Bowel Dysfunction Drugs: Antidiarrheals, Laxatives Flashcards
What is an antidiarrheal?
drugs that counter or combat diarrhea; slow down secretions
Antidiarrheal Mechanism of Action
- Anticholinergic drugs - work to slow peristalsis by reducing the rhythmic contractions and smooth muscle tone of the GI tract; also have a drying effect and reduce gastric secretions
-Probiotics - work by replenishing the body’s normal bacterial flora –> helps restore the balance of normal flora and suppress the growth of diarrhea-causing bacteria
- Opiates - reduces bowel motility
Antidiarrheals Indications:
- Absorbents: milder cases (coats GI tract and binds to the toxin (combines to stool and take it out)
- Antimotility Drugs (anticholinergics and opiates): more severe cases –> stops cramping and increases the transit time for food to move through the bowel, which increases the absorption of water, electrolytes, and other nutrients (it takes time)
- Probiotics: antibiotic-induced diarrhea (natural flora –> replace microbes/natural flora
Antidiarrheals Contraindications
- known allergy
- any major, acute GI condition
Antidiarrheals Side Effects
Absorbents
- increases bleeding time
- constipation
- may decrease absorption of other drugs
Anticholinergics
- urinary retention
- headache and dizziness or confusion
- dry skin and blurred vision
- bradycardia
Opiate category (Loperamide)
- drowsiness/lethargy
- respiratory depression
Antidiarrheals Nursing Management
- Use ABSORBENTS carefully in OLDER patients and those with decreased bleeding time, clotting disorders recent bowel surgery, or confusion
- do NOT administer anticholinergics to patients with a history of narrow-angle glaucoma, GI obstruction, myasthenia graves, paralytic ileum, or toxic megacolon
- TEACH patients to take medications exactly as prescribed and to be aware of their fluid intake (I/O) and dietary changes
- assess fluid volume status, I&O, and mucous membranes before, during, and after initiation of treatment
What is the most common antidiarrheal drug used?
Loperamide (Immodium)
What is a laxative and what is it used to treat?
- Drugs that promote bowel evacuation by increasing the bulk of feces, softening the stool, or lubricating th intestinal wall
- used for treatment of constipation
Laxatives Mechanism of Action
Bulk Forming (Psylium)
- high fiber meds. that absorb water to increase the bulk of stool
Emollient (Docusate)
- stool softeners and lubricants work by promoting more water/fat in the stools and lubricating the stool
–> easier pass of stool; prevent water from moving out of the intestines, which softens and expands the stool
Stimulant (Senna)
- increases peristalsis via intestinal nerve stimulation
Hyperosmotic (Lactulose and Polyethylene Glycol)
- increase the water content in the stool which leads to distention and increased peristalsis (increased water in the stool –> distends colon —> triggers nerves to contract –>increases peristalsis
Laxatives Contraindications
- known allergy
- acute surgical abdomen
- appendicitis symptoms: abdominal pain, nausea, vomiting
- fecal impaction
- intestinal obstruction
- undiagnosed abdominal pain
Laxatives Side Effects
- Abdominal bloating and distention
- Cramping
- Electrolyte imbalances
- Nutrient and vitamin absorption concerns
- Rectal skin irritation
Laxatives Nursing Management
- thorough history of symptoms and onset and bowel patterns
- check labs for fluid and electrolyte imbalances
- no laxatives with nausea/vomiting (gastroenteritis)
- increased fluid intake and fiber diet
- take all laxatives with a glass of water
- contact the provider if abdominal pain becomes severe or the patient develops cramps/dizziness
- patent may experience a loss of muscle tone
