Drugs affecting GI motility Ch 58 Flashcards
What are drugs affecting motility?
Used to speed up or improve motility
Used to increase tone/ stimulate motility
Used to decrease GI tract movement
Categories:
Bulk Stimulants
Stool Softeners
Stimulants
Antidiarrheals
Describe constipation
Slower emptying of large intestine
Symptom, not a disease
Can be caused by a variety of diseases or drugs
Treatment determined by patient condition and reason
for use
What is psyllium (Metamucil)?
Laxative bulk stimulate
What is therapeutic action of psyllium (Metamucil)?
Laxative bulk stimulate
Bulk forming fiber/ increases
water
Cause fecal matter to increase in
bulk turn gel like
Distend bowel to initiate reflex
bowel activity
What are adverse effects of psyllium (Metamucil)?
Laxative bulk stimulate
Diarrhea, cramps, F/E imbalances,
dehydration
What are contras of psyllium (Metamucil)?
Laxative bulk stimulate
-Acute abd process
- Intestinal obstruction; fecal impaction
What are cautions of psyllium (Metamucil)?
Laxative bulk stimulate
Cardiac disease due to F/E imbalance
What are Nursing considerations with psyllium (Metamucil)?
Laxative bulk stimulate
Take 30 minutes before/after other meds
take with generous amount of water
What is lactulose and magnesium citrate?
Osmotic laxative
What are therapeutic actions of lactulose and magnesium citrate?
Osmotic laxative
Pulls fluid in GI tract increases pressure GI tract stimulate motility
What are adverse effects of lactulose and magnesium citrate?
Osmotic laxative
-GI diarrhea, abdominal cramping and bloating
- Dehydration
What is docusate (Colace)?
Stool softeners
What are therapeutic actions of docusate (Colace)?
Stool softeners
-Promote more water and fat in the stools
- Lubricate the fecal material and intestinal walls
Usually act within 1-3 days
What are contras of docusate (Colace)?
Stool softeners
Acute abd process, allergy
What are cautions of docusate (Colace)?
Stool softeners
Cardiac disease
Can decrease absorption of fat soluble vitamins A, D, E, K
What is bisacodyl (Ducolax)?
Laxatives: chemical stimulants
What are therapeutics of bisacodyl (Ducolax)?
Laxatives: chemical stimulants
Directly stimulates the nerve plexus in intestinal wall
What are contras of bisacodyl (Ducolax)?
Laxatives: chemical stimulants
Acute abd. process
What are cautions of bisacodyl (Ducolax)?
Laxatives: chemical stimulants
-Cardiac disease – stimulation of vagus nerve with PR administration
-Bleeding precautions with PR administration
What are nursing considerations with laxatives
Obtain a thorough history of presenting
symptoms, elimination patterns, and
allergies
Assess fluid and electrolytes
Hold for nausea, vomiting, and/or
abdominal pain, s+sx of obstruction,
post-op
Fecal impaction – suppository/enema
first
Children/ infants – glycerin PR; older
children –lactulose – not long term
Caution with pregnancy as stimulation
could induce premature labor
A healthy, high-fiber diet and increased
fluid intake should be encouraged as an
alternative to laxative use
Long-term use of laxatives often results
in decreased bowel tone and may lead to
dependency
All laxative tablets should be swallowed
whole, not crushed or chewed, especially
if enteric coated
Take tablets with 6-8 oz. of water
When to notify PCP
What is **metoclopramide (Reglan)?
Gastrointestinal stimulants
What are therapeutic actions of metoclopramide (Reglan)?
Gastrointestinal stimulants
Stimulate parasympathetic activity
What are contras of metoclopramide (Reglan)?
Gastrointestinal stimulants
GI obstruction or perforation
What are cautions of metoclopramide (Reglan)?
Gastrointestinal stimulants
Pregnancy
Can cause extra-pyramidal effects, Parkinson like symptoms
Monitor N/V/D and spasm
