Sh*ts and Ladders
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What is the purpose of a laxative?
Ease of stimulate defecation.
What are FOUR ways in which a laxative works?
- 1. soften stools.
- 2. Increase stool volume.
- 3. Hasten passage of fecal material through bowel.
- 4. Facilitate evacuation from rectum
What is the function of the colon?
Absorb water and electrolytes,
How do we determine constipation?
Hardness of stool, frequency of secondary importance
What are the primary causes of constipation?
poor diet, medication
Why are laxatives used? (5 reasons)
- 1. soften stool
- 2. correction of constipation
- 3. fresh stool samples
- 4. empty bowel prior to procedure, surgery
- 5. After medical treatment for parasites
Why wouldn't we prescribe laxatives?
- Unexplained abdonimal pain
- Symptoms of appendicitis
- Regional enteritis
- Ulcerative Colitis
- Acute surgery of abdomen
What are FIVE ways in which we classify laxitives?
- 1. Bulk-forming
- 2. Surfactants
- 3. Stimulants
- 4. Osmotics
- 5. According to time effect
What is an example of a bulk-forming lax?
What is an example of a surfactant?
Docusate soidum (colace)
What is an example of a stimulant?
What is an example of an osmotic?
Milk of Magnesia
What are the three groups of time effect?
- Group I: 2-6 hours
- Group II: 6-12 hours
- Group III: 1-3 days
What is lactulose?
Misc lax that is not given as a primary lax. Removes ammonia in chronic liver disease
What is polyethylene glycoeclectrolyte solutions?
Increase amt of electrolytes, isosmotic, ingest a huge volume and then bowel movements start an after the drug is ingested.
What is Opiod Antagonist Methylnaltrexone bromide?
What does relistorr do?
treats opioid induced constipation. Is opioid. Used when other laxitives are not successful.
How id relistor administered?
Adminitered sub-q, every other day?
What are typical BM responses to relistor?
1/3 have BM within 30 min, 60% have BM within 4 hours.
What is important to know about relistor in regards to those with renal failure?
Reduce dose by half
What are two other important things to do about relistor-hint: vial, opioids?
- Don't resuse vial!
- Discontinue if patient stops taking opioids
What are FIVE adverse reactions to laxatives?
- Abdominal pain
Why are laxatives abused?
- Think should have a BM everyday
- Continued use->perpetuates use
- Leads to dimished defecatory reflexes: e'lyte impalance, dehydration, colitis
What is diarrhea?
Stools of excessive volume, fluidity, increased frequency
What causes diarrhea?
- Inflammtion and functional disorders of the intestine
- Complication of dehydration and depletion of electrolytes
What are two types of antidiarrheals?
- Nonspecific: opioids, bulk-forming agents
- Specific: when cause is bacertial fungal, treated with antibiotics, nonspecific agents, correct malabsorption
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