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NURS2514 > Week 2: GI Tract - Laxatives > Flashcards

Week 2: GI Tract - Laxatives Flashcards

1
Q

What are the 4 types of laxatives?

A
  • bulk-forming
  • surfactant
  • stimulant
  • Osmotic
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2
Q

Which medication is an example of a bulk-forming laxative? (2)

A

Psyllium
AKA meta mucil

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3
Q

What is the MOA of bulk-forming laxatives?

A
  • Similar action to fiber
  • increase in bulk leads to soft formed stool

good for people to struggle to meet fiber requirements

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4
Q

What is psyllium made of?

A
  • polysaccharides and cellulose derived from grains and plants (nondigestible)
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5
Q

How should psyllium be administered and why? (3)

A
  • Not absorbed systemically (side effects rare)
  • Should be administered with large glass of water to avoid obstruction/impaction (esophageal)
  • Produces a soft but still formed stool in 1-3 days
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6
Q

What are the indications for psyllium? (3)

A
  • chronic constipation
  • Prevent straining of stool
  • IBS
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7
Q

Which 3 medications are examples of osmotic laxatives?

A
  • lactulose
  • Laxative salts: Magnesium Hydroxide
  • Polyethylene Glycol (restoraLAX)
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8
Q

What is lactulose made of? (2)

A

combination of galactose and fructose

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9
Q

What is the MOA of lactulose? (3)

A
  • Turns into lactic acid in the colon, which has an osmotic action similar to other osmotics
  • Hepatic encephalopathy: helps with excretion of ammonia
  • Produces a soft stool in 1-3 days
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10
Q

What are the side effects of lactulose? (2)

A
  • Poorly absorbed and not digested by enzymes in the GI tract, cause N+V
  • tons of adverse effects and more expensive than other laxatives
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11
Q

How do laxative salts like magnesium hydroxide work?

A
  • Poorly absorbed salts and osmotic action draw water into the intestinal lumen
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12
Q

What are indications for magnesium hydroxide? In other words, when would you use low doses vs high doses?

A

Low dose therapy - stool within 6-12 hrs
High dose - Bowel evacuation prior to surgery or to purge poisons (2-6 Hours)

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13
Q

What is a risk of using magnesium hydroxide?

A

dehydration

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14
Q

What are contraindications for magnesium hydroxide?

A
  • kidney disease (cannot excrete waste as efficiently, causing build up of Mg in bloodstream
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15
Q

What does purgative mean?

A
  • vigorous evacuation of GI because we want to completely clean out our bowels
    ie. before procedures
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16
Q

What is the MOA of polyethylene glycol? (3)

A
  • non-absorbable compound
  • retain water in the intestinal lumen
  • ## Causes the feces to swell and soften
17
Q

What are the indications for polyethylene glycol?

A
  • Chronic constipation
  • Can be used as a bowel cleanse prior to colonoscopy or other procedures at high doses
18
Q

What are the side effects of polyethylene glycol? (4)

A
  • Nausea
  • cramping
  • flatulence
  • diarrhea
19
Q

What is the time of onset for polyethylene glycol in low and high doses?

A

Low: 6-12 hours
High: 2-6 hours

20
Q

Which medication is an example of a stimulant laxative?

A

Bisacodyl (dulcolax)

21
Q

What is the MOA of bisacodyl? (2)

A
  • Stimulate intestinal motility
  • Increases the amount of water and electrolytes within the bowel
22
Q

What are the indications for bisacodyl?

A
  • Opioid induced constipation
23
Q

Which medication is common for laxative abuse?

A
  • Bisacodyl (dulcolax)
24
Q

What routes can bisacodyl be administered? (2)

A
  1. Oral - 6-12h
  2. Rectal - 15-60 mins
25
Q

What time should bisacodyl be administered?

A

often given at bedtime to produce a stool the next day (but route gives a different time of onset)

note that this is not a purgative drug, it just works quicker

26
Q

Which medication is an example of a surfactant laxative?

A
  • Docusate sodium (colace)
27
Q

What is the MOA of docusate sodium? (2)

A
  • works in the small intestine and colon by softening the stool by facilitating penetration of water
  • also causes secretion of water and electrolytes into the intestine

It lowers the surface tension of stool and acts on the intestinal wall

28
Q

What is the time of onset for docusate sodium? (2)

A
  • Slow
  • produces a soft stool in 1-3 days
29
Q

What are the adverse effects of docusate sodium? (2)

A
  • mild cramping
  • Diarrhea
30
Q

What is an indication of docusate sodium?

A

Usually given post MI to reduce straining

31
Q

When should laxatives stop being administered?

A
  • until the desired effect is achieved (soft BM) and should be used short term as they are subject to abuse
32
Q

What are some nursing considerations for administering laxatives? (3)

A
  1. Water consumption is important (bulk forming and osmotic)
  2. Gi assessment to identify desired effect (or if too effective - diarrhea)
  3. Most laxatives are not absorbed systemically so side effects will primarily be GI related

NURS2514 (32 decks)

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