T2-Laxatives

Question 1

Constipation is determined more by stool _____ (degree of hardness) than by _____ bowel movements occur

Answer 1

Consistency; how often

Question 2

What are the common causes of constipation?

Answer 2

Decreased fiber and fluid
Dysfunction of ANS
Medications

Question 3

What are some medications that increase your risk for constipation?

Answer 3

Anti-cholinergic
Opioids
Verapamil (CCB)

Question 4

What happens with laxative overuse (3)?

Answer 4

Dehydration
Electrolyte imbalances
Normal defecation lost (you depend on laxative for BM)

Question 5

Who may take a lot of laxatives (and diuretics)?

Answer 5

People with anorexia nervosa

Question 6

What are the 4 classes of laxatives?

Answer 6

Stool softeners
Osmotic laxatives
Stimulate laxatives
Bowel Preparation

Question 7

What is the drug for stool softeners?

Answer 7

Docusate sodium

Question 8

What does the word emollient mean?

Answer 8

To soften

Question 9

Docusate sodium is similar to ___

Answer 9

Soap

Question 10

If you take docusate sodium, how long before you have a BM?

Answer 10

Several days

Question 11

Docusate sodium is similar to soap in that it mixes fats and water. So it helps water get in the stool to soften it up. What must we teach our client regarding this?

Answer 11

Take docusate sodium with FULL glass of water

Question 12

T/F: Docusate sodium stimulates you to have a BM.

Answer 12

FALSE. It doesn’t stimulate you to have a BM. It just makes you have a SOFT BM so it is easier for you to go

Question 13

When do we give docusate sodium?

Answer 13

Opioid therapy (prophylaxis)
In patients who need to avoid straining!

Question 14

We give docusate sodium in patients who need to avoid straining. What are some examples and what is something that may happen to them if they didn’t take the stool softener and strained during BM?

Answer 14

Patients with:
Hemorrhoids: Bleeding
CV disease: MI
Episiotomy: Big tear

Question 15

What is the MOA of osmotic laxatives?

Answer 15

Pulls water into GI tract

Question 16

What is the drug that is an osmotic laxative?

Answer 16

Polyethylene glycol (PEG) 3350 aka Miralex

Question 17

What does PEG 3350 do to stool?

Answer 17

Softens and increases size of stool

Question 18

What is Polythylene glycol good for?

Answer 18

Chronic constipation

Question 19

What are the adverse effects of PEG 3350?

How long does it take to have a BM?

Answer 19

Well tolerated
Bloating, cramping

2-4 days

Question 20

What do we teach our patients who are taking an osmotic laxative, such as PEG 3350?

Answer 20

Dissolve it in 4-8 ounces of fluid…it usually takes 5-10 minutes to dissolve but it will dissolve completely

Question 21

What is the MOA of stimulant laxatives?

Answer 21

Irritates the GI tract and increases motility

Question 22

If you take a stimulate laxative PO, how long before you have a BM?

Answer 22

12 hours

Question 23

If you take a stimulate laxative PR, how long before you have a BM?

Answer 23

1 hour

Question 24

What are the 3 major stimulants?

Answer 24

Senna
Bisacodyl
Senna/docusate

Question 25

Is senna (stimulate laxative) PO or PR?

Answer 25

PO

Question 26

Is bisacodyl PO or PR?

Answer 26

Both forms

Question 27

When you mix senna with docusate, what happens to stool?

Answer 27

"Mush and push" So the docusate will soften it and the senna will make you have a BM quickly and it's now soft and easy to come out

Question 28

What are the adverse effects to the stimulate laxatives (senna, bisacodyl and senna/docusate)

Answer 28

``` GI discomfort (nausea, cramping, bloating) Yellowish-brown or pink urine (senna) ```

Question 29

When do you give a bowel preparation drug?

Answer 29

Before a surgery or colonoscopy

Question 30

What is the bowel prep. drug?

Answer 30

PEG 3350 with electrolytes

Question 31

What is the trade name for the bowel prep. drug?

Answer 31

GoLYTELY

Question 32

How much GoLYTELY has to be drunk and do patients like it?

Answer 32

4 L!! NO, it has a large sodium concentration so it is salty!

Question 33

What are some tricks for drinking all 4 L of the PEG 3350 with electrolytes (bowel prep)?

Answer 33

Chill before drinking Mix with crystal light Chug: DONT SIP. Make sure a toilet is nearby!!!

Question 34

What class is docusate sodium?

Answer 34

Stool softener

Question 35

What class irritates the lining of the GI tract?

Answer 35

Stimulant

Question 36

Senna

Answer 36

Stimulant

Question 37

PEG 3350

Answer 37

Osmotic

Question 38

Taken to help avoid straining?

Answer 38

Docusate sodium (stool softener)

Question 39

Weird effect of yellowish-brown or pink urine (what drug and class)?

Answer 39

Senna; stimulant

Question 40

BM in 12 hours

Answer 40

PO stimulant

Question 41

BM in 1 hour

Answer 41

PR stimulant

Question 42

BM in 2-4 days

Answer 42

PEG 3350 osmotic

Question 43

BM in several days

Answer 43

Docusate sodium; stool softener

Question 44

BM immediately

Answer 44

PEG 3350 with electrolyte; bowel prep

Question 45

Take with a full glass of water

Answer 45

Docusate sodium

Question 46

Adverse effect of nausea, cramping, bloating?

Answer 46

Stimulants

Question 47

Adverse effect of bloating, cramping ?

Answer 47

PEG 3350; osmotic

Question 48

Dissolve in 4-8 oz?

Answer 48

PEG 3350; osmotic

Question 49

Must drink large volume of 4 L

Answer 49

PEG 3350 with electrolytes; bowel prep

Question 50

What drug is "miraculous"?

Answer 50

Miralex (PEG 3350); osmotic!!

Question 51

Opioid therapy prophylaxis?

Answer 51

Stool softener (docusate sodium)

Question 52

What harmless effect does senna have on a person's urine?

Answer 52

Turn it yellowish-brown or pink

Question 53

What is another situation in which lactulose may be helpful?

Answer 53

Enhance excretion of ammonia to lower it in patients with portal HTN and encephalopathy, secondary to chronic liver disease