pharm antidiarrheal and laxatives Flashcards
diarrhea
3 or more loose stools a day. passage of stool with increased fluidity.
acute diarrhea
3 days -2 weeks. sudden onset
chronic diarrhea
more than 3-4 weeks
associated with weight loss, vomit, diarrhea
antidiarrheal: adsorbents
coat walls of GI tract binds to surface of contaminant
ex- bisbuth subsalicylate
antimotility drug types (2)
anticholinergics and opiates
anticholinergics
decrease intestinal muscle tone and peristalsis, slow movement of fecal matter, dying effect
opiates
decrease bowle motility and abdominal pains by reducing rectal spasms. increase transit time in bowel
opiates examples
codine phosphate, loperamide hydrochloride, diphenoxylate hydrochloride with atropine sulphate
probiotics
intestinal flora modifiers and bacterial replacement drugs. supplies missing gut bacteria and suppress diarrhea causing bacteria.
ex- lactobacillus acidophilus
adsorbents are used for
milder cases
anticholinergics and opiates are used for
more severe cases
probiotics are used for
antibiotic-induced diarrhea
adsorbents adverse effects
increased bleeding, constipation, dark stool, confusion, tinnitus, metallic taste, blue gums, black tongue
anticholinergics adverse effects
drying , urinary retention, sexual dysfunction, headache, dizziness, confusion, anxiety blurred vision, hypotension
opiates adverse effects
drowsy, dizziness lethargy, nausea, hypotension, urinary retention, flushing
adsorbents decrease the absorption of many drugs including _____
digoxin, quindine sulphate, hypoglycemic drugs
adsorbents and anticoagulants
increased bleeding time and bruising
toxic effects of methotrexate are more likely when given with
adsorbents
risk of Reyes syndrome if bismuth subsalicyate is given to kids with….
chicken pox or influenza
use adsorbents carefully in older adults with….
decreased bleeding time, clotting disorders, recent bowel surgery
dont administer anticholinergics to people with
narrow eyed glaucoma, GI obstruction, myasthenia gravis, toxic megacolon
do you have to measure fluid intake and output druing treatment
yes
constipation
infrequent or difficulty passing stool
is constipation a disease
no its a symptom
causes of constipation
not enough fiber or water, increased dairy products, inactivity, diabetes
nonsurgical treatments for constipation
dietary, increased physical activity, drugs
bulk-forming laxatives MOA
high fiber, increase water to increase bulk, distends bowel
example of bulk-forming laxatives
psyllium (metamucil)
emollient 2 types and MOA
stool softener and lubricant, increased water and fat in stool
emollient example (stool soft and lub)
stool softener- docusate salts (Colace)
lubricants- mineral oil
hyperosmotic MOA
increase fecal water content, increased peristalsis
hyperosmotic examples
polyethylene glycol, glycerin, lactulose (reduced serum ammonia levels).
polyethylene glycol is used…
to replace Metamucil before bowel surgery
saline MOA
increase osmotic pressure in intestinal tract, causes more water to enter intestines, bowel distension
saline examples
magnesium hydrochloride (milk of magnesia) and magnesium citrate
stimulants MOA
increased peristalsis vai intestinal nerve stimulation
examples of stimulants
senna (sennakot) and bisacodyl (dulcolx)
peripherally acting opioid antagonists
treat constipation related to opioid use. blocks entrance of opioid into bowel
bulk-forming laxative use
acute and chronic constipation, ibs diverticulosis
emollient laxative use
acute and chronic constipation, fecal impaction, facilitation of bowel movement
hyperosmotic laxative use
chronic constipation, surgical procedures
saline laxative use
surgical procedures, constipation
stimulant laxative use
acute constipation, surgical procedures
which 2 types can cause dehydration in elderly
hyperosmotic and saline
adverse effects of bulk forming
impaction, fluid overload, electrolyte imbalance, gas, allergic reaction
adverse effects of emollient
skin rashes, decrease absorption of vitamins, electrolyte imbalance, lipid pneumonia
adverse effects of hyperosmotic
bloating, electrolyte imbalance, rectal irritation
adverse effects of saline
magnesium toxicity, cramping, electrolyte imbalance, cramping, thirst
adverse effects of stimulants
nutrition malabsorption , skin rashes, gastric irritation, electrolyte imbalance, discolored urine, rectal irritation
common adverse effects of all laxatives
electrolyte imbalance
what do you assess before initiating therapy
fluid and electrolytes
inform pts to not take laxatives if they have…
nausea, vomiting, abdominal pain
should laxatives be crushed
no never crush laxatives, especially if its enteric coated
long term laxative use result
decreased bowel tone
pts should take all laxatives with how much water
180-240ml
pts should take bulk-forming laxatives with how much water
240ml
how should you take bisacodyl
with water on an empty stomach
irritable bowel syndrome
chronic intestinal discomfort, cramps, diarrhea, constipation
how do ppl cope with ibs
avoiding bad foods, taking over the counter drugs