GI V: motility and inflammatory bowel disease Flashcards
Drugs used to relieve constipation
1st line–> Bulk laxatives (methylcellulose)
2nd line –> osmostic laxatives (Mg hydroxide, Sodium citrate)
3rd line –> Stimulant laxatives (Senna)
Osmotic laxatives Examples
Mg Sulfate
Mg hydroxide
Sodium citrate
Sodium Phosphate
Lactulose
Macrogols
MoA of Osmotic laxatives
Provides osmotic load to draw water into GI lumen –> traps increased volumes of fluid in the lumen of the bowel –> accelerate the transfer of the gut contents through the small intestine.
* Distension in colon and purgation within 1h
Clinical uses of Magensium sulfate/ Mg hydroxide
2nd line tx of constipation
they are Saline purgatives→ poorly absorbed
solutes. Mg absorbed is too small to have adverse effects
AE of Osmotic laxatives
1) Heart block,
2) neuromuscular block or CNS depression.
3) Abdominal cramps.
Contraindication of Osmotic laxatives
In Small kids and
poor renal function
Bulk laxatives Examples
Methylcellulose
Sterculia
Agar
Bran
Ispaghula husk
Psyllium
Clinical uses of Methylcellulose and Psyllium
1st line anti-constipation drugs
* May take a few days to work
* slow-acting
* Bulk laxatives
AE of Bulk laxatives
Bloating
* no serious AE
MoA of Bulk laxatives
soluble fibers that draw water into gut lumen, forming viscous liquid (bulky hydrated mass) that promotes peristalsis
Clinical uses of Lactulose
1) Relives constipation
2) tx of hepatic encephalopathy
AE of Lactulose
1) Flatulence (“passing wind”),
2) cramps,
3) diarrhoea,
4) electrolyte disturbance.
Stimulant laxatives examples
Bisacodyl
Glycerol
Senna
Dantron
*Great Bella Sees Delusions
MoA of Senna/ Bisacodyl
Enteric nerve stimulation –> colonic contraction (increases peristalsis)
* Stimulant laxatives
Clinical uses of Senna/ Bisacodyl
3rd line anti-constipation tx
* Stimulant laxatives