Gastrointestinal Conditions: Constipation & Diarrhea Flashcards
Bulk-forming laxative
ie; soluble fiber such as psyllium + dietary fiber = 1st line, and drug of choice in pregnancy
absorb water in intestine, add bulk to stool. inc peristalsis and dec stool transit times
Osmotic laxatives
ie. Polyethylene Glycol (PEG)
draw fluid into bowel lumen via osmosis, distends cold and inc peristalsis
Stimulant laxatives
ie. Senna, Bisacodyl
directly stimulate neurons in colon, causing peristaltic activity
Stool softener
ie: docusate
Emollients that reduce surface tension of stool oil-water interface, allowing more water and fat to mix with stool.
softening your shit and making it easier to go.
Lubricant laxatives
ie. mineral oil
coat bowl and stool in waterproof film
keeps moisture in stool, makes pooping easier
OTC recommendation for constipation in most adults
fiber
OTC recommendation for constipation in iron induced or hard stools
tool softener or bulk-forming drug
OTC recommendation for constipation in opioid-induced patients
stimulant or osmotic laxative
OTC recommendation for constipation in pregnancy
fiber
OTC recommendation for constipation if fast relief is req
adults: bisacodyl or glycerin suppository
children: glycerin suppository
Bulk forming drugs
Psyllium = Metamucil
Calcium polycarbophil = FiberCon
Methylcellulose = Citrucel
Wheat Dextrin = Benefiber
Bulk forming side effects
flatulence
abdominal cramping
bloating
bowel obstruction
Bulk forming drug notes
onset 12-72hrs
req adequate fluids
Osmotic laxatives
Magnesium hydroxide = Milk of magnesia
Polyethylene glycol 3350 = miralax
Glycerin = Fleet
Lactulose = Constulose, Enulose
Sodium phosphates = Fleet enema
Sorbitol = enema
Osmotic laxatives side effects
electrolyte imbalance
abdominal cramping
flatulence
dehydration
osmotic laxatives notes
30min - 96hrs onset
magnesium containing = caution renal impairment
lactulose = used in hepatic encephalopathy
glycerin supp = used commonly in children
Stimulant laxatives
Senna = Senokot, Ex-lax
Senna + decussate = Senna S, Senokot S
Bisacodyl = Dulcolax
Stimulant laxative warnings
avoid use with stomach pain, N/V, or sudden change in bowel movements in last > 2wks
Stimulant laxative side effects
abdominal cramping, electrolyte imbalance, rectal irritation
Stimulant laxative notes
onset 6-12hrs for oral, 15-60min rectal
take at bedtime to induce movement in morning
often given with chronic opioids