Laxatives, Cathartics, Anti-diarrheals and Enemas Flashcards
Before you administer a laxative what is the most important thing?
Need to determine underlying cause first
Often misused, results in dependence or bowel damage.
Laxatives
A. Absorb water & increase bulk in bowel
B. Stretch intestinal wall to stimulate peristalsis
C. Must mix with at least 1c. water or juice & swallow quickly or may cause obstruction. Follow with additional water
D. Can also be used to relieve mild diarrhea
Bulk forming laxative
High fiber, absorbs water to increase stool bulk. What are the names of products that cause this effect?
Citrucel, Metamucil, Fibercon
Docusate sodium, Colace, Correctol, Disonate, Docusate calcium-Surfak
What type of laxative is this?
Wetting Emollient
What is the only laxative that is able to be used long term?
Bulk Forming
A. Lower surface tension of feces, so more water & fat can penetrate.
B. Short term use to prevent straining after surgery, MI, pregnancy.
What type of laxative causes these effects?
What is a stool softeners and allows water and fat to penetrate?
Docusate potassium-Dialose
What are the names of laxatives that have an osmotic effect and increases pressure in bowel to act as a stimulant?
Milk of Magnesia, Sodium Phosphate, Magnesium citrate or citrate of magnesia;
A. ↑osmotic pressure in small intestine by inhibiting water absorption & ↑water & electrolyte secretions from bowel wall. Promotes peristalsis, lubricate feces.
B. Used for bowel prep before diagnostic procedure or surgery
C. Don’t use on renal pts. or those on fluid restriction
What type of laxative have these effects?
Saline
Agents increase intestinal mucosa to increase motility and agents decrease absorption in small bowel and colon. What are the names of cathartics products that cause this effect?
Bisacodyl-Dulcolax; castor oil; Casanthranol-peri-colace; Senna-ex-lax, Senokot;
A. Irritate intestinal mucosa to increase motility
B. Decrease absorption in small bowel & colon
What type of laxative has these effects?
Cathartics
A. May cause severe abdominal cramping
B. Generally used to prepare bowel for diagnostic procedures
C. Not for long-term use, may cause F&E imbalance
D. Not for use during pregnancy or lactation
Stimulant cathartics
A. agents that coat feces allowing easier passage of stool
B. agents reduce water absorption in colon
What are the names of laxatives products that cause this effect?
Mineral oil- Haley’s M-O; Petrogalar Plain;
A. Coat fecal contents allowing for easier passage
B. Reduce water absorption in colon
What type of laxative has these effects?
Lubricants
A. Prevent straining on defecation
B. Risk for decrease absorption of fat-soluble vitamins
C. May cause aspiration pneumonia
D. If taken w/ emollients or mineral oil, increases risk of fat emboli.
What type of laxative have these effects?
Lubricants
A. Treat underlying cause first.
A. Decreases intestinal muscle tone to slow passage of feces
What are the names of products that cause this effect?
Immodium – OTC
Lomotil (diphenoxylate) – opiate Rx.
Anti-Diarrheals
A. Opiates inhibit peristaltic waves, but increase segmental contractions to increase water absorption
What effect does this cause?
Anti-diarrheal
A. promote defecation by stimulating peristalsis. B. Cleansing: from the colon
What laxative is this called?
Enema
Hypotonic and exerts an osmotic pressure lower than fluid in interstitial spaces; do not repeat because water toxicity or circulatory overload develops if the body absorbs lg amounts of water. What kind of enema is this?
Tap Water Enema
Safest because it exerts the same osmotic pressure as fluids in interstitial spaces surrounding the bowel. Does not create danger of excess fluid absorption. What kind of enema is this?
Normal Saline Enema
Exerts osmotic pressure that pulls fluids out of interstitial spaces; the colon fills with water and the distention promotes defecation. commercially prepared; do not give to those that cannot tolerate lg volumes of fluid or hydrated pts. What kind of enema is this?
Hypertonic Solution Enema
Add soapsuds to tap water or saline to create the effect of intestinal irritation to stimulate peristalsis. use pure castile soap. What kind of enema is this?
Soapsuds Enema
Lubricate the rectum and colon for softer stool.
What kind of enema is this?
Oil Retention Enema
This enemas provide relief from gaseous distention to improve the ability to pass flatus
What kind of enema is this?
Carminative Enema
MGW solution which contains 30 mL of ________, 60 mL of _______ and 90 mL of ______
Medicated enemas contain _________.
Magnesium
Glycerin
Water
Drug
A. pts with impaction
B. used as a last resort
What kind of enema is this?
Digital Removal
vagus nerve will slow heart
rate and due to the complications a provider’s order is required high and low refer to the height from which and hence the pressure with which the fluid is delivered.
High enemas cleanse the entire colon; Low enemas cleanses only the rectum and sigmoid colon.
What kind of enema is this?
Digital Removal
