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HLST220: Pharmacology > Chapter 82: Laxatives > Flashcards

Chapter 82: Laxatives Flashcards

1
Q

laxative are used to

A

ease or stimulate defication
- soften the stool
- increase stoole volume
- hasten fecal passage through the intestine
- facilitate evacuation from the rectum
- misuse comes from misconceptions of what constitutes normal bowel function

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2
Q

laxative effect

A
  • production of soft, formed stool over 1 or more days
  • relativelty mild
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3
Q

Catharsis

A
  • prompt, fluid evaculation of bowel
  • fast and intense
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4
Q

what is the function of the colon

A
  • absorbs water and electrolytes
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5
Q

delayed transport through colon causes

A

excessive fluid absorption and hear stool

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6
Q

what is normal bowel elimination

A

varies widely (2-3 times per day to 2 times per week)

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7
Q

proper bowel movement is dependent on

A

dietary fibre

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8
Q

benefits of fibre

A
  • absorbs water (softens feces and increases size)
  • can be digested by colonic bacteria whose growth can increase fecal mass
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9
Q

what is the frequent cause of constipation

A

low fibre diet

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10
Q

what is potimal fibre intake per day

A

20-60 g

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11
Q

constipation can be cuased by

A

variety of disease or drugs, poor diet, dysfunction of pelvic floor and anal sphincter or slow intestinal transit

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12
Q

what are the factors that can cause intestinal slowdown

A
  • dehydration
  • inadequate amounts of fibre
  • ignoreing urge to deficate
  • lack of physical activity
  • irritable bowel syndrome
  • changes in lifestyle or outine, includinf pregnancy, aging and travel
  • illness
  • frequent use or misuse of laxiatives
  • specific diseases, such as stroke, diabetes, thryroid disease, and parkinson disease
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13
Q

constipation

A

type 1-2

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14
Q

normal

A

type 3-4

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15
Q

diarrhea

A

type 5-7

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16
Q

contradictions to laxative use

A
  • abdominal pain, nausea, cramps, symptoms of appenndicitis, regional enteritis, diverticulitis, or ulcerative colitis
  • acute surgical abdomen
  • fecal impaction or bowel obstruction
  • habitual use/abuse
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17
Q

laxatives should be used with caution is

A

pregnancy and lactation

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18
Q

Classification of Laxatives

A
  • Bulk-forming laxatives (psyllium [metamucil] _
  • surfactant laxatives (docusate sodium [Colace] )
  • stimulant laxatives (Bisacodyl [dulcolax])
  • osmotic laxatives (polyethylene Glycol [restoralax])
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19
Q

Group I

A

act rapidly (2-6 hours) and give stool a watery consistency; useful for preparing bowel for diagnostic procedures or surgery

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20
Q

Group II

A

intermediate latency (6-12 hours)
- produce semifluid stool

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21
Q

Group III

A

act slowly (1-3 days) to produce a soft, formed stool; uses include treating chronic constipation and preventing straining at stool

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22
Q

Bulk Forming Laxatives include

A

psyllium [metamucil]
- mehtylcellulose [entroce; solution]
- polycarbophil [Prodiem]
- inulin [Benefibre]

