objective 2.5 (2) Flashcards
the passage of stools with abnormal frequency, fluidity,
and increased water excretion. 3 or more liquid stools / day
diarrhea
- Sudden onset
- Lasting 3 days to 2 weeks.
- Caused by: Bacteria, Viruses, Drugs (drug induced), Nutritional factors, Protozoa
acute diarrhea
- Lasts for more than 3 to 4 weeks
- Associated with recurring passage of diarrheal stools, fever, loss of appetite, nausea,
vomiting, weight loss, and chronic weakness - Caused by: Tumours, Diabetes, Addison’s disease, Hyperthyroidism, Irritable bowel
syndrome, Acquired Immune deficiency syndrome (AIDS)
chronic diarrhea
what are the antidiarrheals?
Adsorbents; Antimotility drugs
(anticholinergics and opiates); Probiotics (also known as
intestinal flora modifiers and bacterial replacement drugs).
used for milder cases.
* Coat the walls of the gastrointestinal tract and bind to the
causative bacteria or toxin, which is then eliminated through
the stool.
* Examples: bismuth subsalicylate (Pepto-Bismol), activated
charcoal.
adsorbents
what are the AE of adsorbents?
- Constipation, dark stools, confusion, tinnitus, metallic taste
- Decrease the absorption of many drugs, including digoxin and
cause increased bleeding time and bruising when given with
anticoagulants.
More severe cases.
* Slows peristalsis by reducing the rhythmic
contractions and smooth muscle tone of the GI tract.
Ie. IBS.
* Used in combination with adsorbents and opiates.
* Example: Dicyclomine (Bentyl)
anticholinergics
what are the AE of anticholinergics?
Urinary retention, sexual dysfunction, headache,
dizziness, confusion, anxiety, drowsiness,
hypotension, bradycardia
decrease peristalsis. More severe cases.
* Decrease bowel motility and reduce pain by relief of rectal
spasms.
* Decrease transit time through the bowel, allowing more time
absorption.
* Examples: codeine, loperamide (Imodium), diphenoxylate +
atropine (Lomotil), morphine
opiates
what are the AE of opiates?
Drowsiness, dizziness, lethargy, N/V, constipation, respiratory
depression, hypotension, urinary retention, flushing.
- Also known as intestinal flora modifiers and bacterial replacement
drugs - Bacterial cultures of Lactobacillus organisms are given and work by
- Supplying missing bacteria to the gastrointestinal tract
- Suppressing the growth of diarrhea-causing bacteria
- Example: Lactobacillus acidophilus
probiotics
a symptom, not a disease.
* Abnormally infrequent and difficult passage of feces through
the lower gastrointestinal trac
constipation
what are the types of laxatives?
- Bulk forming
- Emollient (stool softeners, lubricant laxatives)
- Hyperosmotic
- Saline
- Stimulant
what are the indications of laxatives?
- Bulk forming: Acute and chronic constipation, irritable bowel
syndrome, diverticulosis - Emollient: Acute and chronic constipation, fecal impaction,
facilitation of bowel movements in anorectal conditions - Hyperosmotic: Chronic constipation, diagnostic and surgical
procedures - Saline: Constipation, diagnostic and surgical procedures
- Stimulant: Acute constipation, diagnostic and surgical procedures
High fibre, absorb water to increase bulk.
* Examples: psyllium (Metamucil), methylcellulose.
Indication:
* Impaction
* Fluid overload, electrolyte imbalances
* Gas formation
* Powder forms must be mixed with a full glass of water and
consumed immediately.
bulk forming laxatives
Stool softeners and lubricants
* Promote more water and fat in the stools to emulsify and lubricate
the fecal material and intestinal walls
* Examples:
* Stool softeners: docusate salts (Colace)
* Lubricants: mineral oil – decreases the absorption of fat soluble
vitamins.
Adverse effects
* Decreased absorption of fat soluble vitamins(ex with mineral oil)
* Electrolyte imbalances
emollient
increase fecal water content and results in bowel
distention, increased peristalsis, and evacuation.
* Examples: Polyethylene glycol, Sorbitol, glycerin, Lactulose
(also used to reduce elevated serum ammonia levels).
Adverse effects:
* Abdominal bloating
* Electrolyte imbalances
* Rectal irritation
hyperosmotic
Increases osmotic pressure within the intestinal tract, causing
more water to enter the intestines, having the same effects as a
hyperosmotic.
* Examples: Magnesium hydroxide (Milk of Magnesia®), Magnesium
citrate
Adverse Effects:
* Magnesium toxicity (with renal insufficiency)
* Electrolyte imbalances.
* Cramping, diarrhea
* Increased thirst
saline
Increase peristalsis via intestinal nerve stimulation
* Examples: Senna (Senokot); Bisacodyl (Dulcolax); Bisacodyl
(Fleet enema)
Adverse effects
* Rapid evacuation of the bowel’s contents
* Nutrient malabsorption
* Gastric irritation and urgency to defecate
* Electrolyte imbalances
* Discoloured urine
* Rectal irritation
stimulants
