1
Q
Psyllium powder/wafer brand name
A
metamucil
2
Q
methylcellulose brand name
A
citrucel
3
Q
polycarbophil brand name
A
fiber con
4
Q
inulin gummies brand name
A
mirafiber
5
Q
Psyllium powder/wafer drug class
A
oral bulk forming laxative
6
Q
methylcellulose drug class
A
oral bulk forming laxative
7
Q
polycarbophil drug class
A
oral bulk forming laxative
8
Q
inulin gummies drug class
A
oral bulk forming laxative
9
Q
oral bulk forming laxative gummies like inulin are approved for what ages?
A
2 or 4+
10
Q
oral bulk forming laxative powder and tablets are approved for what ages?
A
6+
11
Q
how do oral bulk forming laxatives work?
A
fiber absorbs water -> expands -> increases pressure on intestine walls -> promotes bowel movement
12
Q
what happens if an oral bulk forming laxative is not taken with adequate water?
A
the fiber dries up like cement and can cause a bowel obstruction
13
Q
oral bulk forming laxatives are used for treatment/prevention of what?
A
prevention of constipation or treatment of chronic constipation
14
Q
what is the first line therapy for an adult who does not require rapid relief and drinks adequate fluids everyday
A
oral bulk forming laxatives
15
Q
T/F: oral bulk forming laxatives are okay for acute constipation
A
False, has a slow onset and could worsen symptoms if a blockage is present
16
Q
what side effects are associated with oral bulk forming laxatives?
A
flatulence and abdominal bloating/gas buildup
17
Q
which medication most closely approximates the body’s physiological process
A
oral bulk forming laxatives
18
Q
do oral bulk forming laxatives cause any systemic side effects?
A
no; fiber is not systemically absorbed
19
Q
T/F: oral bulk forming laxatives are safe in pregnancy and breastfeeding
A
true
20
Q
how long after taking an oral bulk forming laxative would a patient expect relief?
A
72hours
21
Q
T/F: oral bulk forming laxatives may be used to treat opioid induced constipation
A
false
22
Q
which patients would be at risk for bowel obstructions or choking when taking an oral bulk forming laxative?
A
pts with dysphagia or difficulty swallowing, bedridden, cannot drink adequate fluids
23
Q
which medication should be dosed 2 hours after any medication due to interactions?
A
oral bulk forming laxatives and saline laxatives -mg products (chelating)
24
Q
what may worsen side effects of oral bulk forming laxatives?
A
not drinking enough water and starting with a high dose
25
bisacodyl brand name
dulcolax
26
senna brand name
senakot, exlax
27
bisacodyl suppository brand name
fleed bisacodyl
28
bisacodyl drug class
oral stimulant laxative/ rectal stimulant suppositories
29
senna drug class
oral stimulant laxative
30
how do stimulant laxatives work?
irritate the GI mucosa, stimulating smooth muscle contraction and secretion of water
31
T/F: stimulant laxatives reverse the effects of opioids
true; stimulant laxatives increase peristalsis while opioids slow peristalsis
32
stimulant laxatives may be used to treat/prevent:
treat acute constipation
treat/prevent acute/chronic opioid induced constipation
pre procedure emptying
33
what are the side effects of stimulant laxatives
GI cramping
overuse: diarrhea
34
how quickly do bisacodyl suppositories work?
15-60mins
35
how quickly do senna and bisacodyl oral tablets work?
6-10hrs
36
T/F: stimulant laxatives are safe in pregnancy and breast feeding
True
BUT
pregnant women should use very short term because GI cramping may be confused with contractions
37
what are the preferred laxatives for pregnant women?
fiber, PEG, docusate
38
Senna may cause what concerning side effect? why do we counsel the patient on this?
discoloration or urine (red/pink/brown)
they may think there is blood in their urine
39
why should bisacodyl tablets never be chewed/crushed/broken
bisacodyl tabs are enteric coated
40
which medication should not be taken with PPIs, H2RAs, or antacids? why?
bisacodyl tablets because they are enteric coated; tab will dissolve in stomach since pH is higher, which prevents efficacy and causes irritation or dyspepsia
41
a patient is on an acid reducer (PPI, H2RA, antacid) and wants to take a stimulant laxative... what do you reccomend
take senna since its not enteric coated
42
how long can a stimulant laxative be used?
