Final: GI - Laxatives and Antidiarrheals Flashcards
Psyllium (Metamucil)
Bulk forming laxatives
Action: Keeps water in stool to mechanically distend colon and promotes evacuation, prolonged onset
Adverse reactions: Esophageal obstruction, intestinal obstruction or impaction
Off-label: Cholesterol lowering, decrease diarrhea (IBS/diverticulosis)
Administer with 8 ounces of water
Do not give to patient with fecal impaction, GI bleeding, or new onset acute abdominal pain (undiagnosed)
Bisacodyl (Dulcolax)
Stimulant and Irritant Laxative
Action: Suppositories work in 15-60 minutes, oral bisacodyl administered at bedtime and works within 6-12 hours. Stimulates motility, increases water and electrolytes within intestinal lumen
Education: Anthraquinones (Senna) = change in urine color may occur. Increase water intake daily, report new abdominal pain
Polyethylene Glycol (PEG)
Osmotic Laxatives
Action: Poorly absorbed salts whose osmotic action draws water into the intestinal lumen
Adverse reactions: Substantial loss of water
Caution: Magnesium hydroxide used cautiously with renal failure and heart failure
Drug-drug: Sulfonylureas, quinidine
PEG used routinely in bowel programs and acute/LTC
Diphenoxylate HCl (Lomotil)
Schedule V controlled substance, chemically related to narcotic meperidine, antidiarrheal agent
Action: Slow intestinal motility
Atropine added to discourage misuse (anticholinergic)
Contraindications: Diarrhea of infectious nature, obstructed jaundice, children under 2, severe electrolyte imbalance or dehydration
Adverse effects: Opioid effects, anticholinergic effects
Education: Rehydrate with commercial oral electrolyte solution, take only as directed, avoid caffeine, when stools decrease stop taking this medication
All antidiarrheals must be used in caution in patients with ________________
Inflammatory Bowel Disease (IBD)