GI - Constipation, Diarrhea, N/V Flashcards
Laxatives are used prophylactically for
- bedridden (immobile, drugs, gravity)
- have neuro issues
- before/after surgery
- before diagnostic
Types of Laxatives
1 bulk-forming
2 surfactant lax
3 stimulant lax
4 osmotic lax
bulk-forming lax
drug name + MOA
psyllium husk (Metamucil)
-contains fiber, absorbs water
*bulk-forming lax
RN/teaching
- need to drink water (8ox+++)
- slow acting
- for chronic conditions
surfactant lax
drug name + MOA
docusate sodium
““stool softener””
-lowers surface tension so water + fats can penetrate
-made defecation more comf
stimulant lax
drug + MOA
bisacodyl, senna, DSS (ducolax)
incr peristalsis by irritating bowel mucosa
stimulant lax
RN/teaching
- watch for hypokalemia
* no milk w/in 1 hr of bisacodyl (can cause burning sensation)
osmotic lax/lactulose
drug + MOA
Mg hydroxide, Mag citrate, Na Phosphate
- draws water into mass of stool, stretched muscles, incr peristalsis
- strongest
osmotic lax / lactulose
indication
- bowel prep,
- PEG
- lactulose
- sorbitol
- ion exchange resins - kayexalate
Pro-Kinetics
drug
metoclopramide
—dopamine antagonist
metoclopramide (pro kinetic)
MOA
augments action of ACH
—causes incr in upper GI motility
metoclopramide (pro kinetic)
CI
- GI obstruction/perforation
- hx of seizure
- ETOH
- pheochomocytoma
- parkinson’s
metoclopramide (pro kinetic)
indications
- diabetic gastroparesis
- constipation
- manage GERD
- emesis
metoclopramide (pro kinetic)
A/E
- tardive dysknesia
- EPS
- NMS
- sedation
- diarrhea
- low BP
- anti Ach effects
metoclopramide (pro kinetic)
interactions
digoxin
metoclopramide (pro kinetic)
admin
PRN IVP
metoclopramide (pro kinetic)
RN/teaching
- type of anti-emetic
- singultus (incr tone of LES)
Antidiarrheals
drugs
1 diphenoxylate + atropine (opioid)
2 loperamide
diphenoxylate + atropine
MOA
-activates opioid receptors in colon to induce constipation
diphenoxylate + atropine
CI
- electrolyte imbalance
- dehydration
- blood
- infection
diphenoxylate + atropine
indications
reduce sympt of diarrhea (freq + fluid content)
diphenoxylate + atropine
A/E
atropine added so patients don’t take high doses of this drug
diphenoxylate + atropine
interactions
ETOH + other CNS depressants
diphenoxylate + atropine
admin
PO
-if no result in 36-48 hrs then see Dr
diphenoxylate + atropine
RN/teaching
- schedule 5 substance
- monitor dehydration
- avoid ETOH, caffeine, rehydrating w plain water
loperamide
MOA
analog of meperidine (an opioid) but loperamide IS NOT A CONTROLLED SUBSTANCE
loperamide
CI
- UC
- bloody stools
- if diarrhea w high fever
- diarrhea caused by ABX
loperamide
indications
diarrhea
- often used to reduce amt of stools in people w ileostomy
- often to keep the stoma clean + healthy
loperamide
A/E
QT prolonation
SJS (stevens johnsons syndrm)
loperamide
RN/teaching
dehydration (DONT DRINK TONIC WATER or GRAPEFRUIT JUICE - it 4x the concentration in the blood! Report rash)
anti-emetics
1 serotonin antagonist (ondansetron)
—-has aspartame (CI in PKU), AE prolonged QT
2 anticholinergic med (scopolamine)
—-AE obv anti-ACH > always watch BPH/glaucoma
scopolamine vs ondansetron
O=chemo
S=motion sickness
