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Cassandra's Pharmacology > Module 4 Chapter 65 Laxatives > Flashcards

Module 4 Chapter 65 Laxatives Flashcards

1
Q

production of a soft, formed stool over a period of 1 or more days

A

laxative effect

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2
Q

prompt, fluid evacuation of the bowel

A

catharsis

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3
Q

hard stools, infrequent stools, excessive straining, prolonged effort, a sense of incomplete evacuation and unsuccessful defacation

A

constipation - determined more by stool consistency then by how often bowel movements occur

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4
Q

a common cause of constipation is

A

poor diet - specifically deficient in fiber and fluid

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5
Q

other causes of constipation include

A

pelvic floor dysfunction

anal sphincter dysfunction

slow intestinal transit

IBS

use of certain drugs (opioids, anticholinergics, antacids)

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6
Q

non-drug help for constipation

A

increase fiber (fruits and vegetables)

increase fluid

mild exercise - esp after meals

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7
Q

laxatives safe for infants

A

docusate
lactulose
glycerin suppositories

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8
Q

laxatives safe for children and adolescents

A 
milk of magnesia
mineral oil
senna
docusate
bisacodyl
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9
Q

laxatives safe in pregnancy

A

no! can induce labor

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10
Q

laxatives in breastfeeding

A

Senna is safe

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11
Q

older adults with laxatives

A

all can be used

monitor for dehydration

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12
Q

constipation is determined by

A 
stool consistency (degree of hardness)
not by how often BM occurs
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13
Q

reason for laxatives in cardiovascular disease

A

prevent dangerous elevation of BP

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14
Q

other uses for laxatives

A

adjunct to anthelmintic therapy (parasites) to get a fresh sample, facilitate export of dead parasites

emptying bowel before surgery and diagnostic procedures
modifying the effluent from an ileostomy and colonoscopy
prevent fecal impaction in bedridden pt
remove ingested poisons
correct constipation with pregnancy and certain drugs like opioids

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15
Q

contraindications for laxatives

A

fecal impaction

abd pain, nausea, cramps, signs of appendicitis’

regional enteritis

diverticulitis

UC

surgical abdomen

caution during pregnancy

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16
Q

what criteria is used for constipation

A

Rome IV

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17
Q

what type of laxative works by absorb water which softens and enlarges the fecal mass to promote peristalsis

A

Bulk forming laxatives

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18
Q

name the bulk forming laxatives

A

methylcellulose
psyllium
polycarbophil

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19
Q

which laxatives use surfactant action softens stool by facilitating penetration of water and also cause secretion of water and electrolytes into intestine

A

surfactant laxatives

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20
Q

name surfactant laxatives

A 
Docusate sodium (colace)
Docusate calcium
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21
Q

Group I agents act

used for

A

rapidly (within 2-6 hours)

bowel prep

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22
Q

Group II agents act

used for

A

intermediate latency (6-12 hours)
stool that is semifluid
most frequently abused

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23
Q

Group III agents act

used for

A

slowly (1-3 days)
soft but formed stool
treat chronic constipation and prevent straining

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24
Q

adverse effect of Bulk forming laxatives and how to prevent

A

esophageal obstruction can occur if they are swallowed in the absence of sufficient fluid. Swallow with a full glass of water or juice

intestinal obstruction or impaction

25
Q

what group is bulk forming laxatives in

A

III

26
Q

surfactants are group

A

III

27
Q

surfactant laxatives should be taken with

A

a full glass of water

28
Q

Stimulant laxatives

A

Bisacodyl (Dulcolax)
Senna
Castor oil

29
Q

Stimulant laxatives are group

A

II

30
Q

Oral bisacodyl acts within

Bisacodyl (dulcolax) suppositories act within

A

6-12 hours

15 -60 min

31
Q

What formulation of Bisacodyl (dulcolax) are used to prevent gastric irritation

A

enteric coated

32
Q

Bisacodyl (dulcolax) food consideration

A

milk and antacids accelerate dissolution of the enteric coating so space 1 hour from these

33
Q

adverse effect of Bisacodyl (dulcolax) suppositories

A

burning sensation and with continued use proctitis may develop. avoid long term use

34
Q

what type of lax is Bisacodyl (dulcolax)

A

stimulant

35
Q

which stimulant laxative is plant derived

A

Senna

36
Q

which laxative causes a yellow brown or pink color to urine, what do you do?

A

Senna, harmless

37
Q

Castor oil works on the

A

small intestine

38
Q

Castor oil belongs in what group

A

I (other stimulant lax are in group II)

39
Q

when should you give castor oil and how

A

not at bedtime

unpleasant taste, you can chill and mix with fruit juice

40
Q

high doses of osmotic laxatives-laxative salts are used to

A

purge the bowel of ingested poisons

evacuate dead parasites after anthelmintic therapy

41
Q

what are the 2 groups of laxative salts

A

magnesium salts
magnesium hydroxide (milk of magnesia)
magnesium citrate
magnesium sulfate

sodium salt
sodium phosphate

42
Q

Milk of magnesia is also known as

A

magnesium hydroxide

43
Q

osmotic laxatives can cause substantial loss of

A

water - make sure to increase fluid intake to avoid dehydration

44
Q

renal impairment - which lax can this pt not take

A

magnesium salts

and sodium phosphate

45
Q

what lax can cause fluid retention that can exacerbate heart failure, HTN and edema

A

Sodium phosphate

46
Q

which lax can cause acute renal failure

who is at higher risk

A

sodium phosphate

renal disease and those taking diuretics, ACEs and ARBS

47
Q

Polyethylene Glycol (Miralax) adverse effect

A 
nausea
abd bloating
cramping
flatulence
diarrhea
48
Q

how long for a bowel movement with Polyethylene Glycol (Miralax)

A

2-4 days

49
Q

Lactulose works in

A

1-3 days

50
Q

lactulose side effects

A

flatulence

cramping

51
Q

lactulose should be reserved for pt who do not respond to

A

bulk forming agent

52
Q

lactulose is used to lower

A

lower ammonia in pt with portal HTN and hepatic encephalopathy secondary to chronic liver disease

53
Q

Lubiprostone is what class

A

chloride channel activators

54
Q

Lubiprostone works within

A

24 hours

semisoft stool

55
Q

3 indications for Lubiprostone

A

chronic idiopathic constipation in adults

IBS-C (at least 18 years old)

opioid induced constipation in chronic noncancer pain

56
Q

Lubiprostone side effect

A

nausea - can be reduced with food and water

diarrhea, abd distension
abd pain
gas
vomiting
loose stools

headache
difficulty breathing and sense of tightness in chest

57
Q

Plecanatide (Trulance) works by

A

indirectly stimulates secretion of chloride and bicarbonate into intestinal lumen

take with food and water

58
Q

Polyethylene Glycol-Electrolyte Solutions (GoLYTELY)

A

bowel cleansing product for colonoscopy

has an osmotic with a ELS (potassium chloride, sodium chloride, sodium sulfate and sodium bicarbonate)

dehydration does not occur and electrolyte balance is preserved.

safe for renal impairment and cardiovascular disease

59
Q

bowel cleansing products for colonoscopy

A

Polyethylene Glycol-Electrolyte Solutions (GoLYTELY) - safe

Sodium Phosphate - electrolyte imbalance

magnesium oxide/anhydrous citric acid/sodium picosulfate (prepopik) combo of stimulant and osmotic lax which is superior to the PEG-ELS - can cause fluid and electrolyte imbalances, renal impairment, seizures and dysrhythmias secondary to electrolyte abnormalities

Cassandra's Pharmacology (14 decks)

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