Laxatives

Question 1

Examples of bulk forming laxatives

Answer 1

Ispagula husk (Fibogel)
Methylcellulose (Celevac)

Question 2

MOA of bulk forming laxatives

Answer 2

Bulk out the stool with fibre
Increasing faecal mass and stimulating peristalsis

Question 3

Onset of action of bulk forming laxatives

Answer 3

72 hours

Question 4

What advice should be given to patients taking bulk forming laxatives

Answer 4

Increase fluid intake

Question 5

Give some examples of osmotic laxatives

Answer 5

Lactulose
Macrogols (Movicol and Laxido)

Question 6

MOA of osmotic laxatives

Answer 6

Draw water via osmosis into the stool making it softer and easier to pass

Question 7

Examples of stimulant laxatives

Answer 7

Senna (Senokot)
Bisacodyl (Ducolax)
Sodium picosulfate

Question 8

MOA of stimulant laxatives

Answer 8

Stimulate the nerves of the digestive tract to cause peristalsis

Question 9

Examples of stool softening laxatives

Answer 9

Docusate

Question 10

Treatment of short term constipation

Answer 10

1. Bulk forming laxative
2. Osmotic
3. Stimulant

BOS

Question 11

Treatment of opioid induced constipation

Answer 11

1. Osmotic and stimulant laxative
2. Add softener laxative

Not really going to be helped by a bulk so makes sense to skip it

Question 12

Faecal impaction treatment

Answer 12

Consider oral macrogol or oral stimulant
If inadequate response to oral laxatives consider rectal administration of bisacodyl/glycerol

Question 13

Treatment of chronic constipation

Answer 13

1. Bulk
2. Add in or switch to osmotic
3. Stimulant