Laxatives

Question 1

What are the bad things about laxatives?

Answer 1

Can cause electrolyte imbalance
Impaired drug absorption
Dependency

Question 2

Senna is a stimulant/irritant and its ised w/ docusate containing stool softener for the tx of _______ induced constipation.

Answer 2

Opioid induced

Question 3

Senna is given _______ (ROA) and causes evacuation in 6-12 hrs

Answer 3

Orally

Question 4

Bisacodyl
MOA?
ROA?

Answer 4

MOA = stimulates nerve fibers in colon mucosa
ROA = suppository & enteric coated tablets

Question 5

Castor oil shouldn’t be used in pregnant women because?

Answer 5

It may cause uterine contractions

Question 6

Why is castor oil not recommended?

Answer 6

Poor palatability

GI adverse effects

Question 7

What is the mechanism of action of bulk laxatives?

Answer 7

Form gells in the intestine that attract water (cause water retention)

Question 8

When are bulk laxatives not used?

Answer 8

In immobile patients (risk of intestinal obstruction)

In people with gut ulceration

Question 9

When are bulk laxatives used?

Answer 9

For tx of chronic constipation

Irritable bowel syndrome

Question 10

What are some conditions when taking bulk laxatives?

Answer 10

Generous water intake
Straining at stool has to be avoided
If taking any drugs, 2 hour gap is need

Question 11

What are the names of bulk laxatives?

Answer 11

Psyllium
Methyl cellulose
Bran
Seed

Question 12

What are the adverse effects of bulk laxatives?

Answer 12

Bloating

Flatulence

Question 13

What are the adverse effects of stimulants?

Answer 13

If used chronically, cathartic colon develops (colonic distention)

Question 14

What are the types of osmotic laxatives?

Answer 14

Salt free

Salt containing

Question 15

What is the advantage of salt free osmotic laxatives?

Answer 15

Less cramping and gas (PEG powder w/o electrolytes)

Question 16

What are the salt containing osmotic laxatives? And MOA?

Answer 16

Mg hydroxide
Mg citrate
MOA = Hold water in intestine by osmosis

Question 17

What are the uses of polyethylene glycol?

Answer 17

To prepare the bowel for colonic lavage

Question 18

What is the MOA of lactulose?

Answer 18

Lactulose goes in colon undigested and there the bacteria ferment them into lactic, formic and acetic acid and increasing osmotic pressure

Question 19

For what other reason lactulose is used?

Answer 19

Hepatic encephalopathy (because it can reduce ammonia levels)

Question 20

Stool softener or emollient laxatives are used for _________ (treating/prophylaxis of) constipation

Answer 20

Prophylaxis (because it may take days to become effective)

Question 21

Stool softener like docusate should not be used w/ __________ bcz of potential for absorption

Answer 21

Mineral oil

Question 22

Laxatives are stool softener also called __________ (aperients/cathartics)

Answer 22

Aperients

Question 23

Purgatives increase peristaltic activity and are also called ________ (aperients/cathartics)

Answer 23

Cathartics

Question 24

What is the moa of stool softeners?

Answer 24

It emulsifies w/ the stool produce softer stools

Question 25

What are some lubricant laxatives?

Answer 25

Mineral oil | Glycerin suppositories

Question 26

Mineral oil should be taken orally in _______ (position) to avoid it aspiration and potential for lipids or lipoid pneumonia

Answer 26

Sitting upright

Question 27

What is the adverse effect of mineral oil?

Answer 27

Leakage of oil can cause irritation of the anus

Question 28

Lubiprostone is a chloride channel activator and it’s used for the tx of?

Answer 28

Chronic constipation | Irritable bowel syndrome constipation

Question 29

How does lubiprostone work?

Answer 29

Activate chloride channels in the intestine and increase fluid secretion

Question 30

What are the advantages of lubiprostone

Answer 30

No drug dependency Minimal drud drug interactions Little change in electrolyte imbalance

Question 31

Why are the drug drug interaction minimal for lubiprostone

Answer 31

Its metabolism occurs quickly in stomach and jejunum

Question 32

Lubiprostone is indicated in ______ w/ IBS-C

Answer 32

Women

Question 33

Adverse effects of lubiprostone

Answer 33

N/V/dyspepsia Headache Dizziness/ hypotenstion