Self- care and Non- Rx > Constipation Matrix > Flashcards

Constipation Matrix Flashcards

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1
Q

oral bulk forming laxatives options

A

psyllium powder (metamucil)
methycellulose (citrucel)
polycarbophil (fiber con)
Inulin (Mirafiber)

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2
Q

oral bulk forming laxatives MOA

A

fiber absorbs water. as the fiber expands, pressure is increased on the intestine walls, and this promotes bowel movement (push on walls, walls push back)

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3
Q

oral bulk forming laxatives sx to be treated

A

PREVENTION of constipation or treatment for CHRONIC constipation

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4
Q

oral bulk forming laxatives is 1st line treatment when

A

rapid relief is not required and patient drinks adequate fluids daily

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5
Q

why are oral bulk forming laxatives not a good choice for acute constipation

A

slow onset of action

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6
Q

oral bulk forming laxatives SE

A

flatulence
abdominal bloating/ gas buildup

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7
Q

can oral bulk forming laxatives be used chronically YE

A

yes

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8
Q

T/F: oral bulk forming laxatives are safe for all populations

A

true

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9
Q

are oral bulk forming laxatives recommended for opioid induced constipation?

A

no

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10
Q

avoid oral bulk forming laxatives in patients with

A

dysphasia
difficulty swallowing
bedridden
cant drink adequate fluids
(fiber can swell in throat and can cause choking in not taken with full glass of fluid)

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11
Q

oral/ rectal stimulant laxative options

A

bisacodyl (dulcolax) (fleet bisacodyl)
senna (senaknot) (Exlax)

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12
Q

are oral/ rectal stimulant laxative mush or push

A

push

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13
Q

when is it a good idea to use rectal suppositories

A

patients with nausea and vomiting

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14
Q

oral/ rectal stimulant laxative MOA

A

stimulants irritate the GI mucosa, stimulating smooth contraction and secretion of water resulting in a bowel movement

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15
Q

why are oral/ rectal stimulant laxative last tine for pediatric pateints

A

gastric cramping

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16
Q

oral/ rectal stimulant laxative sx to be treated

A

TREATMENT of acute constipation

PREVENTION AND TREATMENT of acute and chronic opioid induced constipation

pre- procedural emptying

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17
Q

why do some opioids cause constipation

A

opioids decrease peristalsis

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18
Q

oral/ rectal stimulant laxative SE

A

GI cramping
rectal irritation (suppository: less preferred by patients)

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19
Q

T/F: diarrhea is technically a SE of any laxative

A

true

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20
Q

bisacodyl suppository on set of action

A

15- 60 min

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21
Q

senna and bisacodyl tablet onset of action

A

6- 10 hours

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22
Q

are oral/ rectal stimulant laxative pregnancy and lactation parameters

A

safe in pregnancy for short- term use, but not preferred because can be confused for contractions

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23
Q

senna can cause

A

discoloration of urine

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24
Q

bisacodyl patient counseling points

A

bisacodyl tablets are enteric coated, so they should not be taken with PPIs, H2RAs, or antacids as the acid reducers promote degradation of enteric coating, leading to dissolution in the stomach instead of intestines which prevents efficacy and causes gastric irritation or dyspepsia

