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GI Fitzy > Laxatives and cathartics > Flashcards

Laxatives and cathartics Flashcards

1
Q

What are examples of stool softeners?

A

Docusate

Mineral oil

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2
Q

What is the MoA of docusate?

A

Surfactant –> allows mixing of aqueous and fatty substances

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3
Q

What is the MoA of mineral oil?

A

Lubricates feces –> decreased water absorption from stool

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4
Q

What are the side effects of mineral oil?

A

Severe lipid pneumonitis if aspirated

Fat-soluble vitamin deficiency

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5
Q

What are examples of bulk laxatives?

A

Dietary fiber
Methycellulose
Psyllium

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6
Q

What is the MoA of bulk laxatives?

A

Increase mass of stool –> distension –> enteric reflex –> increased GI motility

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7
Q

What is required for bulk laxatives to be effective?

A

Functional enteric plexus

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8
Q

Can bulk laxatives be used if the constipation is of unknown origin?

A

No

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9
Q

What are the stimulant (contact) cathartics?

A

Anthraquinone derivatives
Bisacodyl
Castor oil

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10
Q

What are examples of anthraquinone derivatives?

A

Cascara sagrada
Danthron
Senna

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11
Q

Where do anthraquinone derivatives work?

A

Only the large intestine

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12
Q

What are the side effects of anthraquinone derivatives?

A

Dependence

Brown pigmentation of colonic mucosa**

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13
Q

Is bisacodyl commonly used?

A

No…cardiac toxicity

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14
Q

If bisacodyl was used, where would it work?

A

Only the large intestine

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15
Q

What is castor oil converted to to become activated?

A

Ricinoleic acid

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16
Q

Where is castor oil effective?

A

Small AND large intestine

17
Q

What are some pharmacokinetics of castor oil?

A

Short latency

Very potent

18
Q

What are some side effects of castor oil?

A

Dependence

Dehydration with electrolyte imbalance

19
Q

What are examples of osmotic (saline) cathartics?

A

Lactulose
Magnesium hydroxide
Sodium phosphate
Polyethylene glycol solution

20
Q

Why shouldn’t magnesium hydroxide be used to treat constipation in renal insufficient patients?

A

Hypermagnesemia and death

21
Q

How can polyethylene glycol solution be used to treat constipation?

A

Hasten removal of toxins and reduce absorption

Whole body irrigation –> enhanced decontamination

22
Q

When is polyethylene glycol solution commonly used?

A

Before endoscopic procedures

23
Q

What is the MoA of osmotic cathartics?

A

Increase water and electrolyte concentrations in colon via osmosis

24
Q

What can lactulose be used for?

A

Reduces plasma ammonia concentrations

Treating portal-systemic encephalopathy

25
Q

What are some side effects of the saline cathartics?

A

Drug interactions

Intravascular volume depletion and electrolyte imbalances

26
Q

Who should be watched when treating with osmotic cathartics?

A

Old frail people with renal or cardiac disease

27
Q

What is the MoA of lubiprostone?

A

Activates Cl- channel –> increases liquid secretion (only effects channels on apical membranes of GI epithelial cells)

28
Q

What was lubiprostone developed to be?

A

A prokinetic drug…they’re still working on it

29
Q

What is lubiprostone used to treat?

A

Chronic, idiopathic constipation

Constipation-predominant IBS

30
Q

What are some side effects of lubiprostone?

A

Diarrhea
Delayed gastric emptying –> nausea/headache
Increased fetal loss…DON’T give to pregos

31
Q

What are examples of opioid receptor agonists used to treat constipation?

A

Alvimopan

Methylnaltrexone

32
Q

When is alvimopan used?

A

Short term…like if there is a postoperative ileum following small or large bowel resection

33
Q

What are the side effects of alvimopan?

A

Cardiotoxicity…which is why it used short term

34
Q

When is methylnaltrexone used?

A

Long term…like in palliative care

35
Q

What is the MoA of opioid receptor agonists treating constipation?

A

Selective u receptor agonists

Don’t cross BBB

GI Fitzy (6 decks)

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