Gastrointestinal Disorders Flashcards
What is constipation
small, infrequent, or difficult BM
Fewer than 3 BMs/week
What is the causes of constipation
Diet (low in fiber)
Lack of exercise
Slowed peristalsis
Pathologic conditions
Obstruction or diverticulitis
What is an impaction
unrelieved constipation
what can an iimapaction lead to
an obstruction
what is an obstruction
a firm, immovable mass of stool obstructs lower GI tract
S/S of an impaction (5)
May have continuous oozing or diarrhea
Loss of appetite
N/V
Abdominal distention
Cramping and pain
What is diarrhea
increase in frequency and fluidity of bowel movements
what can cause ACUTE diarrhea
Infection,
emotional stress,
some medications,
liquid stool around an impaction
what can cause CHRONIC diarrhea
lasting more than 4 weeks
Chronic GI infection
Alterations in motility or integrity
Malabsorption
Endocrine disorders
What is causes EPISODIC diarrhea
Food allergy or irritant
What are the 4 pathophysiologic mechanisms of diarrhea
Osmotic diarrhea
Secretory diarrhea
Exudative diarrhea
Related to motility disturbances
what is osmotic diarrhea
increase in solutes
sodium and water rush into colon
common with mag sulfate
and tube feeding
what is secretory diarrea
caused by bacteria or toxin causing increase secretion and inhibit reabsorbtion.
2 common bacteria in secretory diarrhea
Vibrio cholerae & Staphylococcus aureus
what is exudative diarrhea
active inflammation in bowel lumen resulting in exudate of mucus, blood and proteins in a open wound pulling water into intestines .
common in crohn disease and ulcerative colitits
what is Related to motility disturbances
decrease absoprtion in small intestines with large amounts of fluid delivered to colon.
examples include Dumping syndrome & IBS
problems with diarrhea
Skin breakdown
Fluid/Electrolyte imbalance
Nutritional concerns
Drugs used to treat Diarrhea
Anti-diarrheals
Different groups of diarrheals
Adsorbants
Antimotility (anticholinergics and opiates)
Probiotics
route of antidiarrheals
oral
Drug name for adsorbent drug
bismuth subsalicylate (Pepto-Bismol)
MOA of bismuth subsalicylate
coats the walls of the GI tract
Bind the causative agent for elimination
Adverse Effects (Bismuth subsalicylate)
Increased bleeding time
Constipation
Dark stools and darkening of tongue
characteristics of bismuth subsalicylate (Pepto-Bismol)
form of asprin
contains activated charcoal
What is the antimotility drugs
loperamide (Imodium)
diphenoxylate [atropine] (Lomotil)
MOA of antimotility drugs
Slow peristalsis
Drying effect*
adverse effects of antimotility drugs
Urinary retention
Headache
dizziness
anxiety
drowsiness
Bradycardia
hypotension
Dry skin
Flushing
T/F Antimotility drugs can be Used alone or in combination with adsorbants and opiates
TRUE
MOA of probiotics
Replenish these bacteria and restore normal flora
These bacteria make up the majority of normal flora of gut
Lactobacillius organisms (Bacid, Culturelle)
Medication used in the treatment of C-Diff
Saccharomyces boulardii (Florastor)
What are laxatives used for
treatment of constipation
Different groups of laxatives
Bulk-forming
Emollient
Hyperosmotic
Saline
Stimulant
How laxative treatment is prioritized
Individualized by:
Age
Severity
Contributing factors
Bulk-forming medication
psyllium (Metamucil)
MOA of psullium
Act similar to dietary fiber
Absorb water into the intestine, increasing bulk
Distends bowel to initiate reflex bowel activity and bowel movement
T/F psullium is OK for long term use
TRUE
Adverse effects of psullium
Impaction above strictures
Fluid/electrolyte imbalance
Gas formation
Esophageal blockage
Emollient medications
docusate sodium (Colace)
mineral oil
MOA of docusate sodium
lubricates fecal material and walls, promotes fat absorption into fecal mass
uses of docusate sodium
prevent opioid-induced constipation
route of docusate sodium
PO
MOA of mineral oil
lubricate intestines
uses of mineral oil
fecal impactions
route of mineral oil
PO
PR
Adverse effects of emollients
skin rashes, decreased absorption of vitamins
what do emollients prevent
water from moving out of intestines
Hyperosomtic drugs
glycerin
lactulose
polyethylene glycol
MOA of hyperosomtic drugs
Increasing water content in feces
Promotes distention, peristalsis, and evacuation
uses of hyperosomtic drugs
Evacuate bowels before diagnostics and surgical procedures
adverse effects of hyperosomtic drugs
Abdominal bloating
Rectal irritation
Electrolyte imbalance
MOA of saline laxatives
increase osmotic pressure and draw water into colon
Adverse effects of saline laxatives
Magnesium toxicity
Electrolyte imbalance
Cramping, diarrhea
2 Types of Saline salts
Magnesium salts
sodium salts
3 types of magnesium salts
magnesium citrate (Citroma)
magnesium hydroxide (Phillips Milk of Magnesia)
magnesium sulfate (epsom salts)
type of sodium salt
fleet enema
2 Type of stimulant laxative
bisacodyl (Ducolax)
senna (Senokot)
route of bisacodyl
PO
PR
route of senna
PO
Uses of stimulant laxatives
OTC for constipation or whole bowel evacuation
Adverse Effects of stimulant laxatives
Nutrient malabsorption
Gastric irritation
Electrolyte imbalance
