constipation/laxatives

Question 1

first line laxative in constipation

Answer 1

bulk-forming laxative
- ispaghula

Question 2

second line laxative in constipation

Answer 2

osmotic laxative
- macrogol

Question 3

laxatives avoided in diverticulosis

Answer 3

stimulant laxatives (senna)

Question 4

what is a bulk-forming laxative

Answer 4

bulk out the stool with fibre- increases faecal mass and stimulates peristalsis
advice patients to increase fluid intake
example: ispaghula husk, methylcellulose

Question 5

what are osmotic laxatives

Answer 5

draw water via omosis to make stool softer and easier to pass
can cause diarrhoea, abdo cramps
example: lactulose, macrogols (laxido)

Question 6

what are stimulant laxatives

Answer 6

stimulate the nerves of digestive tract to cause peristalsis
example: senna

Question 7

what are stool softening laxatives

Answer 7

decrease the surface tension of faecal mass and increase intestinal fluid in the stool
example: docusate

Question 8

management of patients with short term consitpation

Answer 8

1. start bulk forming
2. add or switch to osmotic
3. add stimulant

Question 9

management of patients with opioid induced constipation

Answer 9

1. start osmotic laxative and stimulant laxative
2. add softener