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NAPLEX review 2024 RXPrep Book > Gastrointestinal Conditions: Constipation & Diarrhea > Flashcards

Gastrointestinal Conditions: Constipation & Diarrhea Flashcards

1
Q

Bulk-forming laxative

A

ie; soluble fiber such as psyllium + dietary fiber = 1st line, and drug of choice in pregnancy

absorb water in intestine, add bulk to stool. inc peristalsis and dec stool transit times

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2
Q

Osmotic laxatives

A

ie. Polyethylene Glycol (PEG)

draw fluid into bowel lumen via osmosis, distends cold and inc peristalsis

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3
Q

Stimulant laxatives

A

ie. Senna, Bisacodyl

directly stimulate neurons in colon, causing peristaltic activity

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4
Q

Stool softener

A

ie: docusate

Emollients that reduce surface tension of stool oil-water interface, allowing more water and fat to mix with stool.

softening your shit and making it easier to go.

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5
Q

Lubricant laxatives

A

ie. mineral oil

coat bowl and stool in waterproof film
keeps moisture in stool, makes pooping easier

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6
Q

OTC recommendation for constipation in most adults

A

fiber

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7
Q

OTC recommendation for constipation in iron induced or hard stools

A

tool softener or bulk-forming drug

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8
Q

OTC recommendation for constipation in opioid-induced patients

A

stimulant or osmotic laxative

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9
Q

OTC recommendation for constipation in pregnancy

A

fiber

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10
Q

OTC recommendation for constipation if fast relief is req

A

adults: bisacodyl or glycerin suppository
children: glycerin suppository

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11
Q

Bulk forming drugs

A

Psyllium = Metamucil
Calcium polycarbophil = FiberCon
Methylcellulose = Citrucel
Wheat Dextrin = Benefiber

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12
Q

Bulk forming side effects

A

flatulence
abdominal cramping
bloating
bowel obstruction

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13
Q

Bulk forming drug notes

A

onset 12-72hrs

req adequate fluids

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14
Q

Osmotic laxatives

A

Magnesium hydroxide = Milk of magnesia
Polyethylene glycol 3350 = miralax
Glycerin = Fleet
Lactulose = Constulose, Enulose
Sodium phosphates = Fleet enema
Sorbitol = enema

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15
Q

Osmotic laxatives side effects

A

electrolyte imbalance
abdominal cramping
flatulence
dehydration

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16
Q

osmotic laxatives notes

A

30min - 96hrs onset

magnesium containing = caution renal impairment
lactulose = used in hepatic encephalopathy
glycerin supp = used commonly in children

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17
Q

Stimulant laxatives

A

Senna = Senokot, Ex-lax
Senna + decussate = Senna S, Senokot S
Bisacodyl = Dulcolax

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18
Q

Stimulant laxative warnings

A

avoid use with stomach pain, N/V, or sudden change in bowel movements in last > 2wks

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19
Q

Stimulant laxative side effects

A

abdominal cramping, electrolyte imbalance, rectal irritation

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20
Q

Stimulant laxative notes

A

onset 6-12hrs for oral, 15-60min rectal

take at bedtime to induce movement in morning

often given with chronic opioids

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21
Q

Emollients (stool softeners)

A

Docusate sodium = Colace
Docusate + Senna = Senna S/ Senokot S

22
Q

stool softener CI and Side effects

A

CI: abdominal pain, N/V, using with mineral oil OTC use > 1wk

SE: abdominal cramping

23
Q

Stool softener notes

A

onset 12-72hrs for oral
preferred when straining should be avoided ie post partum/hemorrhoids
use when stool hard/dry

24
Q

Lubricant laxatives

A

Mineral oil

25
Q

Mineral oil info

A

CI: Age < 6, pregnancy, bedridden

SE: abdominal cramping, nausea, incontinence, rectal discharge

26
Q

RX medications for constipation

A

Lubiprostone = Amitiza
Linaclotide = Linzess
Plecanatide = Trulance
Alvimopan = Entereg
Prucalopride = Motegrity

methylnaltrexone = Relistor
Naloxegol = Movantik

27
Q

Lubiprostone (Amitiza) info

A

CI: mechanical bowel obstruction
MOA: chloride channel activator
SE: N, diarrhea, abdominal pain, headache
Notes: take w/ food/water to dec nausea

