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1. Stimulants cascara, senna, bisacodyl[Dulcolax,Correctol], castor oil[Purge] contraindicated in pregnancy drug of choice when rapid response is needed short term use only
2. Osmotics: draws water into the intestinal lumen to increase intraluminal pressure, hypertonic salt-based magnesium hydroxide[Phillips chewables, MOM], magnesium citrate, sodium phosphate[Fleets], polyethylene glycol electrolyte solution[GoLytely][prep for procedures,flush poisons,remove parasites] polyethylene glycol[PEG] 3350[constipation][Miralax]
Magnesium hydroxide contraindicated in renal insufficiency, hypermagnesemia, hypocalcemia, heart block
Osmotic contraindicated in children polyethylene glycol electrolyte solution b/c of concerns of electrolyte disturbance; PEG 3350[Miralax] not in children un der 4
3. Bulk-producing: safest, similar to increasing fiber, less habit forming psyllium[Metamucil], methylcellulose[Citrucel, polycarbophil[Fibercon] used for long-term, chronic constipation, to avoid straing, management of chronic watery diarrhea
4. Lubricants Mineral oil; retards colonic absorption and softens stool; does not stimulate peristalsis; concern for aspiration in children under 4; should be avoided in pregnancy r/t decreased absorption of fat-soluble vitamins and hypoprothrombinemia in the newborn
5. Surfactants: stool softeners, docusate compounds[sodium[Colcace], calcium, potassium]; safe in all ages; most helpful in hard/dry stool, painful passage of stool, to avoid straining
6. Hyperosmolar: exert an osmotic effect by drawing water from the extravascular spaces into the intestinal lumen Glycerin[impactions, neurogenic bowel], Lactulose[chronic constipation in older adults, hepatic encephalopathy by inhibiting absorption of ammonia from the intestine]
Bulk-forming precautions allergic rxns such as rash, rhinitis, bronchospasm when pts accidentally inhaled the laxatives; be careful when pouring
Created by: heatherbrown2020