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Pharmacology Test 2 > Test 2 Laxatives > Flashcards

Test 2 Laxatives Flashcards

1
Q

docusate sodium

A
  • laxative
  • surfactant laxatives
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2
Q

docusate sodium: MOA

A
  • produce soft stool in 1-3 days after the onset of tx
  • alter stool consistency by lowering surface tension which facilitates penetration of water into the feces
  • can act on intestines to:
    • inhibit fluid absorption
    • stimulate secretino of water and electrolytes into intestinal lumen
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3
Q

docusate sodium: indications

A
  • constipation
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4
Q

docusate sodium: SEs

A
  • mild cramps
  • diarrhea
  • rashes
  • nausea
  • dehydration
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5
Q

docusate sodium: nursing implications

A
  • contraindications: abdominal pain, nausea, vomiting, individuals with narrowing of intestinal lumen
  • can take with food, but faster results if taken w/o
    • should take with glass of water
  • do not take w/in 2 hours of another laxatives
  • should be used only short term, b/c otherwise can cause electrolyte and fluid imbalance
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6
Q

bisacodyl: class

A
  • stimulant laxative
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7
Q

bisacodyl: MOA

A
  • Stimulates peristalsis.
  • Alters fluid and electrolyte transport, producing fluid accumulation in the colon.
  • produces semi fluid stool in 6-12 hours
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8
Q

bisacodyl: indications

A
  • Treatment of constipation.
  • Evacuation of the bowel before radiologic studies or surgery.
  • Part of a bowel regimen in spinal cord injury patients.
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9
Q

bisacodyl: SEs

A
  • abdominal cramps
  • nausea
  • diarrhea
  • chronic use:
    • hypokalemia
    • muscle weakness
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10
Q

bisacodyl: nursing implications

A
  • contraindicated in individuals with narrowing of intestinal lumen
  • tablets are enteric coated to prevent gastric irritation
    • swallow whole
    • if drink milk or take antacids which accelerate dissolution of enteric coating, then tablets should be administered no sooner than 1 hour after ingesting substances
  • do not take long term
  • suppository administration can cause burning
  • take with a full glass of water to prevent esophageal obstruction
  • widely abused in the elderly population
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11
Q

lactulose: class

A
  • osmotic laxative
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12
Q

lactulose: MOA

A
  • in the colon, resident bacteria metabolize lactulose to lactic, formic, and acetic acid
    • exerts a mild osmotic effect to produce soft stool in 1-3 days
  • Lowers the pH of the colon, which inhibits the diffusion of ammonia from the colon into the blood, thereby reducing blood ammonia levels.
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13
Q

lactulose: indications

A
  • Treatment of chronic constipation.
  • Adjunct in the management of portal-systemic (hepatic) encephalopathy (PSE) secondary to chronic liver dz
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14
Q

lactulose: SEs

A
  • flatulence
  • cramping
  • belching
  • distention
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15
Q

lactulose: nursing implications

A
  • contraindicated in pts on low galactose diets
  • Mix with fruit juice, water, milk, or carbonated citrus beverage to improve flavor
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16
Q

polyethylene glycol with electrolytes: class

A
  • osmotic laxative
17
Q

polyethylene glycol with electrolytes: MOA

A
  • the mixture is isoosmotic with body fluids, so water and electrolytes are neither absorbed from nor secreted into the intestinal lumen
    • so dehydration does not occur, and electrolyte balance is preserved
18
Q

polyethylene glycol with electrolytes: indications

A
  • chronic constipation
    • better than lactulose in regard to relief of abdominal pain and improvements of stool consistency
  • bowel cleansing for GI exam
    • can be used in pts who are dehydrated or who are sensitive to alterations in electrolyte levels (renal impairment and CV dz)
19
Q

polyethylene glycol with electrolytes: SEs

A
  • nausea
  • abdominal bloating
  • cramping
  • flatulence
  • diarrhea
20
Q

polyethylene glycol with electrolytes: nursing implications

A
  • contraindicated in pts with:
    • GI obstruction;
    • Bowel perforation
    • Gastric retention;
    • Toxic colitis;
    • Toxic megacolon.
  • only take in clear liquids
  • avoid solid food and milk w/in 1-2 hours after taking, but need to be well hydrated
  • more expensive than other laxatives
21
Q

mineral oil: class

A
  • lubricant laxative
22
Q

mineral oil: MOA

A
  • made of indigestible hydrocarbons to provide lubrication
    • Coats surface of stool and intestine with lubricant film to allow passage of stool through intestine.
    • Improves water retention of stool.
23
Q

mineral oil: indications

A
  • administered via enema to treat fecal impaction
  • Used to soften impacted feces in the management of constipation.
24
Q

mineral oil: SEs

A
  • pruritus
  • soiling
  • dec absorption of fat soluble vitamins
  • lipid pneumonia
25
Q

mineral oil: nursing implications

A
  • should not take within 2 hours of ingesting food
  • take only short term
  • pts need to wear protective clothing if experience any leakage
  • do not use if abdominal pain, nausea
26
Q

magnesium citrate (PO): class

A
  • saline laxative
  • mineral and electrolyte replacement
27
Q

magnesium citrate (oral): MOA

A
  • Essential for the activity of many enzymes.
  • Play an important role in neurotransmission and muscular excitability.
  • Are osmotically active in GI tract, drawing water into the lumen and causing peristalsis.
    • accumulation of water causes feces to soften and swell–>stretch intestines–>inc peristalsis
28
Q

magnesium citrate (PO): indications

A
  • laxative
  • bowel evacuant
  • purge bowel of ingested poisons
29
Q

magnesium citrate (PO): SEs

A
  • substantial water loss
  • diarrhea
  • flushing
  • sweating
30
Q

magnesium citrate (PO): nursing implications

A
  • contraindicated in pts with hypermagnesemia, hypocalcemia, w/in 2 hours of delivering baby, heart block, renal dysfunction
  • inc fluid intake to avoid dehydration
  • use for short term
31
Q

magnesium sulfate (IV): class

A
  • mineral and electrolyte replacements
32
Q

magnesium sulfate (IV): MOA

A
  • many enzymes need Mg
  • role in neurotransmission and muscle excitability
33
Q

magnesium sulfate (IV): indications

A
  • Treatment/prevention of hypomagnesemia.
  • Treatment of hypertension.
  • Prevention of seizures associated with severe eclampsia, pre-eclampsia, or acute nephritis.
  • Torsades de Pointes
34
Q

magnesium sulfate (IV): SEs

A
  • diarrheas
  • muscle weakness
  • flushing
  • dec in respiratory rate
  • drowsiness
  • bradycardia
35
Q

magnesium sulfate (IV): nursing implications

A
  • contraindicated: hypermagnesemia, hypocalcemia, heart block, in OB pts avoid for using more than 5-7 days for preterm labor or within 2 hours of delivery, renal impairment
  • inc fluid intake

Pharmacology Test 2 (9 decks)

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