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Hemorrhoids & Const

Hemorrhoids and constipation

When do you refer for hemorrhoids? severe pain, bleeding, seepage, change in bowel pattern, prolapse, thrombosis
nonpharm treatment: what are some methods avoid heavy lifting, foods that aggravate symptoms, NSAIDS or aspirin, only sit on toilet for 10 minutes, increase fiber and fluid intake
Local antihistamines: what are these drugs benzocaine, lidocaine, pramoxine, tetracaine
Local antihistamines: druf reactions allergen reaction, CNS and CV effects
Local antihistamines: special notes about where to apply? DONT USE INTERNALLY
Vasoconstrictors: what are meds in this class ephedrine, epinephrine, phenylephrine
Vasoconstrictors: which of the three can be used internally? phenylephrine and epherine
Vasoconstrictors: which of the three can be used only externally? epinephrine
Vasoconstrictors: what are some adverse effects of all three drugs nervousness, tremors, sleeplessness, nausea, no desire to eat
Vasoconstrictors: what are some adverse effects of only ephedrine and phenylephrine increased cardiac contractility, increased heart rate, bronchodilation
Protectants: what meds are in this class al hydroxide, glycerin, mineral oil, white petrolatum
Protectants: what are some adverse drug reactions? may cause an allergic reaction,
Astringents: what are some meds in this class calamine, zinc oxide, witch hazel-external use only
Astringents: adverse effects witch hazel: stinging, CD. Calamine and zinc: dont use chronically, may cause zinc toxicity, NV, lethargy, severe pain
Keratolytics: what are some meds in this class alcoxa and recoursinol
Keratolytics: what are some adverse effects in this class death in infants, tinnitis, unconsiousness, convulsions
Analgesics/anesthetics/antipruretics: what are some meds in this class menthol, jupiter jar, camphor
Analgesics/anesthetics/antipruretics: cautions in this class all externally used, menthol allergic reaction, jupiter jar contains phenol and if ingested can cause organ failure, camphor may cause convulsions
Corticosteroids: what meds are in this class? hydrocortisone
Corticosteroids: adverse effects skin atrophy, bacterial and fungal infections
special pop: pregnant and lactation external products only, internal products ok
special pop: children under 12 refer
special pop: elderly more prone to hemorrhoids, treatment similar to younger patients
What are some nonpharm solutions to constipation? adequate fluid intake, exercise, dont keep yourself from pooping, balanced diet, behavior modifications, increase fiber intake
Exclusions for self treatment for constipation abdominal pain, NV, sudden change in bowel movements that last over 2 weeks, using lax for 7+ days no relief, rectal bleeding
What are some causes for constipation being sedentary, disorders in the structure of the bowel, electrlyte abnormalities, diabetes or thyroid stuff, dimentia, parkinsons, depression, ED
Bulk-forming: what meds are in this class methylcellulose, calcium polycarbophil, psyllium
Bulk-forming: methylcellulose come in what types of dosage forms capsule and powder
Bulk-forming: calcium polycarbophil comes in what dosage form capsule
Bulk-forming: psillium comes in what dosage form capsule and powder
Bulk-forming: whats the MOA swell up in int fluid forming an emollient gels that soften stools and stimulate peristalsis
Bulk-forming: onset 12-24h up to 72
Bulk-forming: warning/precautions children under 6, separate bulk forming and other meds by 2 hours, hypercalcemia, diabetics, CHF or CRF
Hyperosmotic: MOA draws water into the colonand rectum through osmosis to stimulate a BM
Hyperosmotic: onset PEG 3350: 12-72 hours up to 96, Glycerin: 15-30mins
Hyperosmotic: dosage forms for PEG 3350 and glycerin PEG 3350: powder. Glycerin: rectal solid supp and rectal liquid supp
Hyperosmotic: SE of PEG 3350 minimal, bloating, abdominal discomfort, cramping, farting
Hyperosmotic: SE of Glycerin minimal, rectal irritation, hypokalemia, dont use if you have a hemorrhoid
Hyperosmotic: warnings for PEG and glycerin PEG 3350: IBS, renal disease, children under 6. Glycerin: previous issues with anal irritation
Emollient: MOA increase wetting of int fluid and make a mix of fat and watery stuff to soften stools
Emollient: onset 12-72 h up to 5days
Emollient: what dosage form does Docusate sodium come in capsule and syrup
Emollient: what dosage form does docusate calcium come in. capsule
Emollient: side effects minimal diarrhea, abdoninal cramping
Emollient: drug interactions dont use with mineral oil
Lubricant: MOA softens stool by coating teh stool and preventing absorption of fecal water
Lubricant: onset 6-8 hours for oral, 5-15 mins for rectal
Lubricant: what meds are in this class mineral oil
Lubricant: what dosage forms does mineral oil come in? oral liquid, oral liquid emulsion, oral liquid enema
Lubricant: side effects anal leakage, anal puss
Lubricant: precautions aspiration into lungs, children under 6yo, pregnant, bedridden, older, diff swallowing
Lubricant: drug interactions BC, digoxen, blood thinners, docusate
Saline: MOA osmosis to draw in water and increasing interluminal pressure
Saline: onset Mg hydroxide 30mins-6h
Saline: onset mg citrate and Na2+ phosphate preps oral: 30mins-3h Rectal: 2-15mins
Saline: what druga are in this class Mg citrate, mg hydroxide, monobasic na phosphate, mg sulfate
Saline: what DF does mg citrate come in liquid
Saline: what DF does mg hydroxide come in liquid
Saline: what DF does monobasic NA phosphate and dibasic na phosphate come in rectal liquid enema
Saline: what DF does mg sulfate come in solid
Saline: side effects minimal, abdominal cramping, NV, dehydration, electrolyte imbalance
Saline: warnings precautions renal impairment, newborns, older adults, Naphosphate contraindicated in CHF
Saline: drug interactions oral anticoagulants, digoxin, chlorpromazine, tetracycline, other products with mg
Stimulant: MOA stimulate muscle in GI to contract and move stool, soften stool, increase of electrolytes
Stimulant: onset oral: 6-10h up to 24 rectal: 15-60mins
Stimulant: what are some drugs in this class senna, bisacodyl, castor oil
Stimulant: what DF does senna come in tab
Stimulant: what DF does bisacodyl come in tab and rectal solid supp
Stimulant: what DF does castor oil come in liquid
Stimulant: what are some SE cramp, electrolyte deficiencies, malabsorption, increased mucous secretion Senna makes the pee pink/brown
Stimulant: drug interactions bisacodyl: antacids, H2RA, PPI, Milk
docusate increases what mush
bisacodyl and senna increase what push
Children 2-6 recommendation 1st: oral docusate or mg hydroxide, quicker: glycerin syrup
children 6-12 recommendation 1st: bulk forming, docusate, mg hydroxide, quicker relief: glycerin or bisacodyl supp
opioid induced recommendation stim+emolient (senna and bisacodyl+ docusate)
ocassional constipation bulk forming or PEG 3350, mg hydroxide
prevent straining recommedation emoliant like docusate
colonoscopy recommendation peg 3350 w or wo stimulant mg citrate
hemorrhoids recomendation emollient docusate
advanced age recomendation oral bulk orming, peg 3350 and docusate
pregnancy/lactation recommendation 1st: oral bulk forming, docusate 2nd: senna, bisacodyl, peg 3350
Created by: carlypentland



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