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Nur210 Laxatives
Pharmacology laxatives
| Question | Answer |
|---|---|
| What are properties of lubricants? | Mineral oil (Haley's MO) Coats fecal contents for easier passage Reduces water reabsorption in colon - makes stool a little bit softer Used to prevent straining Decrease absorption of fat soluble vitamins (A, D, E and K) because of the coating |
| What are properties of osmotic laxatives? | Milk of magnesia Osmotic effect increases pressure in the bowels - draws water into intestinal lumen Stimulates peristalsis used for acute emptying of bowel Avoid in patients with kidney dysfunction |
| What are properties of stimulant laxatives? | bisacodyl (Dulcolax) Irritate intestinal mucosa to increase motility - can cause semisolid stool in 6-12 hours Used to prepare bowel for diagnostic procedures Can cause severe cramping People will abuse to lose weight Chronic use fluid imbalance |
| What are properties of surfactant laxatives? | Docusole sodium (Colace) - take 1-3 days to work Detergents that lower surface tension Increase secretion of water by intestine - causes bulk formation Short-term therapy to prevent straining Little to no value for chronic constipation |
| What are properties of bulk-forming laxatives? | Psyllium (metamucil) - takes several days to work Least irritating, most natural, identical to dietary fiber Best for chronic constipation Used to relieve mild, watery diarrhea Can cause esophageal obstruction; turns to concrete upon standing |
| What are the classifications of laxatives? | Lubricants Osmotic Stimulant Surfactant Bulk-forming |
| What are indicators for laxative use? | Constipation - stool consistency; frequency Treatment/procedure preparation (i.e. colonoscopy) Eases defecation Stimulates defecation |
| What are some steps to take in bowel training? | Provide privacy and normal position Recognize the "urge" Gastro-colonic reflex - food in/ food out Increase fluid intake - stimulates food in/food out reflex Increase fiber Increase activity Avoid valsalva maneuver - very hard on heart |
| How would one do an assessment for constipation? | Assess rectal and colon problems Assess medications - narcotics cause constipation as does anasthesia Assess lifestyle - eat enough fiber? active? stress? change in routine? Assess age - older lose sensation, peristalsis and perineal/anal muscle tone |
| What are the Rome II criteria for functional constipation? | Adults - Two or more of the following at 12 weeks: straining, lumpy hard stool, sensation of incomplete evacuation, less than 3 stools/week Infants/children - pebble-like hard stool, firm stools 2X/week or less for 2 weeks |
| What are properties of normal feces? | 75% H2O, 25% solid material Soft, brown, formed stool 100-400 grams/day Frequency varies with individuals |
| What is the function of the large intestine? | 90% of H2O reabsorption occurs in the large intestine Reabsorb H2O and electrolytes Flatus and fecal elimination |
| What are proton pump inhibitors? | Prilosec, Nexium (omeprazole) Blocks the proton pump (H+) Inhibits gastric acid secretion Short half-life; supposed to be used for short-term Side effects - headache, GI nausea, vomiting and diarrhea |
| How do Histamine-2-antagonists work? | Same effects as antacids, but don't have to take as frequently Inhibit histamine receptors of parietal cells (that produce acid) Decrease acid production |
| What are some Histamine-2-agonists? | End in -tidine May have to double dosage to reach prescription strength Cimetidine (Tagament) - interacts with multiple meds; increased confusion in older adults Ranitidine (Zantac) - not as much confusion; doesn't enter CNS readily Axid,Pepcid |
| What are effects of antacids? | Increase pH; want above 5 to inhibit pepsin activity Decreases destruction of gut wall Neutralizes stomach acid |
| What are properties of antacids? | Neutralize stomach acid ADRs - constipation (aluminum hydroxide), diarrhea (magnesium hydroxide), drug interactions, too much sodium Used for GERD and as calcium supplement |
| What is some information on Helicobacter pylori? | Test for presence by biopsy, breath, serum and stool Treatment - at least 2 antibiotics to minimize resistance Also need to be on Histamine-2-antagonists or PPIs |
| What are the classes of antiulcer drugs? | Antiobiotics - against H. pylori Antacids Antisecretory agents - Histamine-2-antagonist and proton pump inhibitors |
| What are some lifestyle modifications to prevent peptic ulcers? | Stop smoking Avoid ASA and NSAIDs Little evidence to support changing diet, avoiding alcohol, or decreasing stress |
| What are aggressive factors associated with peptic ulcer formation? | Helicobacter pylori - 75% of people with peptic ulcers have this bacterial infection Gastric acid Smoking - nicotine - decreases bicarbonate NSAIDs Corticosteroids |
| What are defensive factors against the formation of peptic ulcers? | Protect the stomach Mucus Bicarbonate (neutralize acid) Blood flow Prostaglandins |
Created by:
ssbourbon
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