Quiz #1 Flashcards
Types of Laxatives
– Bulk-forming
– Emollient/Lubricant
– Hyperosmotic/Saline
– Stimulant
3 main mechanisms of laxatives
– Alter stool consistency
– Increase stool movement
– Increase defecation
Metamucil Dosing
- 2.5–7.5 g/dose po 1–3 times daily
- Maximum 30 g/day
Bulk-forming Agents
- Psyllium
- Polycarbophil
- Methylcellulose
Hyperosmotic Agents
- Polyethylene glycol (PEG)
- Lactulose
- Glycerin
- Sorbitol
Lax-A-Day Dosing
17g po once daily (in 250mL of fluid)
Lactulose Dosing
15-30mL po once or twice daily
Saline Laxatives
- MgOH (Milk of magnesia)
- Mg citrate
- Sodium phosphate (Fleet)
Milk of Magnesia Dosing
15–30 mL po once or twice daily
Stimulant Laxatives
- Sennosides
- Cascara
- Bisacodyl
Sennosides Dosing
8.6-48 mg po qHS
Bisacodyl Dosing
- tabs: 5-15mg po once
- supp: 10mg pr once
Emollient Laxatives
Docusate (100mg po BID)
Lubricant Laxatives
Mineral oil (15-45 mL po qHS or 120 mL pr once)
Diarrhea: Acute vs. Persistent vs. Chronic
Acute: < 14 days
Persistent: > 14 days
Chronic: > 30 days in duration or repeated episodes of diarrhea lasting less than 14 days each
Bristol Stool Chart - Types 1,2
Constipation
Bristol Stool Chart - Types 3,4
Normal
Bristol Stool Chart - Types 5,6,7
Diarrhea
Diarrhea: Most common causes
- Bacterial infections
- Viral infections
- Food toxins
Diarrhea: Bacterial Infections
- Campylobacter jejuni
- E. coli
- Salmonella
- Shigella
Diarrhea: Viral Infections
- Rotavirus - severe diarrhea in infants and children
- Norwalk-like virus - milder diarrhea in older children and adults
Drugs that cause Diarrhea
- Laxatives (lactulose, sennosides)
- Antacids (magnesium salts)
- Antibiotics
- Hypoglycemic agents (acarbose, metformin)
Dehydration: Children
◦ Dry mouth, tongue, skin
◦ Few or no tears
◦ Decreased urination
> less than 4 wet diapers in 24 h
◦ Decreased skin turgor
> pinched skin flattens slowly
◦ Irritability, listlessnessORT
Oral Rehydration Therapy
- replace fluid and electrolytes
- Utilizes the sodium/glucose-coupled absorption mechanism in the small intestine
- IV fluids required in severe cases
- e.g. gastrolyte, pedialyte
- Do not use pop, tea with sugar, or fruit juices