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23
Q

Bulk Forming Laxatives MOA

A

swell with water to form a gel that softens and increases fecal mass

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24
Q

Bulk forming laxatives is often used in the treatment of

A

diverticulosis and IBS

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25
Bulk forming laxatives adverse effects
minimal - esophageal obstruction if swallowed without sufficent fluids; intestinal obstruction
26
Surfactant Laxatives are also called
stool softeners
27
Surfactant Laxatives MOA
lowers surface tension, which facilitates penetration of water into feces. Act on intestinal wall to - inhibit fluid absorption - stimulate secretion of water and electrolytes into intestinal lumen
28
surfactant laxatives promote
more water and fat in the stools
29
Surfactant laxatives examples
Docusate salts [sodium and calcium] (colace)
30
how long does it take for Docusate salts [sodium and calcium] (colace) to produce a soft stool
several days
31
surfactant laxative require
adequate fluids
32
Stimulant laxative is used for
treatment of medication related constipation and slow intestinal transit constipation
33
Stimulant laxatives MOA
stimulate intestinal motility and increase amounts of water and electrolytes in intestinal lumen
34
stimulant laxatives include
Bisacodyl (Dulcolax) - senna/sennosides (senokot preperations; Ex-Lax) - cascara sagrada
35
osmotic laxatives low doeses work in
6-12 hours
36
high doses of osmotic doses see results in
2-6 hours
37
Polyethylene glycol (PEG) [Restoralax]
- non absorbing compound that retains water in the intestinal lumen causing fecal mass to soften and swell
38
Glycerin suppository onset
15-60 mins
38
Polyethylene glycol (PEG) [Restoralax] onset
48-96 hours
39
Polyethylene glycol (PEG) [Restoralax] can also be used for
catharsis
39
Lactulose onset
24-48 hours
40
osmotic laxatives examples
- Polyethylene glycol (PEG) [restoralax] - glycerin suppository - lactulose - magnesium hydroxide [milk of magnesium]
41
osmotic laxatives adverse effects
- dehydration - acute renal failure - sodium retention: exacerbated heart failure, hypertension, edema
42
Glycerin suppository
softens and lubricates hardened impacted feces and may also stimulate rectal contration
43
Glycerin suppository onset
occurs about 30 mins after insertion
44
Mineral oil use
- especially useful when administered by enema to treat fecal impaction
45
mineral oil adverse effects
- lipid pneumonia - anal leakage
46
mineral oil is available in
oral liquid, enema, oral jelly
47
precalopride [resotran] MOA
- binds with serotonin receptors in the colon and activities the release of Ach - increases tone and motility
48
precalopride [resotran] is used for
chronic constipation in females who have other therapies
49
precalopride [resotran] side effects
headache, nausea and vomiting
50
Linaclotide [Constella] indication
- chronic idiopathic constipation and IBS-C in adults
51
Linaclotide [Constella] adverse effects
diarhea and abdominal pain
52
Laxatives should be administered
30 minutes before the first meal of the day
53
Methylnaltexone [relistor] is indicated for
opiod induced constipation in palliative care in patients who have other therapies
54
Methylnaltexone [relistor] side effects
abdominal pain. diarrhea, flatulence, nausea, dizziness
55
Methylnaltexone [relistor] negatives
expensive, protect from light
56
Methylnaltexone [relistor] onset
30mins-4houra
57
what are the types of bowel cleansing products for colonoscopy
- sodium phosphate (oral fleet or fleet enema) - polyethylene glycol (PEG)
58
sodium phosphate (oral fleet or fleet enema)
- hypertonic with body fluid - can cause dehydration and electrolyte disturbances - possibility or renal damage
59
Polyethylene Glycol - Electrolyte solutions adminstration
typically 4L - must ingest 250-500ml every 10 mins for 2-3 hours. - 2L evening before; 2L day or colonoscopy
60
hwo do you know if a patient is fully cleansed
BM becomes clear yellow liquid
61
Polyethylene Glycol - Electrolyte solutions onset
commences within 1 hour
62
Polyethylene Glycol - Electrolyte solutions most common adverse effect
nausea, bloating, and abdominal discomfort
63
Polyethylene Glycol - Electrolyte solutions tips
- drink through straw, rinse with mouthwash, non red candy, dimenhydrinate if nausea, chew gum, refrigerate solution
64
laxative abuse causes
- bowel movements occur daily - weight loss
65
Polyethylene Glycol - Electrolyte solutions consequences
- diminished defectory reflexes, leading to further reliance on laxatives - electrolyte imbalance, dehydration, colitis
66
bulk forming use
- acute and chronic constipation - IBS - diverticulosis
67
Surfactant use
- acute and chronic constipation - softening of fecal impaction; movements in anorectal - facilitation of bowel condition s
68
osmotic laxative use
- chronic constipation - diagnostic and surgical preps
69
stimulant laxative use
- acute constipation - diagnostic and surgical bowel preps
70
adverse effects of bulk forming laxatives
- impaction - fluid overload - electrolyte imbalances - esophageal blcokage
71
surfactant laxatives adverse effects
- skin rashes - decreased absorption of vitamins - electrolyte imbalances
72
osmotic laxatives adverse effects
- abdominal bloating - electrolyte imbalances - rectal irritation
73
stimulant laxatives adverse effects
- nutrient malabsorption - skin rashes - rectal irritation - electrolyte imbalances - gastric irritation - rectal irritation
74
laxative drug interaction
bulk forming laxative concurrently with other medications

HLST220: Pharmacology (46 decks)

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