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Pharmacology > Constipation > Flashcards

Constipation Flashcards

1
Q

List the Bulk Laxatives

A

Dietary Fiber

Psyllium (metamucil)

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2
Q

Bulk Laxatives

MOA

A

Increase stool weight, bringing in more water and activating peristalsis

Effective within 12-24 hours (max several days)

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3
Q

Bulk Laxatives

Adverse Effects

A

Flatulence

Requires increased fluid intake or else they will become even more constipated

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4
Q

Osmotic Laxatives

What are the big 3 categories?

A

Nonabsorbable sugars

Saline and magnesium salts

Polyethylene glycol

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5
Q

List the Nonabsorbable Sugars used as osmotic laxatives

A

Sorbitol

Lactulose

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6
Q

Nonabsorbable Sugars

MOA

A

Help liquid enter stool via osmosis, increasing osmotic pressure and acidifying the stool

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7
Q

Nonabsorbable Sugars

Adverse Effects

A

Bloating
Cramps
Flatulence
“Sickly” sweet tase

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8
Q

Nonabsorbable Sugars

Indication

A

Constipation

Works after a day or two to reach full effectiveness

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9
Q

List the Saline and Magnesum Salts

A

Magnesium citrate

Magnesium hydroxide (MOM)

Sodium phosphate

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10
Q

Saline and Magnesium Salts

MOA

A

Osmotically active particles enter gut and pull fluid into stool. Stimulates intestinal activaity

Magnesium may also stimulate CCK to push gut forward and cause peristalsis

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11
Q

Saline and Magnesium Salts

Adverse Effects and Contraindications

A

Bowel Obstruction

Dehydration

Electrolyte abnormalities
- do NOT use in renal failure; be careful with CHF and liver failure

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12
Q

What is a specific adverse effect that comes with Sodium Phosphate agents?

A

Acute phosphate nephropathy

  • Intratubular deposition of Calcium and Phosphorous
  • Happens in sick people with lots of comorbidities
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13
Q

Magnesium Citrate and Sodium Phosphate

Indications

A

Bowel preps (for colonoscopies, surgeries)

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14
Q

Magnesium hydroxide (MOM)

Indications

A

Constipation

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15
Q

Polyethylene Glycol

Indications

A

Depends on dose taken. Small doses are good for constipation, while large doses (4L) are used for bowel prep.

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16
Q

Polyethylene Glycol

MOA

A

Osmotically active, nonabsorbable sugars that retain water in the stool. Cause softer stools and more frequent bowel movements

17
Q

List the Stimulant Laxatives

A

Senna

Bisacodyl (Dulcolax)

18
Q

Stimulant Laxatives

MOA

A

Senna stimulates the myenteric plexus in the colon

Bisacodyl stimulates sensory nerve endings, which increases parasympathetic stimulation to activate peristalsis

19
Q

Stimulant Laxatives

Adverse Effects

A

Cramping

Melanosis Coli (when used chronically, lamina propria macrophages increase product of drug which appears as brown pigment)

20
Q

Stimulant Laxatives

Indications

A

Constipation

21
Q

Detergent Laxatives

What is the main drug used clinically in this category?

A

Docusate

22
Q

Docusate

MOA

A

Stool softener

Surfactant that sits in gut, allowing stool to break up more and mix with water

23
Q

Docusate

Indication

A

PREVENTS formation of hard stool

24
Q

What are the lubricants used in clinical practice?

A

Glycerin suppository/enema

Mineral oil enema

25
Q

What is a suppository?

A

Small tablet inserted into rectum, which breaks up and makes stool in rectum more slippery. Other drugs may be given via suppository (acetaminophen).

26
Q

What is an enema?

A

Large bag filled with a liquid (often tap water), squeezed into rectum

27
Q

Lubricants

MOA

A

Soften stool to make it easier to pass

May see a response in as fast as 30 min

28
Q

Why should mineral oil NEVER be given orally?

A

If the patient aspirates it, is can cause a lipoid pneumonitis (fat pneumonia)

29
Q

Lubricants (Glycerin or mineral oil)

Indication

A

Fecal impaction

30
Q

What is fecal impaction?

A

Mass of stool that has caused a bowel obstruction. Can become rock hard

31
Q

What are some complications of fecal impaction?

A

Rectum filled with rock hard stool

May distend bladder and cause inability to empty (urinary retention and increased risk for infection)

Pharmacology (67 decks)

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