GI MOTILITY FINAL

Question 1

who do u treat constipation ?

Answer 1

first with diet if does not work then move to laxative

Question 2

The number one cause of constipation ?

Answer 2

is laxatives

Question 3

What are Laxatives

Answer 3

Used to ease stimulate defecation

• soften stools
• Increase stool volume
• Misuse comes from misconceptions of what constitutes normal bowel function

Question 4

Laxative Effect

Answer 4

• Production of soft, formed stool over 1 or more days

- Relatively mild

Question 5

Catharsis

Answer 5

• Abrupt fluid evacuation of the bowel
• Fast and intense
• That ED!!!

Question 6

Types of laxatives

Answer 6

Chemical Stimulants: Chemically irritate the lining of the GI tract

Bulk stimulants: Cause the fecal matter to increase in bulk

Lubricants: Help the intestinal content move more smoothly

Stool Softeners

Question 7

Diet: Benefits of fiber

Answer 7

Absorbs water: softens feces and increases size

Can be digested by colonic bacteria whos growth increases fecal mass.

Low fiber diet = constipation

Question 8

Indication of Laxative

Answer 8

• Obtain fresh stool sample
• Empty bowel before treatment of procedure
• Expel dead parasites after treatment
• Constipation (opioid use)
• Prevent fecal impaction in bedridden patients (concern )
• Remove posions

Question 9

Contraindications of laxative use

Answer 9

• Abdominal pain, nausea, cramps, or other symptoms of appendicitis, regional enteritis, diverticulitis, or colitis,
• Acute surgical abdomen
• Fecal impaction or bowel obstruction
• Habitual use
• Use with caution in pregnancy and lactation

Question 10

Class of laxatives

Answer 10

• Bulk-forming laxatives
• Surfactant laxatives
• Stimulant laxatives
• Osmotic laxatives

Question 11

Bulk-forming laxatives

Answer 11

Magnesium Sulfate (Epsom Salt) 
Magnesium Citrate (citrate of Magnesia)
Magnesium Hydroxide (MOM)
Lactulose (chronulac) 
Polycarbophil (fiberCon)
Psyllium (metmucil)

Question 12

Bulk-forming laxatives must be taken with the following or will cause even worse constipation

Answer 12

WATER! MUST BE TAKEN WITH LOTS OF WATERRRRR

Question 13

BUlk stimulants action

Answer 13

stretch the bowel content intestinal walls which causes reflex contractions that pushes bowls fwd

Question 14

Surfactant laxatives

Answer 14

Docusate sodium (colace)

Question 15

Docusate Sodium: Emollients

Answer 15

Glycerin suppositories: insert into the rectum

Question 16

Stimulant laxatives

Answer 16

Bisacodyl (ducolax)

Question 17

Osmotic laxatives

Answer 17

Milk of magnesia MOM

Question 18

Saline and osmotic laxatives: MOM

Answer 18

Effectes in 1-3 hrs

Used in purge intestine

Question 19

Classification of laxative

Group 1

Group 2

Group 3

Answer 19

Group 1: Act rapidly 2 to 6 hr stool is watery, useful for preparing bowel for a procedure

Group 2: 6 to 12 hrs Intermediate latency produce a semifluid stool

Group 3: Most abused by the public take 1 to 3 days to produce soft formed stool

Question 20

What Salt saline laxative will you use for a patient before a colonoscopy or checking the prostate.

Answer 20

Sodium phosphate (used in enema)

Sodium citrate ( used as enema)

Question 21

Chemical stimulants laxative prototype

Answer 21

Cator oil

Question 22

Castor oil

Answer 22

Used for treating parasitic infection

Question 23

Are laxative safe for children and pregnancy

Answer 23

YES

Question 24

Lubiprostone- PGE1 stimulates chlroide channels causing

Answer 24

chloride rich secretions

Question 25

cholinergic substances

Answer 25

Betanechol ACE Inhibitors - distigmine (Ubretid) - neostgmine (synostigmin, proteigmin) - Pyridostigmine

Question 26

Gastrointestinal Stimulants

Answer 26

Dexpanthenol (Ilopan) - Increases acetylcholine levels and stimulates the parasympathetic system Metoclopramide (Reglan) - Blocks dopamine receptors and makes the GI cell more sensitive acetylcholine - Leads to increased GI activity and rapid movement of foods - Parkinson like syndorme Domperidon (Motilium) - Low penetration into CNS decreased side effects ``` Erythromycin Indications - Diabeticgastroparesis -small intestine dysmotility - scleroderma ileus ```

Question 27

ACE Inhibitor side effects

Answer 27

- Salivation - sweating - diarrhea - bradycardia - misos

Question 28

what are antispamodics

Answer 28

Butylscopolamine: antimuscarinic agent Fenpiverine: anitmuscuarinic agent

Question 29

Gastrointestinal Stimulants Adverse Effects

Answer 29

- Nausea - vomiting - diarrhea - intestinal spasm - cramping - low BP - weakness - fatigue

Question 30

Gastrointestinal stimulants D to D interaction

Answer 30

Digoxin Cyclosporine Alcohol

Question 31

Nursing considerations for gastrointestinal stimulants

Answer 31

``` Asess Intestinal obstruction, bleeding, proferation pregnancy and lactation cardiopulmonary status, pulse and Bp skin ```

Question 32

Metoclopramide

Answer 32

Relief acute and chronic diabetic gastropraresis, short term treatment of GI reflux, GERD if cant tolerate other meds if you gave a patient barium u should give them metoclopramide instead Prevention of chemo nausea and vomiting

Question 33

Lubiprostone Selective chloride channel activator

Answer 33

promotes secretion of chloride rich fluid into the intestines Enhances motility semi soft stool in 24 hr

Question 34

A patient who abused laxative to start everything again

Answer 34

use glycerin suppository

Question 35

Bowel Cleansing

Answer 35

Sodium phosphate used for enema -hypertonic can cause dehydration and electrolyte disturbance possible renal damage

Question 36

Indications for diarrhea

Answer 36

2-3 days Severe diarrhea in the elderly or small children Chronic inflammatory disease When the specific cause has been determined

Question 37

Anti diarrheal Agents

Answer 37

Diphenoxylate (Lomotil) | Loperamide

Question 38

Diphenoxylate (Lomotil)

Answer 38

opidate agonist likes to ask or wah eva ``` is poisoned with atropine, to make it less tolerable Low in addiction little CNS peneration Not IV administration short acting ``` Side effects: those of morphine and atropine

Question 39

Loperamide (Imodium, )

Answer 39

no atropine in prep long acting half life 7 to 14 hrs Side Effects: dry mouth, nausea and vomiting, drowsiness, dizziness Mechanism same as morphine

Question 40

Loperamide

Answer 40

drug of choice no atropine in prep long acting half life 7 to 14 hrs Side Effects: dry mouth, nausea and vomiting, drowsiness, dizziness Mechanism same as morphine

Question 40

Adsorbants

Answer 40

Bismuth

Question 41

Treat Cdiff

Answer 41

discontinue antibiotic and use Metronidazole and Vancomycin (contraindication turns you red REDMAN effect)

Question 42

Avoid the following for diarrhea

Answer 42

``` caffeinated Alcohol spicy milk foods 3L of water should be drinking ```

Question 43

Simethicone

Answer 43

Helps break down gas Alters elasticity of mucus- coated bubbles causing them to break