LAXATIVES And Antidiarrhes Drugs

Question 1

Laxatives are commonly used in the treatment of constipation to (3)

Answer 1

to accelerate the motility of the bowel,
soften the stool,
and increase the frequency of bowel movements.

Question 2

—They may cause electrolyte imbalances when used chronically.

Answer 2

No answer here

Question 3

—Constipation is not a disease but a symptom of an underlying disease or problem like

Answer 3

—Disorders of the GI tract (e.g., irritable bowel syndrome or diverticulitis)
—metabolic disorders (e.g., diabetes) or
—endocrine disorders (e.g., hypothyroidism)may cause constipation.
—Pregnancy

Question 4

Constipation commonly results from

Answer 4

diet low in fiber

from use of constipating drugs such as opiates

Question 5

life style change in constipation

Answer 5

—Avoid refined food (eat whole grains)
—Vegetables & fruits
—Exercise regularly (walking)
—Toilet habits

Question 6

Classification of laxatives (5)

Answer 6

—1Stimulant laxatives 
—2Bulk laxatives 
—3Osmotic laxatives 
—4Stool softeners (emollient laxatives or surfactants) 
—5Chloride channel activators

Question 7

STIMULANT LAXATIVES mechanism

Answer 7

They increase intestinal motility by various mechanisms

Question 8

STIMULANT LAXATIVES adverse effects

Answer 8

They may cause abdominal cramps

Question 9

STIMULANT LAXATIVES and pregnancy

Answer 9

—Should used only with caution in pregnancy, and never where intestinal obstruction is suspected.

Question 10

STIMULANT LAXATIVES are 4

Answer 10

Bisacodyl
Sodium picosulphate
Senna
Caster oil

Question 11

Bisacodyl mechanism

Answer 11

stimulates sensory endings in the colon by direct action from the lumen.

Question 12

Sodium picosulphate

Answer 12

is similar and is also used to evacuate the bowel for investigative procedures and surgery.

Question 13

Castor oil mechanism

Answer 13

promptly increases peristalsis. (not used now)

Question 14

Castor oil kinetic

Answer 14

broken down in the small intestine to ricinoleic acid, which is very irritating to the stomach

Question 15

Castor oil and pregnancy

Answer 15

Pregnant patients should avoid castor oil because it may stimulate uterine contractions.

Question 16

STOOL BULKING AGENTS mechanism

Answer 16

which add fibre to the diet, are the treatment of choice for simple constipation.

Question 17

The bulk laxatives include

Answer 17

hydrophilic colloids
methylcellulose
psyllium seeds
bran
Psyllium

Question 18

hydrophilic colloids origin

Answer 18

From indigestible parts of fruits and vegetables

Question 19

hydrophilic colloids mechanism

Answer 19

They form gels in the large intestine, causing water retention and intestinal distension, thereby increasing peristaltic activity.

Question 20

bulk laxatives Caution in

Answer 20

in immobile patients (because it may cause intestinal obstruction)
They should be taken with liberal quantities of fluid (at least 2 litres daily).

Question 21

Psyllium interaction

Answer 21

reduce the absorption of other oral drugs,

Question 22

OSMOTIC LAXATIVES include (3)

Answer 22

Some inorganic salts
Lactulose
Polyethylene glycol (PEG)

Question 23

Some inorganic salts (Saline cathartics) mechanism

Answer 23

are nonabsorbable salts (anions and cations) that retain water in the intestinal lumen by osmosis.

Question 24

Lactulose is

Answer 24

is a semisynthetic disaccharide sugar.

Question 25

Polyethylene glycol (PEG) used for

Answer 25

Solutions that contain electrolytes are used for colonic lavage to prepare gut for radiologic or endoscopic procedures.

Question 26

PEG powder for solution without electrolytes is used as a laxative and it causes less cramping and gas than other laxatives.

Answer 26

No answer here

Question 27

Stool softeners (emollient laxatives or surfactants) mechanism

Answer 27

Surface-active agents that become emulsified with the stool produce softer feces and ease stool passage. —They may take days to become effective

Question 28

Stool softeners include

Answer 28

docusate sodium, docusate calcium, and docusate potassium.

Question 29

Stool softeners are used for

Answer 29

used for prophylaxis rather than acute treatment.

Question 30

Stool softeners contraindicated with

Answer 30

Stool softeners should not be taken concomitantly with mineral oil because of the potential for absorption of the mineral oil.

Question 31

—Liquid paraffin is a chemically inert mineral oil and is not digested. —Paraffin taken orally over long periods, especially at night, may be aspirated and cause chronic lipoid pneumonia. —Because of these disadvantages its use is declining and it should never be used long term as a laxative.

Answer 31

No answer here

Question 32

Chloride channel activators include

Answer 32

Lubiprostone

Question 33

Lubiprostone mechanism

Answer 33

works by activating chloride channels to increase fluid secretion in the intestinal lumen.

Question 34

Lubiprostone used for

Answer 34

is used in the treatment of chronic constipation and irritable bowel syndrome with constipation (IBS-C),because no tolerance or dependency have been shown with this drug.

Question 34

Lubiprostone used for

Answer 34

is used in the treatment of chronic constipation and irritable bowel syndrome with constipation (IBS-C),because no tolerance or dependency have been shown with this drug.

Question 35

common side effect with lubiprostone.

Answer 35

Nausea

Question 36

Diarrhea mechanism (2)

Answer 36

Increased motility of the gastrointestinal tract and decreased absorption of fluid are major factors in diarrhea.

Question 37

ANTIDIARRHEALS include (3)

Answer 37

antimotility agents adsorbents modify fluid and electrolyte transport

Question 38

Antimotility agents include

Answer 38

Diphenoxylate and loperamide.

Question 39

Antimotility agents mechanism

Answer 39

They activate presynaptic opioid receptors in the enteric nervous system to inhibit acetylcholine release and decrease peristalsis.

Question 40

Antimotility agents contraindicated in

Answer 40

young children or in patients with severe colitis (can cause toxic megacolon)

Question 41

Agents that modify fluid and electrolyte transport include

Answer 41

Bismuth subsalicylate

Question 42

Bismuth subsalicylate used for

Answer 42

traveler’s diarrhea, decreases fluid secretion in the bowel.

Question 43

Bismuth subsalicylate side effects

Answer 43

They may cause black tongue and black stools.

Question 44

Adsorbents include

Answer 44

aluminum hydroxide and methylcellulose

Question 45

Adsorbents mechanism

Answer 45

by adsorbing intestinal toxins or microorganisms and/or by coating or protecting the intestinal mucosa.