T2-Laxatives Flashcards Preview

Melissa's Pharm 2 > T2-Laxatives > Flashcards

Flashcards in T2-Laxatives Deck (53):
1

Constipation is determined more by stool _____ (degree of hardness) than by _____ bowel movements occur

Consistency; how often

2

What are the common causes of constipation?

Decreased fiber and fluid
Dysfunction of ANS
Medications

3

What are some medications that increase your risk for constipation?

Anti-cholinergic
Opioids
Verapamil (CCB)

4

What happens with laxative overuse (3)?

Dehydration
Electrolyte imbalances
Normal defecation lost (you depend on laxative for BM)

5

Who may take a lot of laxatives (and diuretics)?

People with anorexia nervosa

6

What are the 4 classes of laxatives?

Stool softeners
Osmotic laxatives
Stimulate laxatives
Bowel Preparation

7

What is the drug for stool softeners?

Docusate sodium

8

What does the word emollient mean?

To soften

9

Docusate sodium is similar to ___

Soap

10

If you take docusate sodium, how long before you have a BM?

Several days

11

Docusate sodium is similar to soap in that it mixes fats and water. So it helps water get in the stool to soften it up. What must we teach our client regarding this?

Take docusate sodium with FULL glass of water

12

T/F: Docusate sodium stimulates you to have a BM.

FALSE. It doesn't stimulate you to have a BM. It just makes you have a SOFT BM so it is easier for you to go

13

When do we give docusate sodium?

Opioid therapy (prophylaxis)
In patients who need to avoid straining!

14

We give docusate sodium in patients who need to avoid straining. What are some examples and what is something that may happen to them if they didn't take the stool softener and strained during BM?

Patients with:
Hemorrhoids: Bleeding
CV disease: MI
Episiotomy: Big tear

15

What is the MOA of osmotic laxatives?

Pulls water into GI tract

16

What is the drug that is an osmotic laxative?

Polyethylene glycol (PEG) 3350 aka Miralex

17

What does PEG 3350 do to stool?

Softens and increases size of stool

18

What is Polythylene glycol good for?

Chronic constipation

19

What are the adverse effects of PEG 3350?

How long does it take to have a BM?

Well tolerated
Bloating, cramping

2-4 days

20

What do we teach our patients who are taking an osmotic laxative, such as PEG 3350?

Dissolve it in 4-8 ounces of fluid...it usually takes 5-10 minutes to dissolve but it will dissolve completely

21

What is the MOA of stimulant laxatives?

Irritates the GI tract and increases motility

22

If you take a stimulate laxative PO, how long before you have a BM?

12 hours

23

If you take a stimulate laxative PR, how long before you have a BM?

1 hour

24

What are the 3 major stimulants?

Senna
Bisacodyl
Senna/docusate

25

Is senna (stimulate laxative) PO or PR?

PO

26

Is bisacodyl PO or PR?

Both forms

27

When you mix senna with docusate, what happens to stool?

"Mush and push" So the docusate will soften it and the senna will make you have a BM quickly and it's now soft and easy to come out

28

What are the adverse effects to the stimulate laxatives (senna, bisacodyl and senna/docusate)

GI discomfort (nausea, cramping, bloating)
Yellowish-brown or pink urine (senna)

29

When do you give a bowel preparation drug?

Before a surgery or colonoscopy

30

What is the bowel prep. drug?

PEG 3350 with electrolytes

31

What is the trade name for the bowel prep. drug?

GoLYTELY

32

How much GoLYTELY has to be drunk and do patients like it?

4 L!! NO, it has a large sodium concentration so it is salty!

33

What are some tricks for drinking all 4 L of the PEG 3350 with electrolytes (bowel prep)?

Chill before drinking
Mix with crystal light
Chug: DONT SIP.
Make sure a toilet is nearby!!!

34

What class is docusate sodium?

Stool softener

35

What class irritates the lining of the GI tract?

Stimulant

36

Senna

Stimulant

37

PEG 3350

Osmotic

38

Taken to help avoid straining?

Docusate sodium (stool softener)

39

Weird effect of yellowish-brown or pink urine (what drug and class)?

Senna; stimulant

40

BM in 12 hours

PO stimulant

41

BM in 1 hour

PR stimulant

42

BM in 2-4 days

PEG 3350 osmotic

43

BM in several days

Docusate sodium; stool softener

44

BM immediately

PEG 3350 with electrolyte; bowel prep

45

Take with a full glass of water

Docusate sodium

46

Adverse effect of nausea, cramping, bloating?

Stimulants

47

Adverse effect of bloating, cramping ?

PEG 3350; osmotic

48

Dissolve in 4-8 oz?

PEG 3350; osmotic

49

Must drink large volume of 4 L

PEG 3350 with electrolytes; bowel prep

50

What drug is "miraculous"?

Miralex (PEG 3350); osmotic!!

51

Opioid therapy prophylaxis?

Stool softener (docusate sodium)

52

What harmless effect does senna have on a person's urine?

Turn it yellowish-brown or pink

53

What is another situation in which lactulose may be helpful?

Enhance excretion of ammonia to lower it in patients with portal HTN and encephalopathy, secondary to chronic liver disease