7 day max but may be used chronically for opioid induced constipation (w/ providers consent)
43
which drug is commonly used in people with eating disorders?
stimulant laxatives
44
how many grams of fiber should an adult take in daily?
25-35 grams
45
polyethylene glycol 3350 brand name
miralax
46
polyethylene glycol 3350 drug class
oral hyperosmotic laxative
47
glycerin suppository brand name
pedia-lax
48
glycerin suppository drug class
hyperosmotic laxative
49
hyperosmotic laxative may be used in what ages?
17+ or children with pediatrician approval
50
hyperosmotic laxatives MOA
has large, poorly absorbed ions or molecules that draw water into the colon/rectum via osmosis
51
gylcerin suppositories may be used for treatment/prevention of?
treatment of acute constipation
52
polyethylene glycol may be used for treatment/prevention of?
treatment of acute and chronic constipation
and
treatment/prevention of opioid induced constipation
and
bowel prep
53
what are some side effects of polyethylene glycol?
abdominal discomfort, flatulence
overuse: diarrhea
54
what are some side effects of glycerin suppositories?
rectal irritation
overuse: diarrhea
55
what happens if a hyperosmotic agent like miralax is not taken with a full glass of water?
it wont work, no serious side effects
56
what makes PEG so safe?
minimal systemic absorption, no DDIs
57
what is the preferred OTC for infants and children
PEG (with provider approval)
58
T/F: glycerin suppositories should not be cut
false; may be cut because they contain no drug
59
how quickly do glycerin suppositories work?
15-30min
60
how quickly does PEG take to work?
12-72hrs
61
what counseling points should be discussed with a patient taking PEG?
take once daily with 4-8oz of water and use no more than 7 days (unless physician is made aware)
62
T/F: PEG may be used chronically
true
63
magnesium citrate drug class
oral saline laxative
64
magnesium hydroxide brand name
milk of magnesia/ pedialax chews
65
mirafast drug class
oral saline laxative
66
magnesium hydroxide drug class
oral saline laxative
67
sodium phosphate brand name
fleet, pedialax
68
sodium phosphate drug class
rectal saline laxative enema
69
70
how do saline laxatives work?
contain electrolytes that draw water into the small intestine and large intestine (oral) or distal colon (rectal) by osmosis, increase intraluminal pressure and stimulate peristalsis
71
what are saline laxative used to treat/prevent?
treatment of acute constipation
bowel prep
(MOM is sometimes used chronically)
72
what are side effects of saline laxatives?
abdominal cramping
overuse: diarrhea
chronic use: Mg toxicity
73
how fast do saline enemas take to work?
2-15mins
74
how long dose magnesium citrate take to work?
30min-3hrs
75
how long does it take for magnesium hydroxide to work?
30min-6hrs
76
T/F: saline laxatives are safe in pregnancy and lactation
False: only use for breastfeeding unless physician recommended use during pregnanct
77
which laxative is most likely to cause diarrhea, dehydration, and electrolyte imbalances?
saline laxatives (because of the electrolytes that can be absorbed)
78
sodium phosphate enemas should be used for how long?
1 per day for 3 days
79
oral saline laxatives may be used for how long?
no more than 7 days unless physician recommends MOM
80
who should use caution when taking a saline laxative?
older adults
renal impairment
restricted diets (mg, na, po4)
no sodium phosphate in uncontrolled HT/edema/HF (Na -> increased fluid retention)
pregnant women
81
docusate sodium brand name
colace
82
docusate sodium drug class
oral emollient/stool softener
83
docusate sodium MOA
anionic surfactant that acts in small/large intestine to increase the wetting efficiency of intestinal fluid, facilitating mixture of aqueous and fatty substances to soften fecal mass
84
docusate sodium may be used to treat/prevent:
prevents straining and painful defecation
and treatment of opioid induced constipation (in combo with a stimulant)
85
what are the side effects of docusate?
none
86
docusate is commonly recommended for pts after surgery or post partum. why?
prevents rectal strain
87
how does docusate help with hemorrhoids?
softens stool
88
how long does it take for docusate sodium to work?
