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40 Cards in this Set
- Front
- Back
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What is a laxative effect?
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production of a soft, formed stool over a peroid of 1 or more days
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What is a catharsis?
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prompt, fluid evacuation of the bowel
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What is function of the colon?
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to absorb waer and electrolytes - nutrient absorption is minimal
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What is a normal bowel schedule?
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every day or 2-3 times a week. It varies and cannot establish a norm
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How does fiber help with bowel function?
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it can absorb water helping to soften feces 2) it can be digeste by coloinic bacteria whose growth increase feces mass
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What is best source of fiber?
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bran - fruits & vegies also good
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Constipation is described by
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stool consistency not how often one goes
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What is greatest cause of constipation
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poor diet deficient of fiber and fluid, poor function of pelvic floor and anal spincter, slow intestional transit and some drugs
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Bulk-forming laxatives - site of action
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small intestine and colon
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Name 3 Bulk - forming laxatives
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methylcellulose, psyllium and polycarbophil
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When do bulk forming laxative work
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produce a soft stool in 1-3 days
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Mechanism of action of bulk forming laxative
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same as fiber - are not absorbed increases fecal bulk and stimulates peristalsis
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How often should bulk forming laxatives be used?
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perferred agents for temporary treatment of constipation
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Adverse effects of bulk forming laxatives
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Can cause impaction or intestinal obstruction if not enough water or intestine arrested
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Surfactant laxatives - action
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Group III - soft stool in 1-3 days - lowers surface tension wihch helps water penetrate feces and inhibit fluid absorption
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Name 2 surfactant laxatives
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Docusate sodium & docusate calcium
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Stimulant laxatives - action
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stimulate intestinal motility & increase amount of water & electorlyes within the intestinal lumen Group II - act within 6-12 hours
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Name 3 stimulant laxatives
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bisacodyl, senna, castor oil
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What should stimulant laxatives be used for?
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1) opoid induced constipation 2) constipation from slow intestinal transit
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What is most abused laxative?
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Stimulant laxative
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What laxatives can be administered orally or rectally?
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Bisacodyl
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Time for biscodyl orally to work
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6-12 hours
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Time for biscodyl rectally to work
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15-60 minutes
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Name 3 stimulant laxatives
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Biscodyl 2) Senna 3) Castor Oil
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How does senna work?
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plant derived act con colne to produce soft stool in 6-12 hours - is absorbed systemically can change color of urine - harmless yellow-brown or pink
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Where does castor oil work
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small intestine - acts quickly in 2-6 hours - produces watery stool - shoudl not be used routinely
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Name 5 Osmotic Laxatives - Laxative Salts
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MgS04 hydroxide, 2) MgSO4 sulfate 3) MgSO4 citrate 4) sodium phosphate 5) polyethyleni glycol - MiraLax
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Where is site of action
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Draws water into intestinal lumen - small and large intestine
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Adverse effect of osmotic laxatives
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dehydration d/t substantail loss of water, MgSO4 is absorbed and can cause renal problems in renal pts and reach toxic levels, sodium phosphate should not be used in heart or renal pts.
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Polyethlene glycol - Miralax
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osmotic laxative - not absorbed retains water side effects, cramping, nausea, flatulence
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When to anticipate BM when taking Miralax?
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Coudl be 2-4 days
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Lubiprostone (Amitza) actions
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chloride channel activators - promotes secretion of chloride -rich fliude in to intestine and enhances motility in teh small intstine and colon - stool w/i 24 hours
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Indication for Lubiprostone
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1) chronic idiopthic constipation in adults 2) irritable bowel syndrome with constipation in women at least 18 yo
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What is pregnancy category of lubriprostone?
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C
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Mineral Oil action
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poorly absorbed lubricates
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Lactulose action
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made from sugars - poorly absorbed in colon bacteria metabolize sugars producing acids which creates osmotic effect which pulls water in. Expensive - good for use in children does not create bowel dependence
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Glycerin suppository acitions
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osmotic agent that softens and lubricates
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Polyethylene glycol-electolytes solutions - Golyetely
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does not dehydrate - used for preop bowel cleansing needs
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Laxative abuse causes
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people believe need BM daily and use laxatives to achieve this then purge the bowel which woudl normally take 2-5 days to build back up
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Laxative abuse consequenses
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diminsh defecatory relflexes, leading to furthe reliace on laxatives - electolyte imbalance , dehydration adn colitis
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