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11 Cards in this Set
- Front
- Back
- 3rd side (hint)
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symptoms of constipation
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1. difficulty passing stools
2. a feeling of incomplete evacuation 3. abdominal discomfort and bloating |
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lifestyle factors predispose to constipation
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1. inadequate fluid intake
2. insufficient dietary intake 3. insufficient physical activity 4. suppressing the urge to defecate |
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medical history predispose to constipation
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1. coeliac disease
2. damage to pelvic floor muscles 3. depression 4. diabetes mellitus 5. GI obstruction, IBS |
6. hypercalcaemia, hypokalaemia
7. hypothyroidism 8. multiple sclerosis 9. Parkinson's disease 10. pregnancy |
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medicines cause constipation
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1. 5-HT receptor antagonist
2. antacid containing Al, Ca 3. antidepressants - TGA and some MAOI 4. anticonvulsants - carbamazepine, phenytoin, pregabalin 5. antihistamines (mainly sedating antihistamine) 6. antimuscarinic - benztropine, orphenadrine, benzhexol 7. antipsychotic - clozapine, olanzapine, riseperidone, quetiapine 8. beta-blocker - propanolol |
9. Ca, Fe supplement
10. clonidine 11. diuretics 12. dopaminergic drugs used in Parkisonism 13. opioid 14. sucralfate (contain Al) 15. verapamil 16. vinca alkaloids |
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the need to refer
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1. constipation not attribute to change in diet. lifestyle, disease state or medication
2. alternate constipation and diarrhoea 3. blood, mucus in stools (tarry, red, black stool) 4. persistent/severe abdominal pain and vomitting 5. unintentional weight loss 6. tenemus (continuos feeling of the need to defecate) |
1. sudden change in bowel habits lasting more than 2 weeks
2. constipation persist after 1 week of laxative or 2 weeks of dietary modification 3. infants <3 months |
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bulk-forming laxative
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1. ispaghula
2. sterculia 3. psyllium |
1. 2-3 days for full effect
2. faecal impaction should be treated before that 3. adequate fluid, gradual increase dose to reduce bloating and flatulence |
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osmotic laxative
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1. lactulose (actilax, duphalac, lac-dol)
2. PEG: macrogol 3350 with electrolyte (movicol) 4. glycerol/glycerin 5. sorbitol 6. saline laxative |
1. oral: 2-48 hours (more rapid on empty stomach)
2. rectal: 5-30 mins |
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stool softener
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1. docusate sodium (coloxyl tab)
2. polaxamer (coloxyl drops) |
1. oral: 24-72 hrs
2. no evidence of effectiveness in sole treatment (usually used in combination) |
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stimulant
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1. sennosides (senokot), senna
2. bisacodyl (ducolax, bisalax) 3. sodium picosulfate (dulcolax sp drops, picolax) 4. frangula |
1. oral 6-12 hrs
2. rectal: suppository (15-60 mins), enema (5-30 mins) 3. short-term, max 1 week 4. take at night to produce bowel motion in the morning |
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suppositories instruction
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1. wash hand
2. lie on 1 side, knees pulled up toward chest 3. remove the wrapping, gently push the suppository (narrow end 1st) as far as possible 4. lower legs, roll over onto the stomach, press the buttocks together and remain still for a few mins |
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enema instructions
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1. similar to suppositories
2. tip/nozzle can be lubricated 3. retain the fluid until lower abdominal is felt (5-10 mins) |
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