28
Q

Linaclotide (Linzess) info

A

Boxed warning: dont usein pediatric pts, high risk of dehydration
MOA: Guanylate Cyclase C agonists
CI: < 6yrs old, mechanical GI obstruction
SE: diarrhea, abdominal pain, farting

29
Q

Alvimopan (Entereg) info

A

Boxed warnings: potential risk of MI w/ long-term use, only short term inpatient with REMS

CI: Therapeutic doses of opioids for > 7 consecutive days
SE: Dyspepsia

30
Q

Prucalopride (Motegrity) info

A

CI: GI obstruction
Warning: suicidal ideation
SE: Diarrhea, nausea, abdominal pain

31
Q

Laxatives used for whole bowel prep

A

PEG solution = GoLytely, Colyte
Sodium Phosphates = OsmoPrep
Sodium sulfate, potassium sulfate, mag sulfate = Suprep Bowel Prep Kit

32
Q

Osmoprep boxed warnings

A

Nephropathy

33
Q

Osmoprep contraindications

A

acute phosphate nephropathy, gastric bypass or stapling surgery

34
Q

whole bowel prep irrigation laxative notes

A

prep regimen usually start night before, and morning of procedure

usually clear liquid diet req day prior

dont consume w/ solid or semi-solid foods, anything with red/blue/purple food dye

35
Q

most common cause of diarrhea

A

most cases are viral

E.coli causes most

36
Q

Anti-diarrhea drugs

A

bizmut subsalicylate = Pepto-Bismol
Loperamide = Imodium
Diphenoxylat/atropine = Lomotil
Dicyclomine = Bentyl
Eluxadoline = Vibrezi

37
Q

Pepto-Bismo Contraindications

A

Salicylate allergy
taking other salicylates
GI ulcer
bleeding
black/bloody stool

38
Q

Pepto-Bismo warnings

A

children and tens recovering from flu/chicken pox or other viral infections shouldn’t use

39
Q

Pepto-Bismol side effects

A

black tongue/stool
salicylate toxicity if used too much
nausea

40
Q

Loperamide (Imodium) dosing instructions

A

take 2 tablets by mouth at first episode, then take 1 tablet by mouth each episode following. max 4 tablets per day (8mg) self care or 8 tabs (16mg) hospital

41
Q

Loperamide boxed warnings

A

Torsades de pointes
cardiac arrest and sudden death with higher than recommended dose
Dont use children < 2yrs old

42
Q

Loperamide contraindications

A

acute dysentery = bloody diarrhea/fever
C.diff

43
Q

Loperamide Side effects

A

constipation
abdominal cramping
nausea
QT prolongation

44
Q

max time you should sue loperamide for self treatment?

A

48hrs

45
Q

Diphenoxylate/atropine (Lomotil) contraindications

A

risk of respiratory and CNS depression in kids, dont use if < 2yrs of age ( < 6yrs for tab)

46
Q

Diphenoxylate/atropine (Lomotil) notes

A

liquid formulation recommended < 13 yrs old

47
Q

Diphenoxylate/atropine (Lomotil) side effects

A

possible anticholinergic effects
mild euphoria

48
Q

Dicyclomine (Bentyl) warnings and Side effects

A

warnings:
anticholinergic, caution > 65yrs old
can use in toxic megacolon or paralytic ileum

SE: dizziness, dry mouth, nausea, blurred vision, somnolence, weakness

49
Q

Eluxadoline (Vibrezi) contraindications

A

pts without gallbladder
alcoholic or > 3 drinks/day
hx of severe constipation

50
Q

Eluxadoline (Vibrezi) warnings and side effects

A

Warning: CNS depression

Side effects: constiaption, nausea, abdominal pain

51
Q
A

NAPLEX review 2024 RXPrep Book (71 decks)

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