STOOL

Question 1

Name an osmotic laxative

What other condition can it be used for?

Answer 1

• Lactulose
• Used in hepatic encephalopathy to reduce the amount of ammonia.

Question 1

Name a faecal softener

What is it used for ?

Answer 1

Sodium docusate and Arachis oil

-Emollients; weakest laxatives. Increase water and fat content to into passage

-Reduces pain during straining

-12-72h to take effect
-Prevent constipation but do not treat chronic constipation

Question 2

Name a stimulant laxative.

What does it do ?

Answer 2

• Senna and bisacodyl
• Stimulates persistalsis by irritate the nerve endings

Overuse may cause depednace or cramps if bowel obstruction.

Question 3

Name two other laxatives that increase gasrtic motility but are not commonly used ?

Answer 3

• Dopamine D2 antagonists (metoclopramide, domperidone):
  Decrease sphincter pressure, increase gastric emptying
  Increase peristalsis
• 5-HT4 agonists (prucalopride)
  Highly selective for 5-HT4; prokinetic.
  Generally only used for chronic constipation when other techniques fail
  Diarrhoea, headache
  Avoid with arrhythmias, intestinal obstruction, ulcerative colitis, Crohn’s

Question 4

What medication can decrease GI motility?

What kind of drug is it and where is its mechanism of action ?

Answer 4

• Loperamide
• μ-opioid selective, v. low gut absorption, does not cross BBB: minimal analgesic action
• Opioid activity inhibits myenteric plexus
• Acute diarrhoea, travel sickness, irritable bowel syndrome, bowel re-section

Question 5

What is the first-line treatment for IBS?

Answer 5

Mebeverine

Can also use peppermint oil.