Exam 4 - Constipation Products Flashcards

1
Q

Methylcellulose

A

Bulk forming agent

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2
Q

Calcium polycarbophil

A

Bulk forming agent

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3
Q

Psyllium

A

Bulk forming agent

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4
Q

Onset of action for bulk forming agents

A

12-24 hours; may take up to 72 hours

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5
Q

Adverse reactions of bulk forming agents

A

Abdominal cramping and flatulence

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6
Q

Drug-drug interactions of bulk forming agents

A

Interferes w/ absorption of:
- digoxin
- anticoagulants
- salicylates
- others

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7
Q

How to manage drug-drug interactions w/ bulk forming agents

A

Separate dosing by at least 2 hours

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8
Q

Polyethylene glycol (PEG)

A

Hyperosmotic agent

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8
Q

Glycerin

A

Hyperosmotic agent

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9
Q

Onset of action for PEG

A

12-72 hours; may take up to 96 hours

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10
Q

Onset of action for glycerin

A

15-30 min

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10
Q

Onset of action for docusate sodium/calcium

A

Oral: 12-72 hrs; may take up to 3-5 days

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10
Q

Adverse reactions of glycerin

A

Rectal irritation possible w/ overdose

Avoid in people who have pre-existing rectal irritation

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10
Q

Adverse reactions of PEG

A

Bloating
Abdominal discomfort
Flatulence

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11
Q

Docusate sodium/calcium

A

Emollient agents (stool softeners)

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12
Q

Drug-drug interactions w/ docusate sodium/calcium

A

Increases absorption of mineral oil

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13
Q

Management of drug interactions for docusate sodium/calcium

A

Do not use concurrently

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13
Q

Adverse reactions of mineral oil

A

Caution due to aspiration (lipoid pneumonia)

May impair absorption of fat soluble vitamins

Larger than recommended doses can cause oil leakage through anal sphincter and anal itching

Do NOT use in patients:
- younger than 6 years
- pregnant
- immobile
- difficulty swallowing
- older adults

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14
Q

Mineral oil

A

Lubricant agent

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15
Q

Onset of action for mineral oil

A

Oral: 6-8 hrs
Rectal: 5-15 min

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16
Q

Drug-drug interactions of mineral oil

A

Docusate increases absorption of mineral oil

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17
Q

Management of drug-drug interactions w/ mineral oil

A

Do not use concurrently w/ docusate

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18
Q

Magnesium citrate

A

Saline laxative

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19
Q

Magnesium hydroxide

A

Saline laxative

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20
Q

Monobasic sodium

A

Saline laxative

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21
Q

Monobasic sodium phosphate/dibasic sodium phosphate

A

Saline laxative

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22
Q

Onset of action for saline laxatives

A

Magnesium hydroxide oral: 30 min - 6 hours

Magnesium citrate (for catharsis) oral: 30 min - 3 hours

Magnesium citrate rectal: 2-15 min

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23
Q

Adverse reactions for saline laxatives

A

Magnesium sulfate should NOT be used as a laxative (there are safer products)

ADRs:
- abdominal cramping
- nausea
- vomiting
- dehydration

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24
Q

Magnesium citrate drug-drug interactions

A

May cause decreased drug absorption of fluoroquinolone and tetracycline antibiotics

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25
Q

Management of drug-drug interactions w/ magnesium citrate

A

Avoid taking within 1-3 hrs of ingestion of tetracyclines or quinolones

26
Q

Magnesium hydroxide drug-drug interactions

A

Tetracyclines
Quinolones
Ketoconazole
Captopril
some oral Bisphosphates

Cefdinir
Rosuvastatin
Iron salts
Phenthiazines
Phenytoin
Levothyroxine
Itraconazole
Nitrofurantoin
Gabapentin

(The Queen/King Can Be CRIPPLING)

Decrease in oral bioavailability and/or extent of drug absorption

27
Q

Management of drug-drug interactions w/ magnesium hydroxide

A

Separate by at least 2 hours

Avoid for at least 4 hours before and up to 3 hrs after ingestion of interacting agent

28
Q

Senna

A

Stimulant laxative

29
Q

Bisacodyl

A

Stimulant laxative

30
Q

Castor oil

A

Stimulant laxative

31
Q

Onset of action of stimulant laxative

A

Oral: 6-10 hours but may take up to 24 hrs

Rectal: bisacodyl suppsoitories 15-20 min

32
Q

ADRs for stimulant laxatives

A

Major hazards:
- severe cramping
- electrolyte and fluid deficiencies
- malabsorption
- hypokalemia

High doses:
- cramping
- increases mucus secretion

32
Q

Drug-drug interactions w/ saline laxatives

A

Milk products/products that raise gastric pH (ie PPIs)

