GI: Constipation Flashcards Preview

BNF/Pre-Reg 2017-2018 > GI: Constipation > Flashcards

Flashcards in GI: Constipation Deck (11)
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1
Q

What are the bulk-forming laxatives? (4)

A

Bran
Ispaghula
Methylcellulose (also faecal softener)
Sterculia

2
Q

What are the stimulant laxatives? (4)

A
  1. Bisacodyl
  2. Sodium picosulfate
  3. Senna
  4. Co-danthramer/co-danthrusate

Glycerol acts as a lubricant and as a rectal stimulant by virtue of the mildly irritant action of glycerol.

Docusate sodium is believed to act as both a stimulant laxative and as a faecal softener.

3
Q

How do stimulant laxatives work?

A

Increase intestinal motility and often cause abdominal cramp.

4
Q

What are the faecal softener laxatives? (4)

A
  1. Docusate sodium
  2. glycerol supp
  3. Arachis oil
  4. Liquid paraffin
5
Q

What are the osmotic laxatives? (2)

A
  1. Lactulose - decreases proliferation of ammonia-producing organisms so useful in treatment of hepatic encephalopathy.
  2. Macrogols.
6
Q

What is linaclotide?

A

Linaclotide is a guanylate cyclase-C receptor agonist that is licensed for the treatment of moderate to severe IBS associated with constipation.

It increases intestinal fluid secretion and transit, and decreases visceral pain.

7
Q

What is lubiprostone?

A

Lubiprostone is a chloride-channel activator that is licensed for the treatment of chronic idiopathic constipation in adults whose condition has not responded adequately to lifestyle changes.

8
Q

What is prucalopride?

A

Prucalopride is a selective serotonin 5HT4-receptor agonist with prokinetic properties.

It is licensed for the treatment of chronic constipation in adults, when other laxatives have failed to provide an adequate response.

9
Q

What laxatives should be used/avoided in patients with opioid-induced constipation?

A

In patients with opioid-induced constipation, an osmotic laxative (or docusate sodium to soften the stools) and a stimulant laxative is recommended. Bulk-forming laxatives should be avoided.

10
Q

What is the first choice laxative during pregnancy?

A

A bulk-forming one if fibre supplements fail.

11
Q

What is the second choice laxative in pregnancy?

A

An osmotic laxative, such as lactulose, can also be used. Bisacodyl or senna may be suitable if a stimulant effect is necessary but use of senna should be avoided near term or if there is a history of unstable pregnancy. Stimulant laxatives are more effective than bulk-forming laxatives but are more likely to cause side-effects (diarrhoea and abdominal discomfort), reducing their acceptability to patients. Docusate sodium and glycerol suppositories can also be used.

Decks in BNF/Pre-Reg 2017-2018 Class (144):