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NAPLEX review 2024 RXPrep Book > Gastrointestinal Conditions: Constipation & Diarrhea > Flashcards

Gastrointestinal Conditions: Constipation & Diarrhea Flashcards

(51 cards)

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1
Q

Bulk-forming laxative

A

ie; soluble fiber such as psyllium + dietary fiber = 1st line, and drug of choice in pregnancy

absorb water in intestine, add bulk to stool. inc peristalsis and dec stool transit times

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2
Q

Osmotic laxatives

A

ie. Polyethylene Glycol (PEG)

draw fluid into bowel lumen via osmosis, distends cold and inc peristalsis

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3
Q

Stimulant laxatives

A

ie. Senna, Bisacodyl

directly stimulate neurons in colon, causing peristaltic activity

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4
Q

Stool softener

A

ie: docusate

Emollients that reduce surface tension of stool oil-water interface, allowing more water and fat to mix with stool.

softening your shit and making it easier to go.

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5
Q

Lubricant laxatives

A

ie. mineral oil

coat bowl and stool in waterproof film
keeps moisture in stool, makes pooping easier

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6
Q

OTC recommendation for constipation in most adults

A

fiber

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7
Q

OTC recommendation for constipation in iron induced or hard stools

A

tool softener or bulk-forming drug

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8
Q

OTC recommendation for constipation in opioid-induced patients

A

stimulant or osmotic laxative

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9
Q

OTC recommendation for constipation in pregnancy

A

fiber

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10
Q

OTC recommendation for constipation if fast relief is req

A

adults: bisacodyl or glycerin suppository
children: glycerin suppository

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11
Q

Bulk forming drugs

A

Psyllium = Metamucil
Calcium polycarbophil = FiberCon
Methylcellulose = Citrucel
Wheat Dextrin = Benefiber

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12
Q

Bulk forming side effects

A

flatulence
abdominal cramping
bloating
bowel obstruction

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13
Q

Bulk forming drug notes

A

onset 12-72hrs

req adequate fluids

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14
Q

Osmotic laxatives

A

Magnesium hydroxide = Milk of magnesia
Polyethylene glycol 3350 = miralax
Glycerin = Fleet
Lactulose = Constulose, Enulose
Sodium phosphates = Fleet enema
Sorbitol = enema

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15
Q

Osmotic laxatives side effects

A

electrolyte imbalance
abdominal cramping
flatulence
dehydration

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16
Q

osmotic laxatives notes

A

30min - 96hrs onset

magnesium containing = caution renal impairment
lactulose = used in hepatic encephalopathy
glycerin supp = used commonly in children

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17
Q

Stimulant laxatives

A

Senna = Senokot, Ex-lax
Senna + decussate = Senna S, Senokot S
Bisacodyl = Dulcolax

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18
Q

Stimulant laxative warnings

A

avoid use with stomach pain, N/V, or sudden change in bowel movements in last > 2wks

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19
Q

Stimulant laxative side effects

A

abdominal cramping, electrolyte imbalance, rectal irritation

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20
Q

Stimulant laxative notes

A

onset 6-12hrs for oral, 15-60min rectal

take at bedtime to induce movement in morning

often given with chronic opioids

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21
Q

Emollients (stool softeners)

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A

Docusate sodium = Colace
Docusate + Senna = Senna S/ Senokot S

22
Q

stool softener CI and Side effects

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A

CI: abdominal pain, N/V, using with mineral oil OTC use > 1wk

SE: abdominal cramping

23
Q

Stool softener notes

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A

onset 12-72hrs for oral
preferred when straining should be avoided ie post partum/hemorrhoids
use when stool hard/dry

24
Q

Lubricant laxatives

25
Mineral oil info
CI: Age < 6, pregnancy, bedridden SE: abdominal cramping, nausea, incontinence, rectal discharge
26
RX medications for constipation
Lubiprostone = Amitiza Linaclotide = Linzess Plecanatide = Trulance Alvimopan = Entereg Prucalopride = Motegrity methylnaltrexone = Relistor Naloxegol = Movantik
27
Lubiprostone (Amitiza) info
CI: mechanical bowel obstruction MOA: chloride channel activator SE: N, diarrhea, abdominal pain, headache Notes: take w/ food/water to dec nausea
28
Linaclotide (Linzess) info
Boxed warning: dont usein pediatric pts, high risk of dehydration MOA: Guanylate Cyclase C agonists CI: < 6yrs old, mechanical GI obstruction SE: diarrhea, abdominal pain, farting
29
Alvimopan (Entereg) info
Boxed warnings: potential risk of MI w/ long-term use, only short term inpatient with REMS CI: Therapeutic doses of opioids for > 7 consecutive days SE: Dyspepsia
30
Prucalopride (Motegrity) info
CI: GI obstruction Warning: suicidal ideation SE: Diarrhea, nausea, abdominal pain
31
Laxatives used for whole bowel prep
PEG solution = GoLytely, Colyte Sodium Phosphates = OsmoPrep Sodium sulfate, potassium sulfate, mag sulfate = Suprep Bowel Prep Kit
32
Osmoprep boxed warnings
Nephropathy
33
Osmoprep contraindications
acute phosphate nephropathy, gastric bypass or stapling surgery
34
whole bowel prep irrigation laxative notes
prep regimen usually start night before, and morning of procedure usually clear liquid diet req day prior dont consume w/ solid or semi-solid foods, anything with red/blue/purple food dye
35
most common cause of diarrhea
most cases are viral E.coli causes most
36
Anti-diarrhea drugs
bizmut subsalicylate = Pepto-Bismol Loperamide = Imodium Diphenoxylat/atropine = Lomotil Dicyclomine = Bentyl Eluxadoline = Vibrezi
37
Pepto-Bismo Contraindications
Salicylate allergy taking other salicylates GI ulcer bleeding black/bloody stool
38
Pepto-Bismo warnings
children and tens recovering from flu/chicken pox or other viral infections shouldn't use
39
Pepto-Bismol side effects
black tongue/stool salicylate toxicity if used too much nausea
40
Loperamide (Imodium) dosing instructions
take 2 tablets by mouth at first episode, then take 1 tablet by mouth each episode following. max 4 tablets per day (8mg) self care or 8 tabs (16mg) hospital
41
Loperamide boxed warnings
Torsades de pointes cardiac arrest and sudden death with higher than recommended dose Dont use children < 2yrs old
42
Loperamide contraindications
acute dysentery = bloody diarrhea/fever C.diff
43
Loperamide Side effects
constipation abdominal cramping nausea QT prolongation
44
max time you should use loperamide for self treatment?
48hrs
45
Diphenoxylate/atropine (Lomotil) contraindications
risk of respiratory and CNS depression in kids, dont use if < 2yrs of age ( < 6yrs for tab)
46
Diphenoxylate/atropine (Lomotil) notes
liquid formulation recommended < 13 yrs old
47
Diphenoxylate/atropine (Lomotil) side effects
possible anticholinergic effects mild euphoria
48
Dicyclomine (Bentyl) warnings and Side effects
warnings: anticholinergic, caution > 65yrs old can use in toxic megacolon or paralytic ileum SE: dizziness, dry mouth, nausea, blurred vision, somnolence, weakness
49
Eluxadoline (Vibrezi) contraindications
pts without gallbladder alcoholic or > 3 drinks/day hx of severe constipation
50
Eluxadoline (Vibrezi) warnings and side effects
Warning: CNS depression Side effects: constiaption, nausea, abdominal pain
51

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