IBS Flashcards
When do you take bulk-forming laxatives?
At mealtime with a full glass of water
Lubiprostone (class)
laxative
Lubiprostone (mechanism)
chloride channel activator, increases fluid in the intestines to promote bowel elimination
** take with food and water**
Linaclotide (class)
laxative
Linaclotide (mechanism)
stimulates receptors in the intestines to promote bowel transit time
take daily 30 min before breakfast
Docusate (Classification)
Laxative, emollient; stool soft
Docusate (Mechanism of Action)
Increases water, fat penetration in intestine; allows for easier passage of stool
Docusate (Colace)
Nursing Considerations
ASSESS:
- CAUSE OF CONSTIPATION; identify whether fluids, bulk, or exercise missing from lifestyle; constipating products
- Cramping, rectal bleeding, nausea, vomiting; if these occur, product should be discontinued
Lactulose
Classification
Laxative; ammonia detoxicant (hyperosmotic)
Lactulose
Mechanism of Action
Prevents absorption of ammonia in colon by acidifying stool; increases water, softens stool
Lactulose
Uses
Chronic constipation, portal-systemic encephalopathy in patients with hepatic disease
Loperamide (Imodium)
Functional Classification
Antidiarrheal
Loperamide (Imodium)
Mechanism of Action
Direct action on intestinal muscles to decrease GI peristalsis; reduces volume, increases bulk; electrolytes not lost
Psyllium
Functional Classification
Bulk laxative
Psyllium
Uses
Chronic constipation, ulcerative colitis
Psyllium
Side Effects
GI: Nausea, Vomiting, Anorexia, Diarrhea, cramps, intestinal esophageal blockage
Alosetron (class)
antidiarrheal; SSRI antagonist
Alosetron (adverse effects)
-constipation, impaction, bowel obstruction, perforation of the bowel, ischemic colitis
Bulk-forming laxatives (general mechanism)
absorb water into feces and increase bulk to produce large and soft stools
Bulk-forming laxatives (nursing considerations)
- contraindicated in bowel obstruction**
- dependency LT use
- increase fluid intake to prevent dehydration
Laxatives - Stimulants
Stimulate motility of the large intestine
Laxatives - Emoillients
inhibits the absorption of water so fecal mass is soft and large
used to avoid straining
Laxatives - osmotics
attract water to large intestine to produce bulk and stimulate peristalsis
Diarrhea Meds (nursing considerations)
- treat underlying cause, dehydration, fluid and lytes, abdo discomfort
opiods as antidiarrheal
- decrease intestinal motility and peristalsis
* *caution** opioids NOT used when poisons and toxins are causing diarrhea; makes it worse by delaying its elimination
