LAXITVES/consipation

Question 1

MEDICATION that can cause on consipation

Answer 1

Opioids
Drugs with anticholinergic effects (eg oxybutynin, tricyclic antidepressants)
5-HT3–receptor antagonists (eg ondansetron)
Aluminium- and calcium-containing antacids
Oral calcium supplements
Oral iron supplements
Verapamil

Question 2

other factors that can cause constipation

Answer 2

Medications
Inadequate dietary fibre
Dehydration

Inappropriate bowel habits (eg ignoring the urge to defecate)

Inadequate physical activity (eg from decreased mobility)
Change in environment (eg holiday, entry into residential aged-care facility)

Painful anorectal disorders (eg haemorrhoids, anal fissures)

Loss of muscle power caused by other medical conditions (eg chronic obstructive pulmonary disease)

Question 3

list the fucntion of osmotic laxetives

Answer 3

medications that draw water into the stool, resulting in softer stools and more frequent, easier to pass bowel movements.

Question 4

Constipation medications

Answer 4

1. Bulk forming
2. Stool softeners

Question 5

Bulk forming and stool softeners examples

Answer 5

Bulk forming:
Examples:
- Metamucil
- Psyllium
Mechanism of action:
- Absorb water in the colon, adding bulk, encouraging bowel movement
Adverse effects:
- Flatulence
- Bloating
Contraindications:
- Bowel obstruction, partial or complete

Stool softener:
Examples:
- Docusate (sometimes combined with senna, a laxative)
Mechanism of action:
- Mixes water with faeces
Adverse effects:
- Generally well tolerated, but sometimes results in nausea, vomiting, diarrhoea, abdominal cramps

Question 6

Stimulant laxatives
examples

Answer 6

Examples:
- Senna
- Bisocodyl

Mechanism of action:
- Stimulate the gastric mucosa nerve endings to increase intestinal motility.
Adverse effects:
- Diarrhoea
- Electrolyte and fluid imbalances with prolonged use

Contrainidications:
- Inflammatory bowel conditions
- Acute abdominal conditions (appendicitus)
- Intestinal obstructions
Pregnancy - okay occasionally
Breastfeeding - safe to use**

Question 7

Stepwise approach for constipation management

Answer 7

1. bulk forming
2. osmotic laxatives or stool softeners
3. stimulant laxatives if insufficient bowel motility

Question 8

treatment of Diarrhoea

Answer 8

1. Oral rehydration salts (first line)
2. Antidiarrhoeals (short course may be warranted in adults)
3. Opioid antidiarrhoeals (e.g. loperamide)
4. Bulk forming laxatives (e.g. metamucil and psyllium) - due to their fluid absorption capacities

Question 9

senna vs docusate

Answer 9

Question 10

osmotic laxetives

Answer 10