Week 8: Bowel disorder drugs for constipation: 10 q

Question 1

Constipation vs Bowel Obstruction
Symptoms for BO?
What is obstipation?

Answer 1

Give laxatives for constipation, NEVER for bowel obstruction or suspected bowel obstruction

Distended abdomen
Nausea and Vomiting
Abdominal cramping
dehydration

**Obstipation ( not able to pass stool + gas)

**NOTE: Patients with constipation can have distended abdomens too

Question 2

Docusate Sodium

What does it do
Do not give if?

Answer 2

Stool Softener

Do not give in Bowel Obstruction (can cause bowel perforation)

DOCUSATE= Doc Said if U ATE more fiber, you wouldn’t need Docusate!

Question 3

Polyethylene Glycol-3350
(Miralax, GoLytely)

What kind of laxative are they?
Used for?
Encourage what?
If using for bowel prep?

Answer 3

Osmotic laxatives

Used for constipation, and opioid induced constipation

Encourage hydration

If using for bowel prep, usually add goLYTEly to a 1 gallon jug, finish entire bottle

Question 4

Psyllium, Methylcellulose (powder)

What kind of laxative are they?
Used for?
Needs what?

Answer 4

Bulk Forming/Fiber Laxatives

CHRONIC constipation (only ones typically used for long term use)

Need water to absorb!!!!

Question 5

LactuLOSE

What kind of laxative are they?
Used for?
What happens if u miss a dose?

Answer 5

Osmotic laxative

Used for constipation and
HEPATIC ENCEPHALOPATHY!!!!

Loses ammonia

if using for Hepatic Encephalopathy, do NOT miss a dose.

Missing a dose could result in build up of Ammonia levels, leading back to hepatic encephalopathy!!!!!

Question 6

Magnesium Hydroxide (Milk of Magnesia®/MOM), Magnesium Citrate

What kind of laxative are they?
Used for?
Caution in?
Evaluate for?

Answer 6

Antacid/Saline/Osmotic Laxative

constipation and heartburn

Caution in Renal Impairment (magnesium can accumulate)

Evaluate for dehydration and electrolyte depletion

Question 7

Senna, Bisacodyl

What kind of laxative are they?
Used for?
How are bisacodyl and senna taken?
how long do oral and rectal take to work?

Answer 7

Stimulant laxative

Constipation and Opioid Induced Constipation

Bowel Prep for Procedure (Colonoscopy)

Do NOT crush bisacodyl, it is an enteric coating

Senna: take by itself, don’t take other meds for 1 hour

Oral: 6-12 hours
Rectal: 30 min

Question 8

When to avoid laxatives?

What to teach patients?

Answer 8

Bowel obstruction
Diarrhea
Electrolyte loss

Fluids
Fiber
Frequent exercise