These cause premature dissolution of bisacodyl/enteric coating, which leads to gastric irritation and dyspepsia

33
Q

Dosage form/strength of polyethylene glycol

A

Powder

17 g/capful

33
Q

Management of drug-drug interactions w/ saline laxatives

A

Avoid milk or other interacting drugs within 1 hr before or after bisacodyl

34
Q

Adults/children 12 years and up; PEG

A

17 g in 4-8 oz of beverage once daily in adults and children 17+ years of age

35
Q

Children 6-12 years of age: PEG

A

Not recommended for children younger than 17 EXCEPT under PCP advice

36
Q

Children 2-6 years of age: PEG

A

Not recommended for children younger than 17 EXCEPT under PCP advice

37
Q

Dosage forms/strength of glycerin

A

Rectal solid suppository: 2 g
Pediatric solid suppository: 1 g

38
Q

Adults and children 12+ years: glycerin

A

1 suppository (2 g) or as directed by a PCP

39
Q

Children 6-12 years of age: glycerin

A

1 suppository (2 g) or as directed by a PCP

40
Q

Children 2-6 years of age: glycerin

A

2 g: not recommended for children younger than 6 years EXCEPT under PCP advice

1 g: 1 suppository or as directed by PCP

41
Q

Dosage form/strength: docusate sodium

A

Capsules

50 mg and 100 mg

42
Q

Adults and children older than 12 years: docusate sodium

A

50 - 300 mg daily in single or divided doses

43
Q

Children 6-12 years of age: docusate sodium

A

50 - 150 mg daily in single or divided doses

44
Q

Children 2-6 years of age: docusate sodium

A

50-150 mg daily in single or divided doses

45
Q

Dosage form/strength: docusate calcium

A

Capsule

240 mg

46
Q

Adults and children 12 years of age and older: docusate calcium

A

1 capsule daily for several days or until bowel movements are normal

47
Q

Children 6-12 years of age: docusate calcium

A

NOT recommended for children under 12 EXCEPT under PCP advice

48
Q

Children 2-6 years of age: docusate calcium

A

NOT recommended for children under the age of 6 except under the advice of a PCP

49
Q

Dosage form/strength: magnesium hydroxide

A

Liquid: 400 mg/5 mL
Concentrated liquid: 2400 mg/15 mL

50
Q

Adults and children 12 years and older: magnesium hydroxide LIQUID

A

2-4 tbsp (30-60 mL) daily as single or divided doses

51
Q

Children 6-12 years of age: magnesium hydroxide LIQUID

A

1-2 tbsp (15-30 mL) daily as single or divided doses

52
Q

Children 2-6 years of age: magnesium hydroxide LIQUID

A

NOT recommended for children younger than 6 years EXCEPT under PCP advice

53
Q

Adults and children older than 12 years: magnesium hydroxide CONCENTRATED liquid

A

1-2 tbsp (15-30 mL) daily as single or divided doses

54
Q

Children 6-12 years of age: magnesium hydroxide CONCENTRATED liquid

A

1/2 - 1 tbsp (7.7-15 mL) daily as single or divided doses

55
Q

Children 2-6 years of age: magnesium CONCENTRATED liquid

A

NOT recommended for children under 6 years EXCEPT under PCP advice

56
Q

Dosage form/strength: senna

A

Tablets

8.6 mg sennosides

57
Q

Adults and children 12 years and older: senna

A

Starting dose of 2 tabs once daily

MAXIMUM dose: 4 tablets BID

58
Q

Children 6-12 years: senna

A

Starting dose of 1 tablet once daily

MAXIMUM dose: 2 tabs BID

59
Q

Children 2-6 years of age: senna

A

Starting dose of 1/2 tablet once daily

MAXIMUM dose: 1 tab BID

60
Q

Dosage form/strength: bisacodyl

A

Tablets: 5 mg

Rectal solid suppository: 10 mg

61
Q

Adults and children 12+ years: bisacodyl TABLETS

A

1-3 tabs (usually 2) once daily

62
Q

Children 6-12 years: bisacodyl TABLETS

A

1 tab daily

63
Q

Children 2-6 years of age: bisacodyl TABLETS

A

NOT recommended for children under the age of 6 EXCEPT under advice of a PCP

64
Q

Adults and children 12+ years: bisacodyl SUPPOSITORY

A

1 supp in a single daily dose

65
Q

Children 6-12 years of age: bisacodyl SUPPOSITORY

A

1/2 suppository in a single daily dose

66
Q

Children 2-6 years of age: bisacodyl SUPPOSITORY

A

NOT recommended for children under the age of 6 EXCEPT under PCP advice