12-72hrs, 5 days for full effect
89
T/F: docusate sodium is safe for pregnancy and lactation
true
90
T/F: docusate sodium is an appropriate treatment for acute constipation
false; only softens stool... we need the push
91
is docusate sodium absorbed?
no
92
does docusate sodium interact with any medications
no
93
mineral oil brand name
fleet oil
94
mineral oil drug class
lubricant laxative oral
95
mineral oil enema brand name
fleets
96
mineral oil enema drug class
rectal lubricant laxative
97
how to lubricant laxatives work?
soften fecal content by coating stool and preventing colonic absorption of fecal water
98
what are lubricant laxatives used for?
treatment of acute constipation
99
what are side effects associated with lubricant laxatives?
1 lipid pneumonia if aspiration (oral)
2 anal pruritis and leakage (rectal)
3 impaired absorption of fat soluble vitamins A,D,E,K from overuse (oral)
4 diarrhea (overuse)
100
how quickly does an oral lubricant laxative take to work
6-8 hrs
101
how quickly does a rectal lubricant laxative take to work
5-15min
102
which drug should we not recommend since there are safer/better options?
oral lubricant laxatives
enemas are okay.
103
which drugs are safe for pregnancy?
bulk forming laxatives
stimulant laxatives (short term)
hyperosmotics
emollient/stool softeners
104
which drugs are safe for lactation
bulk forming laxatives
stimulant laxatives
hyperosmotics
saline laxatives
emollient/stool softeners
105
which drugs preferred for quicker onset?
stimulant laxatives - supp:15-60min tablet: 6-10hrs
hyperosmotic agents - supp:15-30min
saline laxatives - enema:2-15min, mg citrate: 30 min-3 hrs, mg hydroxide: 30min- 6hr
lubricant laxatives - oral: 6-8hrs, rectal: 5-15min
106
which drugs can be used for prevention of constipation (non opioid induced)
bulk forming laxatives
107
which drugs can be used for prevention of opioid induced constipation
stimulant laxatives, hyperosmotic laxatives (PEG), emollient/stool softener + stimulant
108
which drugs can be used to treat acute constipation
stimulant laxatives, hyperosmotic agents, saline laxatives, lubricant laxative
109
which drugs can be used to treat chronic constipation
bulk forming laxatives, hyperosmotic agent (PEG)
110
which drugs are used for bowel prep
stimulant laxatives, PEG, saline laxatives
111
which drugs have DDIs?
bulk forming laxatives (separate 2 hr)
stimulant laxatives (PPI,H2RA, antacids)
saline laxatives (mg products): chelation
Self Care
flashcards
Decks in class (18)
# Cards
-
Cold, cough, flu150
-
Cough, cold, flu signs/symptoms and referral criteria7
-
Allergic conjunctivitis and rhinitis134
-
allergic conjunctivitis and allergic rhinitis referral criteria and dx26
-
Headache and fever matrix24
-
contact dermatitis, insect stings and bites MATRIX120
-
Diaper derm and wounds/burns132
-
heartburn, dyspepsia, gas matrix83
-
nausea, vomiting, diarrhea92
-
constipation111
-
insect bites and contact derm diagnosis, referral criteria, nonpharm45
-
prickly heat, diaper derm, burns, wounds, sunburns referral criteria, diagnosis, non pharm11
-
heartburn, dyspepsia, gas diagnosis, referral criteria, non-pharm66
-
nausea, vomiting, diarrhea referral criteria, diagnosis, nonpharm75
-
constipation referral criteria, diagnosis, nonpharm0
-
lice and warts116
-
essential nutrients matrix122
-
complementary medicine and natural products73
