • Decrease caffiene & alcohol
  • increase physical activity
  • Better diet (whole grains, fruits, veges [HIGH FIBERS])
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5
Q

What are some drugs that can cause constipation?

A
  • Antidiarrheals (duh)
  • Anticholinergics (Antihistamines, Antispams, Phenothiazines, TCAs, Incontinance)
  • Antacids with aluminone or calcium
  • Opioids
  • Clonidine
  • Non-DPHs (Verapimil)
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6
Q

What are the types of constipation treatments?

A
  • Bulk Forming
  • Osmotics
  • Stumilants
  • Stool Softeners
  • Lubricants
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7
Q

What type of OTC product is recommedned for most adults?

A
  • Fiber (bulk formings)
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8
Q

What type of OTC product is recommedned for Iron-induced or hard stools?

A
  • Stool softeners (docuate) OR
  • Bulk forming
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9
Q

What type of OTC product is recommedned for Opioid induced?

A
  • Stimulants (senna) OR
  • Osmotics (PEG)
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10
Q

What type of OTC product is recommedned for Pregnancy?

A
  • Bulk Forming
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11
Q

What type of OTC product is recommedned for Fast relief needed?

A
  • Adults: Bisacodyl or Glyercin Supps
  • Kids: Glycerin Supps
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12
Q

What is the MOA for the Bulk Forming Agents for constipation?

A
  • Absorb water in the intestines; creating that “Bulk” stool

FIRST LINE
BEST for pregnancy

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13
Q

What are your Bulk Forming products for constipation?

A
  • Psyllim (Metamucil)
  • Calcum Polycarbophil (FiberCon)
  • Methycellulose (Citrucel)
  • Wheat Dextrin (Benefiber)
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14
Q

`

What are some of the side effects of the bulk forming agents for constipation

A
  • Farting
  • Abdominal Cramping
  • Bloating
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15
Q

What are some additional notes for the bulk forming agents in constipation?

A
  • Drink fluids
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16
Q

What is the MOA for the Osmotic agents for constipations?

A
  • Draw fluids into the intestine via osmosis, distending the colon and causing movement
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17
Q

What are some of the osmotic agents that are used for constiptation

A
  • Magnesium Hydroxide (Milk of Mag)
  • Polyehtylene Gycol (MiraLax)
  • Glycerin
  • Lactulose
  • Sodium Phosphate (Fleets Enema)
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18
Q

What are some of the side effects for the osmotics agents used for constipation?

A
  • Electrolyte Imbalences
  • Abdominal cramping
19
Q

What are some additional notes for the osmotic agents used for constipation?

A
  • Mg products: caution in Renal Impairment
  • Lactulose –> Hepatic Encephalopathy
  • Glycerin Supps: best in kids that NEEDS to poop
20
Q

What is the MOA for the Stimulants used for constipation

A
  • Directly stimulants the neurons in the colon; causing movement
  • Stool Softeners are often given to help

BEST in opioids induced

21
Q

What are some of the stimulants that are used for constipation?/

A
  • Senna (Ex-Lax, Senokot) + Docusate (Senna S, Senokot S)
  • Bisacodyl (Dulcolax)
22
Q

What are some of the side effects of the stimulants used for constipation?

A
  • Abdominal Cramping
23
Q

What are some of the additional notes for the stimulants used for constipation

A
  • Onset orally = 6 - 12 h & rectally = 15 - 60 mins
  • If orally, take at bedtime (to poop in AM)
  • BEST for opioid induced
24
Q

What is the MOA for the stool softeners used for Constipation?

A
  • Emollients that reduce the surface tension of the poop to allow the water to mix better with it
25
What are some of the **stool softeners** that are used for **constipation**?
- Docusate (Colace) + Senna (Senna S, Senokot S)
26
What are some **additional notes** for the **stool softeners** used for **constipation**?
- Onset orally = 12 - 72 h & rectally = 2 - 15 mins - NOT best for those that are **straining** - Best for **Hard and dry** stool (iron induced)
27
What is the **MOA** for the **lubricants** used in **constipation**? ## Footnote -
- Coat the colon in waterproof film; keeping the Moisture in
28
What is the **MOA** for **Lubiprostone (Amitiza)** in **constipation**?
- acts on Cl channels in the gut; leading to increased fluid secretion anf movement ## Footnote **BEST in CIC, OCI, IBS-C**
29
What are some of the **side effects** for **Amitiza** in **constipation**?
- Nausea (take with food)
30
What is the **MOA** for **Linaclotide (Linzess)** in **Constipation**?
- Guanylate Cyclase C agonist that increase Cl & HCO3 into the lumen of the intestine; increases speed of GI tract and decreases pain
31
What are some of the **Side effects** of **Linzess** used in **Constipation**?
- Diarrhea
32
What are the **anti-diarrheals** that are used for **diarrhea**?
- Bismuth Subsalicylate (**Pepto**) - Loperamide (**Imodium A-D**) - Diphenoxylate/Atropine (**Lomotil**)
33
What are some **contraindications** for **Pepto** used for **diarrhea**?
- Salicylate Allergy - Taking other Salicylates (Aspirin) - GI ulcers - Bleeding issues
34
What are some **warnings** for **Bismuth Subsalicylate**?
- **NO** in childern and kids = **Reyes Syndrome**
35
What are some **side effects** for **Pepto** in **Diarrhea**?
- Black tongue/stools (temporay) - Salicylate Toxicity (tinnitus) - Nausea
36
What are some **additional notes** for **pepto** used in **Diarrhea**?
- increased bleeding risk when used with Anticoag/antiplatelets agents or NSAIDS
37
What are some **BOXED WARNINGS** for **Loperamide** used for **Diarrhea**?
- Cardiac Arrest and Sudden Death (Torsades de Pointes) [**DO NOT EXCEED MAX DAILY DOSE**]
38
What is the **Dosing** for **Imodium A-D** used for **Diarrhea**?
- **4 mg** PO after 1st loose stool then **2 mg** after each loose stool - **MAX: 8 mg/day (OTC)** & **16 mg/day (Rx)**
39
What are some **side effects** for **Loperamide** used for **diarrhea**?
- Constipation
40
What are some **contraindications** for **Lomotil** used for **diarrhea**?
- **DO NOT** used in childern (< 2 yo or < 6 yo with tabs) due to **CNS depression**
41
What are the **Antispasmodics** that are used for **Diarrhea**?
- Dicyclomine (Bentyl)
42
What **drug class** is **Lomotil**?
- C-V
43
What are some **warnings** for **Bentyl** for **diarrhea**?
- Anticholinergic Effctes = caution in your **> 65 yo**
44
what are some **side effects** of **Dicyclomine** used for **Diarrhea**?
- Dizziness - Dry Mouth - Nausea - Blurred Vision

Naplex 2025 (49 decks)

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