IBS

Question 1

When do you take bulk-forming laxatives?

Answer 1

At mealtime with a full glass of water

Question 2

Lubiprostone (class)

Answer 2

laxative

Question 3

Lubiprostone (mechanism)

Answer 3

chloride channel activator, increases fluid in the intestines to promote bowel elimination
** take with food and water**

Question 4

Linaclotide (class)

Answer 4

laxative

Question 5

Linaclotide (mechanism)

Answer 5

stimulates receptors in the intestines to promote bowel transit time
take daily 30 min before breakfast

Question 6

Docusate (Classification)

Answer 6

Laxative, emollient; stool soft

Question 7

Docusate (Mechanism of Action)

Answer 7

Increases water, fat penetration in intestine; allows for easier passage of stool

Question 8

Docusate (Colace)

Nursing Considerations

Answer 8

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

Question 9

Lactulose

Classification

Answer 9

Laxative; ammonia detoxicant (hyperosmotic)

Question 10

Lactulose

Mechanism of Action

Answer 10

Prevents absorption of ammonia in colon by acidifying stool; increases water, softens stool

Question 11

Lactulose

Uses

Answer 11

Chronic constipation, portal-systemic encephalopathy in patients with hepatic disease

Question 12

Loperamide (Imodium)

Functional Classification

Answer 12

Antidiarrheal

Question 13

Loperamide (Imodium)

Mechanism of Action

Answer 13

Direct action on intestinal muscles to decrease GI peristalsis; reduces volume, increases bulk; electrolytes not lost

Question 14

Psyllium

Functional Classification

Answer 14

Bulk laxative

Question 15

Psyllium

Uses

Answer 15

Chronic constipation, ulcerative colitis

Question 16

Psyllium

Side Effects

Answer 16

GI: Nausea, Vomiting, Anorexia, Diarrhea, cramps, intestinal esophageal blockage

Question 17

Alosetron (class)

Answer 17

antidiarrheal; SSRI antagonist

Question 18

Alosetron (adverse effects)

Answer 18

-constipation, impaction, bowel obstruction, perforation of the bowel, ischemic colitis

Question 19

Bulk-forming laxatives (general mechanism)

Answer 19

absorb water into feces and increase bulk to produce large and soft stools

Question 20

Bulk-forming laxatives (nursing considerations)

Answer 20

• contraindicated in bowel obstruction**
• dependency LT use
• increase fluid intake to prevent dehydration

Question 21

Laxatives - Stimulants

Answer 21

Stimulate motility of the large intestine

Question 22

Laxatives - Emoillients

Answer 22

inhibits the absorption of water so fecal mass is soft and large
used to avoid straining

Question 23

Laxatives - osmotics

Answer 23

attract water to large intestine to produce bulk and stimulate peristalsis

Question 24

Diarrhea Meds (nursing considerations)

Answer 24

• treat underlying cause, dehydration, fluid and lytes, abdo discomfort

Question 25

opiods as antidiarrheal

Answer 25

• decrease intestinal motility and peristalsis

* *caution** opioids NOT used when poisons and toxins are causing diarrhea; makes it worse by delaying its elimination