Lower GIT medications Flashcards
(23 cards)
Lower GIT includes:
- large intestine
- small intestine
- rectum
- anus
Disorders affecting the Lower GIT are:
- diarrhoea
- constipation
-diverticular disease - irritable bowel syndrome
-irritable bowel disease - carcinoma
- haemorrhoids
2 major types of of Lower GIT drugs:
- laxatives
- antidiarrhoeals
What are laxatives?
- laxatives are used enable and ease elimination of constipation
There are different types of laxatives:
- faecal softeners
- bulk-forming (high fiber) agents
- stimulants
- Osmotics
- lubricants /facael softeners
- combination of stool softener and stimulant
Faecal softeners:
- used to treat acute constipation and to prevent straining
- examples - Coloyxl, Docusate
Nursing considerations - may cause mild cramping or diarrhoea
- should not be used with other laxatives -
Bulk forming agents:
- safest form
- high fibre
- absorbs water and increase volume, bulk and moisture
- examples - Psyllium hydrophilic muciloid (Metamucil
Nursing considerations: - must be followed with a large amount of fluid
- may cause abdominal cramps and diarrhoea
- nausea and vomiting
-prevents calcium absorption
Stimulants (irritant laxatives):
- increase peristalsis
- stimulation of colon nerves (senna)
- stimulation of sensory nerves in intestinal mucosa (durolox)
- stimulation of smooth muscle and inhibition of water and electrolyte reabsorption (castor oil)
- useful in neuromuscular disease/spinal disorders
- used in preparation for surgery
Nursing considerations: - not recommended for regular use
- oral preparations act between 6-12 hours
- suppositories and enemas work more quickly
- may cause rebound constipation as the intestines adapt to being strongly stimulated
Osmotic laxatives:
3 groups of osmotic laxatives:
- non absorbable inorganic salts (Epsom salts)
- non absorbable sugars (lactulose, glycerol, sorbitol, duphalac)
- polyethylene glycol (colonlytely)
Nursing considerations:
- ensure adequate water is consumed
- contraindicated in intestinal obstruction
- non absorbable salts can cause bowel movement 3-4 hours post ingestion
- non absorbable sugars needs to be monitored with patients with diabetes
- polyethylene glycol used to completely evacuate bowel prior to surgery or colonoscopy
Lubricants/faecal softeners:
- creates a barrier between the faeces and the colon wall
- prevents reabsorption of faecal fluid to soften stool
- coats surface of faeces facilitating elimination
- used where straining should be avoided
- example - liquid paraffin
Nursing considerations: - may produce abdominal cramps, vomiting, decreased absorption of nutrients
- may cause leakage and seepage from rectum
Antidiarrhoeals is:
- diarrhoea may be defined as an increase in volume, fluidity or frequency of bowel movements relative to the usual pattern for that individual
- causes include - infectious agents, toxins, drugs anxiety, chronic diseases
Managment of diarrhoea:
- determine the cause - stool sample
- prevent treat fluid and electrolyte imbalances
- prevent dehydration
- all antidiarrhoeals are given orally
- diet restricted to clear liquids for 24 hours
- food gradually added as tolerated -
2 main groups of antidiarrhoeals:
- Absorbents
- Opioid antidiarrhoeals
Absorbents are:
- most commonly used
- clay-like materials administered in tablet or liquid suspension form after each loose bowel movements
- eliminated through stool
- Example - Kaolin-pectin
Opioid antidiarrhoeals are:
- narcotic based OTC opioids
- activate opioid receptors in gut wall - reduction of secretions and suppressed GIT motility slowing passage of intestinal contents
- can also be used to decrease volume of discharge in patients with colostomies
- examples - Loperamide (Imodium), Diphenoxylate, Codeine
Opioid antidiarrhoeals nursing considerations:
- short term treatment of diarrhoea
- adverse reactions are minimal
- all antidiarrhoeals are given orally
- diet changes are part of treatment plan - clear fluids
Other lower GIT Medications include:
- Antispasmodics
- 5-Aminosalycyclates (5-ASA)
- Corticosteroids
- Immunosuppressants
- Antiflatulents
- Anorectal preparations
Antispasmodics are:
-used to treat:
- irritable colon
- hypermotility
- biliary colic
- relieves cramps and spasms
- Examples - Hyoscine, peppermint oil capsules, belladonna
- side effects may include dizziness, drowsiness, dry mouth, nausea, and bloating
5-Aminosalycyclates (5-ASA) are:
- used to treat - inflammatory bowel disease - ulcerative colitis and Crohn’s disease
- consists of sulfasalazine, olsalazine, balasalazide, and mesalazine
- adverse effects include - unexplained bleeding and bruising, itchy skin rash, difficulties breathing, sore throat, change of colour of tears and urine.
- plenty of water should be drunk while taking 5-ASA medications
Corticosteroids are:
- used to treat inflammatory bowel disease
- two most commonly drugs used are
- Prednisolone - Suppository and retention enema
- Budesonide - enteric coated tablet
Immunosuppressants are:
- also used to treat inflammatory bowel disease
- examples - Azathioprine, Mercaptopurine and Methotrexate
Antiflatulents are:
- used to treat bloating; flatulence and post operative gas pains, chronic air swallowing; functional dyspepsia
- may be used together with antacid therapy
- breaks down mucous surrounding gas bubbles allowing all bubbles to come together
- examples- Simethicone, Charcoal
Anorectal preparations are:
- used for symptomatic relief of haemorrhoids
- adverse reactions - sensitisation to the product
- examples - Dibucaine, Hydrocortisone acetate. Zinc sulfate monohydrate, Hydrocortisone foam
