Constipation

Question 1

Medical conditions that can cause constipation

Answer 1

IBS, anal disorders (fissures, fistulae, rectal prolapse), MS, PD, spinal cord tumors, DM, hypothyroidism

Question 2

Constipation is defined as infrequent bowel movements (less than ___ per week)

Answer 2

3 per week

Question 3

Non-drug tx are preferred for constipation. List them.

Answer 3

Inc fluid intake (64oz daily), limiting caffeine and alcohol intake, inc physical activity

Question 4

Drugs that can cause constipation

Answer 4

Antacids (aluminum and calcium containing)
Clonidine
Colesevelam
Diphenhydramine
Baclofen
Amitriptyline 
Iron
Verapamil
Sucralfate

Question 5

If constipation is not improved after ___ days, consult a PCP

Answer 5

7 days

Question 6

Which OTC to recommend for constipation?
Most adults -->
Iron-induced -->
Opioid-induced -->
Preg -->
Fast relief -->

Answer 6

Most adults –> fiber
Iron-induced –> decussate (stool softener)
Opioid-induced –> Senna or bisacodyl (Stimulants)
Preg –> fiber
Fast relief –> glycerin suppository (adult/children); bisacodyl (adult)

Question 7

Psyllium

Answer 7

Metamucil

Question 8

Calcium polycarbophil

Answer 8

FiberCon

Question 9

Methylcellulose

Answer 9

Citrucel

Question 10

Wheat dextrin

Answer 10

Benefiber

Question 11

First-line tx in most constipation cases and DOC in pregnancy. MOA: absorb water in the intestine, soaking up fluid and adding bulk to the stool=INC perstalsis and DEC stool transit time

Answer 11

Bulk-forming

Question 12

Contain large ions or molecules that are poorly absorbed. Draw fluid into the bowel lumen through osmosis which distends the colon and INC peristalsis

Answer 12

Osmotics

Question 13

Directly stimulate neurons in the colon, causing peristaltic activity

Answer 13

stimulants

Question 14

emollients that reduce the surface tension of the stool oil-water interface allowing more water and fat to mix with the stool (commonly used by those with iron supplements)

Answer 14

Stool softeners

Question 15

coat the bowel and stool with a waterproof film. keeps moisture in the stool and makes defecation easier (ex: mineral oil)

Answer 15

lubricants

Question 16

Magnesium hydroxide, PEG, glycerin, lactulose, sodium phosphates, lactitol, sorbitol are examples of

Answer 16

Osmotics

Question 17

Milk of magnesia

Answer 17

magnesium hydroxide

Question 18

Miralax

Answer 18

PEG 3350

Question 19

Fleet liquid glycerin supp, Pedia-Lax

Answer 19

Glycerin

Question 20

Constulose, Enulose, Generlac

Answer 20

Lactulose (Rx)

Question 21

Fleet Enema

Answer 21

Sodium phosphates

Question 22

Pizensy

Answer 22

Lactitol (Rx)

Question 23

Senna and bisacodyl are examples of

Answer 23

Stimulants

Question 24

Brand: Ex-Lax, Senokot

Answer 24

Generic: Senna

Question 25

B: Senna S, Senokot S

Answer 25

G: Senna + docusate

Question 26

Dulcolax

Answer 26

bisacodyl enteric coated tablet, suppository

Question 27

When do you take stimulant oral products?

Answer 27

bedtime to induce a BM the following morning

Question 28

Docusate sodium is an example of

Answer 28

Emollient (stool softener)

Question 29

Colace

Answer 29

docusate sodium

Question 30

What drug is preferred when straining should be avoided? (post MI, postpartum, hemorrhoids)

Answer 30

Docusate sodium/stool softeners

Question 31

Mineral oil is an example of

Answer 31

Lubricant

Question 32

A chloride channel activator that acts on chloride channels in the gut, leading to increased fluid and peristalsis

Answer 32

Lubiprostone

Question 33

A guanylate cyclase C agonist that increases Cl and bicarb secretion into the lumen of the intestine, inc speed of GI transit and reduce abdominal pain

Answer 33

Linaclotide

Question 34

a peripherally acting mu-opioid receptor ANTAGONIST that dec constipation

Answer 34

Alvimopan

Question 35

Amitiza

Answer 35

Lubiprostone -- think nausea & OIC

Question 36

Linzess

Answer 36

Linaclotide

Question 37

Trulance

Answer 37

Plecanatide

Question 38

Alvimopan, methylnaltrexone, naloxegol are examples of

Answer 38

peripherally acting mu opioid receptor atagonists

Question 39

Entereg

Answer 39

alvimopan

Question 40

Relistor

Answer 40

Methylnaltrexone

Question 41

Movantik

Answer 41

Naloxegol

Question 42

A sodium/hydrogen exchanger (NHE3) inhibitor

Answer 42

tenapanor/isbrela

Question 43

Prucalopride and tegaserod are examples of

Answer 43

serotonin 5h4 receptor agonists WARNINGS: suicide ideation

Question 44

What laxative that is used for whole bowel irrigation has a boxed warning for nephropathy

Answer 44

OsmoPrep

Question 45

What laxative has a contraindication to acute phosphate nephropathy, gastric bypass or stapling surgery

Answer 45

OsmoPrep

Question 46

Colyte, GoLytely, NuLytley

Answer 46

Polyethylene glycol electrolyte solution

Question 47

Osmoprep

Answer 47

Sodium phosphates

Question 48

Suprep Bowel Prep kit

Answer 48

Sodium sulfate, potassium sulfate, and magnesium sulfate