Chapter 51 - Bowel Disorder Drugs Flashcards Preview

Exam 3 - Pharmacology > Chapter 51 - Bowel Disorder Drugs > Flashcards

Flashcards in Chapter 51 - Bowel Disorder Drugs Deck (42)
Loading flashcards...
1

What is diarrhea?

abnormal passage of stools with increased frequency, fluidity, weight, or with increased stool water excretion acute and chronic

2

Causes of acute diarrhea

bacterial

viral

drug induced

nutritional factors

protozoa

3

Causes of chronic diarrhea

tumors

diabetes mellitus

Addison's disease

Hyperthyroidism

IBS

AIDS

4

3 types of Antidiarrheals

Adsorbents 

Antimotility drugs (anticholinergics and opiates)

Probiotics (AKA, Intestinal flora modifiers, bacterial replacement drugs)

5

MOA of adsorbents

1. coat walls of GI tract

2. Bind to the causative bacteria/toxin, then eliminated through stool

6

Examples of adsorbents

bismuth subsalicylate (Pepto-Bismol)

activated charcoal

aluminum hydroxide

others

7

MOA of antimotility drugs: anticholinergics

 

  • decreases intestinal muscle tone and peristalsis of GI tract
  • Result: slows movement of fecal matter through the GI tract
  • used in more severe cases of diarrhea

8

Example of anticholinergic antimotility drug

belladonna alkaloids (atropine, hyoscyamine)

9

MOA of opiate antimotility drugs

  • decrease bowel motility, relieve rectal spasms
  • decrease transit time through bowel -> allows more time for water/electrolyte absorption
  • reduce pain by relief of rectal spasms

 

Examples: paregoric, opium tincture, codeine, loperamide (OTC), diphenoxylate

10

MOA Antidiarrheals: Intestinal Flora Modifiers

probiotics or bacterial replacement drugs

bacterial cultures of lactobacillus organisms work by:

supplying missing bacteria to the GI tract

suppressing growth of diarhea-causing bactera

example: L. acidophilus (Lactinex)

11

What are the adverse effects of adsorbent antidiarrheals?

 

increase bleeding time,

constipation/dark stools,

confusion, twitching,

hearing loss, tinnitus, metallic taste, blue gums

12

What are the adverse effects of anticholinergic antidiarrheals?

CNS: h/a, dizziness, confusion, anxiety, fatigue, weakness, drowsiness

CV: hypertension, hypotension, dysrhythmias (VTach, VFib, palpitations

GU: urinary retention, hesitancy, impotence

Sense: mydriasis, blurred vision, increase intraocular pressure

Skin: dry skin, flushing

13

What are the adverse effects of opiate antidiarrheals?

drowsiness, sedation, dizziness, lethargy

nausea, vomiting, anorexia, constipation

respiratory depression

hypotension

urinary retention

flushing

14

Nursing Implications of antidiarrheals?

Do NOT give bismuth subsalicylate to children/teenagers with chickenpox or influenza because of the risk of Reye's syndrome

obtain through history of bowel patterns, general state of health, and recent hisotyr of illness or dietary changes, assess for allergies

Use adsorbetns carefully in elderly, and those with increased bleeding time, clotting disorders, recent bowel surgery, confusion

Do not administer anticholinergics to pts with history of narrow-angle glaucoma, GI obstruction, myasthenia gravis, paralytic ileus, and toxic megacolon

15

What to teach pts for antidiarrheals?

take meds exactly as prescribed, be aware of fluid intake/dietary chagnes

teach pts to notify their physician immediately if symptoms persist

monitor for therapeutic effect

assess fluid volume status, I&O and mucous membranes before, during, and after initiation of treatment

16

What is constipation?

abnormally infrequent and difficult passage of feces through the lower GI tract

disorder of movement through the colon/rectum

17

Is constipation a symptom or disease?

Symptom! yay!

18

Different categories of laxatives?

Bulk-forming

Emollient

Hyperosmotic

Saline

Stimulant

Peripherally acting opioid antagonists

19

MOA of Bulk-forming laxatives

high fiber

absorb water to increase bulk

distend bowel to initiate reflex bowel activity

examples: psyllium (Metamucil) and methylcellulose (Citrucel)

20

MOA of emollient laxatives

stool softeners/lubricants

promote more water/fat in stools

lubricate the fecal material/intestinal walls

Examples: stool softeners: docusate salts (Colace, Surfak) lubricants (mineral oil)

21

MOA of hyperosmotic laxatives

increase fecal water content

results in bowel distention, increased peristalsis, and evacuation

examples: polyethylene glycol (PEG) AKA: GoLytely; sorbitol, glycerin; lactulose (also used to reduce elevated serum ammonia levels)

22

MOA of saline laxatives

 

increase osmotic pressure within the intestinal tract, causing more water to enter the intestines

results in bowel distention, increased peristalsis and evacuation

Examples: Magnesium hydroxide (Milk of Mag)

Magnesium citrate (Citroma)

23

MOA of stimulant laxatives

increased peristalsis via intestinal nerve stimulation

Examples: senna (Senekot) bisacodyl (Dolculax)

24

Peripherally Acting Opioid Antagonists

treatment of constipation r/t opioid use and bowel resection therapy

block entrance of opioid into bowel

strict regulations for use

allow bowel to function normally with continued opioid use

methylnaltrexone (Relistor)

alvimopan (Entereg)

25

Indications fo Bulk Forming laxatives?

acute/chronic constipation

IBS

diverticulosis

26

Indications of Emollient laxatives?

 

acute/chronic constipation

fecal impaction

faciliation of BMs in anorectal conditions

27

Indications of Hyperosmotic laxatives?

chornic constipation

diagnostic/surgical preps

 

28

Indications of Saline Laxatives?

constipation

diagnostic/surgical preps

29

Indications of Stimulant Laxatives

Acute constipation

diagnostic/surgical preps

30

Adverse effects of bulk forming laxatives?

impaction

fluid overload

electrolyte imbalances

esophageal blockages