patients should separate tablets from milk by 1 hour for the same reason

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25
oral/ rectal stimulant laxative max duration of use
max 7 days unless physician recommends longer duration
26
hyperosmotic laxative options
oral polyethylene glycol (miralax) rectal glycerin suppository (pedia- lax)
27
are hyperosmotic laxative mush or push
mush
28
hyperosmotic laxative MOA
contain large, poorly absorbed ions or molecules that draw water into the colon or rectum through osmosis to stimulate a bowel movement
29
glycerin sx to be treated
treatment of acute constipation
30
PEG sx to be treated
treatment of acute and chronic constipation TREATMENT AND PREVENTION of opioid induced constipation bowel evacuation before procedure
31
PEG SE
abdominal discomfort flatulence
32
glycerin suppository SE
rectal irritation
33
T/F: PEG is safe for virtually everyon
true
34
T/F: PEG is the preferred OTC option for infants and children
true
35
why can glycerin suppositories be cut into smaller pieces
they contain no druggl
36
glycerin suppository onset of action
15- 30 min
37
PEG onset of action
12- 72 hours (do not use if patient has been constipated for several days
38
OTC PEG dosing
once daily with 4- 8 ounces of water
39
PEG max duration of use
max 7 days, but safe to use long term if no diarrhea and physician is made aware
40
what will cause hyperosmotic laxatives to not work
if the patient does not drink enough water
41
Oral/ rectal saline laxatives options
magnesium citrate magnesium hydroxide (milk of magnesia) mirafast sodium phosphate (fleet, pedialax)
42
Oral/ rectal saline laxatives MOA
contain electrolytes that draw water into the small and large intestine or distal colon by osmosis, increase intraluminal pressure and stimulate peristalsis
43
should you recommend magnesium sulfate
NO
44
Oral/ rectal saline laxatives sx to be treated
treatment of acute constipation bowel evacuation before procedure
45
Oral/ rectal saline laxatives SE
abdominal cramping
46
rectal saline laxative enema onset of action
rapid acting: 2- 15 min use in bathroom, best to be on toilet
47
mag. citrate onset of action
30 min- 3 hrs
48
mag. hydroxide onset of action
30 min- 6 hours
49
Oral/ rectal saline laxatives pregnancy and lactation parameters
safe in lactation not recommended in pregnancy unless directed by physician
50
are Oral/ rectal saline laxatives the most least likely to cause diarrhea, dehydration, and electrolyte imbalances
NO, MOST LIKEY TO CAUSE because they contain electrolytes and can be absorbed even with rectal doing
51
Oral/ rectal saline laxatives dose warning
max 1 phosphate enema per day for 3 days, no more than 7 day use for oral saline laxatives
52
Oral/ rectal saline laxatives should be used with caution in
older adults as renal function declines with age patients with sodium, phosphate, or magnesium restricted diets anyone with renal impairment uncontrolled hypertension/ edema or HF magnesium products may chelate certain drugs and decrease absorption (separate by at least 2 hours)
53
Oral emollient/ stool softeners
Docusate sodium (Colace)
54
Docusate (Colace) age restriction
2+ yrs
55
T/F: you can use docusate as a monotherpay
F (ony push, needs push)
56
Oral emollient/ stool softeners MOA
Anionic surfactant that act is the small and large intestine to increase the wetting efficiency of intestinal fluid, facilitating a mixture of aqueous and fatty substances to soften the fecal mass (provides mush)
57
Oral emollient/ stool softeners sx to be treated
prevention of straining and painful defecation may be added to stimulant for the treatment of opioid- induced constipation
58
Oral emollient/ stool softeners onset of action
12- 72 hours, but may take up to 5 days
59
Oral emollient/ stool softeners pregnancy/ lactation parameters
safe
60
should Oral emollient/ stool softeners be used to treat acute constipation
no- only softens stool
61
Lubricant laxative oral/ rectal options
oral: mineral oil (fleet oil) rectal: mineral oil enema (fleets)
62
which Lubricant laxative oral/ rectal is safer: oral or enema
enema
63
Lubricant laxative oral/ rectal MOA
softens fecal contents by coating stool and preventing colonic absorption of fecal water
64
Lubricant laxative oral/ rectal sx to be treated
treatment of acute constipation
65
Lubricant laxative oral/ rectal SE
lipid pneumonia from aspiriation of oral dose anal pruritis and leakage impaired absorption of fat- soluble vitamins (A, D, E, K) if overused
66
Lubricant laxative oral/ rectal onset of action
oral: 6- 8 hours rectal: 5- 15 min
67
should you recommend Lubricant laxative oral/ rectal
NOPE
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