Constipation Flashcards
(29 cards)
List some factor that contribute to constipation
PNS - stimulate motility
SNS - stops motility
GI hormons
Serotonin (IBS)
CNS (emotions)
gastro-colic reflex
List some concerns
medication induced
DB
colon cancer
IBS
blood
anal fissure
can’t pass gas
3 days w/o anything
Red flags of constipation
> 7 days w/o BM
change in texture
blood
weight loss
decreased habit
change in BM
fever
pain
narrow stools
unresponsive to treatment
When to get help?
if stomach pain
blood loss
losing weight w/o trying
Non drug measures for C
fluid
exercise
fiber (25 g for women, 38 g for men)
look at diet overall
What medications are preventive?
bulk
docusate
PEG350
What meds are acute use?
senna
bisacodyl
What are worrying signs in elderly?
unexplained weight loss
blood in stool
fever
N, V
family history of colorectal cancer
What meds for C can be used in pregnancy?
docusate
PEG350
What meds are CI in pregnancy?
senna
bisacodyl
MOM (milk of Mg)
What are some meds that can cause C?
opioids
antihistamine (1st gen)
tricyclic antidepressants
Example of bulk forming agents
PEG350
psyllium
poly carbophil
MOA of bulk forming agents
swell intestinal
create gel to help push it thru
takes a few days
make sure to have with fluids
Example of stool softener
docusate
MOA of stool softener
anionic surfactant
softens the fecal mass
CI with stool softener
mineral oil
Examples of lubricant
mineral oil
MOA of mineral oil
softens by coating it
main problems with mineral oil
anal leakage
lipid penumonia
MOA of saline
osmotic
-non-absorbable ions
-remains in the gut
higher osmotic
draws water in
Examples of non-saline osmotic
glycerin suppositories
MOA of glycerin suppositories
osmotic-local irritant
used with young
within 30 mins
MOA of lactulose syrup
colon –> bacteria –> lactic acid –> osmotic pressure –> increase stool volume
works within 1-2 days
S/E of Lactulose syrup
gas/bloating
