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Drugs > GI - Laxatives > Flashcards

GI - Laxatives Flashcards

1
Q

Bulk-forming Laxatives

Brand/Generic

A

Brand: Metamucil, Citrucel, FiberCon

Generic: Methylcellulose, psyllium, calcium polycarbophil

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2
Q

Bulk-forming Laxatives Indication

A

Short term therapy for patients on low-fiber diets, postpartum women, older adults and patinets with colostomies, IBS, diverticulosis.

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3
Q

Bulk-forming Laxatives Special Populations

A

Diabetes, carb, or calorie restrictions: sugar-free agent

Phenylketonuria - avoid sugar-free products

Hypercalcemia - avoid calcium carbophyl

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4
Q

Bulk-forming Laxatives Time to Effect/Length of Therapy

A

Time to Effect: 12- 24 hours, maybe up to 72 hours

Length of Therapy ?

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5
Q

Bulk-forming Laxatives Common Side Effects

A

Abdominal cramping, flatulence (may be due to exceeding recommended dose

May swell in throat if not taken with enough liquid

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6
Q

Bulk-forming Laxatives Serious Side Effects and Precautions/Warnings

A

Bronchospam, anaphylaxis

Seek medical attention: chest pain, vomiting, difficulty swallowing/breathing

DDI: decrease absorption of digoxin, anticoagulants, salycilate - sep. dose by 2 hrs

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7
Q

Bulk-forming Laxatives Contraindications

A

Avoid in pts with swallowing difficulties, esophageal strictures, fluid restricted, intestinal obstruction, intestinal ulceration, stenosis, disabling adhesions

Younger than 6 y/o - no methylcellulose, calcium polycarbophil

Younger than 12 y/o - no psyllium

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8
Q

Bulk-forming Laxatives Administration

A
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9
Q

Hyperosmotic Laxatives Brand/Generic

A

Brand: Miralax, Pedia-Lax

Generic: PEG 3350, glycerin

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10
Q

Hyperosmotic Laxatives MOA

A

Large, poorly absorbed ions or moleculs that draw water into the colon or rectum through osmosis to stimulate bowel movement

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11
Q

Hyperosmotic Laxatives Common Indications

A

Constipation

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12
Q

Hyperosmotic Laxatives Administration

A

Mix 1 capful or 1 packet of liquid

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13
Q

Hyperosmotic Laxatives Time to Effect/Length of Therapy

A

PEG 3350: 12-72 hours, may be up to 96 hours

Glycerin suppositories: 15-30 minutes

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14
Q

Hyperosmotic Laxatives Common Side Effects

A

PEG 3350: bloating, abdominal discomfort, cramping, flatulence

Glycerin: rectal irritaiton with overdosage

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15
Q

Hyperosmotic Laxatives Contraindications

A

IBS

Renal disease (unless under supervision)

PEG3350 - no if <17 y/o (except w/ PCP supervision)

Glycerin - no if <6 y/o (except w/ PCP supervision)

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16
Q

Emollient Laxatives Brand/Generic

A

Brand - Colace

Generic - Docusate

17
Q

Emollient Laxatives Common Indications

A

Constipation

18
Q

Emollient Laxatives MOA

A

Anionic surfactants that act in small and large intestine to increase the wetting efficiency of intestinal fluid, facilitating a mixture of aqueius and fattty sibstance to soften the fecal mass

19
Q

Emollient Laxatives Time to Effect/Length of Therapy

A

Time to Effect - 12-72 hours, may take up to 3-5 days

Poor evidence for efficacy:

100 mg BID ineffetive

240 mg qd increase BMs by 1/week in one study

Another study found 240 mg qd ineffective

20
Q

Emollient Laxatives Common Side Effects

A

Larger than recommended doses may result in weakness, sweating, muscle cramps, arrhythmia

21
Q

Emollient Laxatives Contraindications

A

Docusate Sodium - no age restriction

Docusate calcium - no if <12 y/o (unless under PCP supervision)

DDI: enhances absorption of mineral oil

22
Q

Lubricant Laxatives Brand/Generic

A

Mineral oil

23
Q

Lubricant Laxatives MOA

A

Softens fecal contents by coating the stool and preventing colonic absorption of fecal water

24
Q

Lubricant Laxatives Time to Effect/ Length of Therapy

A

Oral: 6-8 hours

Rectal: 5-15 minutes

25
Q

Lubricant Laxatives Common Side Effects

A

Abdominal cramps, diarrhea, nausea, oily rectal leakage, vomiting, hemorrhoids (large doses)

26
Q

Lubricant Laxatives Serious Side Effects and Precautions/Warnings

A

Lipid pneumonia following aspiration

Repeated and prolonged dosing: droplets may reach the mesenteric lymph nodes, intestinal mucosa, liver and spleen and cause foreign body reaction

DDI: decreases absorption of vitamins A, D, E, K

increases absorption of mineral oil

27
Q

Lubricant Laxatives Contraindications

A

Risk for aspiration

<6 y/o

Pregnant women

Bedridden adults

Older adults

Difficulty swallowing

28
Q
A

Drugs (5 decks)

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