Gastrointestinal Disorders and Drugs Flashcards
constipation
small infrequent or difficult bowel movement that occur less than 3x a week
causes of constipation
- diet (low in fiber)
- lack of exercise
- slowed peristalsis
- pathological conditions like obstruction or diverticulitis
impaction
unrelieved constipation that may lead to an obstruction of a firm immovable mass of stool in the lower GI tract
- may cause continuous oozing or diarrhea
- loss of appetite, N/V, abdominal distention, cramping, pain
diarrhea
inc frequency and fluidity of bowel movements
types of diarrhea
acute: caused by emotional stress, some meds, liquid stool getting around impaction
chronic: lasting more than 4 wks from chronic GI infection, alteration in motility or integrity, malabsorption, endocrine disorders
episodic: food allergy or irritant
pathophysiological mechanisms of diarrhea
- osmotic diarrhea (inc amount of osmotically active solutes)
- secretory diarrhea (bacteria or toxin that inc secretion and inhibits reabsorption of water in the gut)
- exudative diarrhea (active sites of inflammation resulting in exudation of mucus, blood, proteins that will pull water into colon)
- related to motility disturbances
problems associated with diarrhea
- dehydration
- skin integrity
- electrolyte imbalance/nutritional concerns
whats used to treat diarrhea? what groups are there?
antidiarrheals
- adsorbants
- anti motility (anticholinergic, opiates)
- probiotics
adsorbant drug
bismuth subsalicylate
bismuth subsalicylate moa
coats the wall of the GI tract
binds the causative agents for elimination
bismuth subsalicylate se
inc bleeding time
constipation
dark stool, darkening of tongue
anti motility drugs
loperamide and diphenoxylate [atropine}
loperamide moa
slow peristalsis
loperamide se
not really any bc no opiate
diphenoxylate moa
slow peristalsis
drying effect
diphenoxlate adverse effects
- urinary retention
- headache, dizzy, anxiety, drowsy
- bradycardia, hypotension
- dry skin
- flushing
laxatives
used to treat constipation which will be individualized based on age, severity, contributing factors
different groups of laxatives
- bulk forming
- emollient
- hyper osmotic
- saline
- stimulant
psyllium class
bulk forming
psyllium moa
similar to dietary fibers
absorbs water into the intestines inc bulk
distends bowel to initiate reflex bowel activity and movement
psyllium se
impaction above structures
fluid/electrolyte imbalance
gas formation
esophageal
psyllium nc
okay for long term use
docusate sodium class
emollient laxative
docusate sodium moa
lubricates fecal material and walls
promotes fat absorption into fecal mass
prevent water from moving out of intestine
docusate sodium indications
prevents opioid induced constipation
docusate sodium route
PO
docusate sodium se
skin rashes
dec absorption of vitamins
mineral oil class
emollient
mineral oil moa
lubricates intestines
mineral oil indications
fecal impaction
mineral oil route
PO, PR
mineral oil se
- skin rashes
- dec absorption of vitamins
glycerin
lactulose
polyethylene glycol class
hyperosmotic
glycerin
lactulose
polyethylene glycol MOA
increase water content in feces
promote distention, peristalsis, evacuation
glycerin
lactulose
polyethylene glycol indications
evacuate bowels before diagnostics and surgical procedures
glycerin
lactulose
polyethylene glycol se
abdominal bloating
rectal irritation
electrolyte imbalance
magnesium salts and sodium salts class
saline laxatives
magnesium salts and sodium salts moa
increase osmotic pressure and draw water into colon
magnesium salts and sodium salts se
mag toxicity
electrolyte imbalance
cramping
diarrhea
magnesium salts and sodium salts nc
contraindicated for ppl with renal problems bc already having difficulty excreting K
bisacodyl and senna class
stimulant laxatives
bisacodyl and senna moa
inc peristalsis
bisacodyl and senna indications
constipation
whole bowel evacuation
bisacodyl and senna se
- nutrient malabsorption
- gastric irritation
- electrolyte imbalance
bisacodyl and senna nc
- OTC
- can become dependent on
- works on entire GI tract
- bi: PO
- senna: PO, PR
