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Oral Medications > Lower GIT medications > Flashcards

Lower GIT medications Flashcards

1
Q

Lower GIT includes:

A
  • large intestine
  • small intestine
  • rectum
  • anus
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2
Q

Disorders affecting the Lower GIT are:

A
  • diarrhoea
  • constipation
    -diverticular disease
  • irritable bowel syndrome
    -irritable bowel disease
  • carcinoma
  • haemorrhoids
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3
Q

2 major types of of Lower GIT drugs:

A
  1. laxatives
  2. antidiarrhoeals
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4
Q

What are laxatives?

A
  • laxatives are used enable and ease elimination of constipation
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5
Q

There are different types of laxatives:

A
  • faecal softeners
  • bulk-forming (high fiber) agents
  • stimulants
  • Osmotics
  • lubricants /facael softeners
  • combination of stool softener and stimulant
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6
Q

Faecal softeners:

A
  • used to treat acute constipation and to prevent straining
  • examples - Coloyxl, Docusate
    Nursing considerations
  • may cause mild cramping or diarrhoea
  • should not be used with other laxatives -
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7
Q

Bulk forming agents:

A
  • safest form
  • high fibre
  • absorbs water and increase volume, bulk and moisture
  • examples - Psyllium hydrophilic muciloid (Metamucil
    Nursing considerations:
  • must be followed with a large amount of fluid
  • may cause abdominal cramps and diarrhoea
  • nausea and vomiting
    -prevents calcium absorption
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8
Q

Stimulants (irritant laxatives):

A
  • increase peristalsis
  • stimulation of colon nerves (senna)
  • stimulation of sensory nerves in intestinal mucosa (durolox)
  • stimulation of smooth muscle and inhibition of water and electrolyte reabsorption (castor oil)
  • useful in neuromuscular disease/spinal disorders
  • used in preparation for surgery
    Nursing considerations:
  • not recommended for regular use
  • oral preparations act between 6-12 hours
  • suppositories and enemas work more quickly
  • may cause rebound constipation as the intestines adapt to being strongly stimulated
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9
Q

Osmotic laxatives:

A

3 groups of osmotic laxatives:
- non absorbable inorganic salts (Epsom salts)
- non absorbable sugars (lactulose, glycerol, sorbitol, duphalac)
- polyethylene glycol (colonlytely)
Nursing considerations:
- ensure adequate water is consumed
- contraindicated in intestinal obstruction
- non absorbable salts can cause bowel movement 3-4 hours post ingestion
- non absorbable sugars needs to be monitored with patients with diabetes
- polyethylene glycol used to completely evacuate bowel prior to surgery or colonoscopy

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10
Q

Lubricants/faecal softeners:

A
  • creates a barrier between the faeces and the colon wall
  • prevents reabsorption of faecal fluid to soften stool
  • coats surface of faeces facilitating elimination
  • used where straining should be avoided
  • example - liquid paraffin
    Nursing considerations:
  • may produce abdominal cramps, vomiting, decreased absorption of nutrients
  • may cause leakage and seepage from rectum
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11
Q

Antidiarrhoeals is:

A
  • diarrhoea may be defined as an increase in volume, fluidity or frequency of bowel movements relative to the usual pattern for that individual
  • causes include - infectious agents, toxins, drugs anxiety, chronic diseases
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12
Q

Managment of diarrhoea:

A
  • determine the cause - stool sample
  • prevent treat fluid and electrolyte imbalances
  • prevent dehydration
  • all antidiarrhoeals are given orally
  • diet restricted to clear liquids for 24 hours
  • food gradually added as tolerated -
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13
Q

2 main groups of antidiarrhoeals:

A
  • Absorbents
  • Opioid antidiarrhoeals
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14
Q

Absorbents are:

A
  • most commonly used
  • clay-like materials administered in tablet or liquid suspension form after each loose bowel movements
  • eliminated through stool
  • Example - Kaolin-pectin
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15
Q

Opioid antidiarrhoeals are:

A
  • narcotic based OTC opioids
  • activate opioid receptors in gut wall - reduction of secretions and suppressed GIT motility slowing passage of intestinal contents
  • can also be used to decrease volume of discharge in patients with colostomies
  • examples - Loperamide (Imodium), Diphenoxylate, Codeine
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16
Q

Opioid antidiarrhoeals nursing considerations:

A
  • short term treatment of diarrhoea
  • adverse reactions are minimal
  • all antidiarrhoeals are given orally
  • diet changes are part of treatment plan - clear fluids
17
Q

Other lower GIT Medications include:

A
  • Antispasmodics
  • 5-Aminosalycyclates (5-ASA)
  • Corticosteroids
  • Immunosuppressants
  • Antiflatulents
  • Anorectal preparations
18
Q

Antispasmodics are:

A

-used to treat:
- irritable colon
- hypermotility
- biliary colic

  • relieves cramps and spasms
  • Examples - Hyoscine, peppermint oil capsules, belladonna
  • side effects may include dizziness, drowsiness, dry mouth, nausea, and bloating
19
Q

5-Aminosalycyclates (5-ASA) are:

A
  • used to treat - inflammatory bowel disease - ulcerative colitis and Crohn’s disease
  • consists of sulfasalazine, olsalazine, balasalazide, and mesalazine
  • adverse effects include - unexplained bleeding and bruising, itchy skin rash, difficulties breathing, sore throat, change of colour of tears and urine.
  • plenty of water should be drunk while taking 5-ASA medications
20
Q

Corticosteroids are:

A
  • used to treat inflammatory bowel disease
  • two most commonly drugs used are
  • Prednisolone - Suppository and retention enema
  • Budesonide - enteric coated tablet
21
Q

Immunosuppressants are:

A
  • also used to treat inflammatory bowel disease
  • examples - Azathioprine, Mercaptopurine and Methotrexate
22
Q

Antiflatulents are:

A
  • used to treat bloating; flatulence and post operative gas pains, chronic air swallowing; functional dyspepsia
  • may be used together with antacid therapy
  • breaks down mucous surrounding gas bubbles allowing all bubbles to come together
  • examples- Simethicone, Charcoal
23
Q

Anorectal preparations are:

A
  • used for symptomatic relief of haemorrhoids
  • adverse reactions - sensitisation to the product
  • examples - Dibucaine, Hydrocortisone acetate. Zinc sulfate monohydrate, Hydrocortisone foam

Oral Medications (13 decks)

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