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What is the purpose of a laxative?
Ease of stimulate defecation.
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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
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What is the function of the colon?
Absorb water and electrolytes,
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How do we determine constipation?
Hardness of stool, frequency of secondary importance
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What are the primary causes of constipation?
poor diet, medication
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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
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Why wouldn't we prescribe laxatives?
- Unexplained abdonimal pain
- Nausea
- Cramps
- Symptoms of appendicitis
- Regional enteritis
- Diverticulitis
- Ulcerative Colitis
- Acute surgery of abdomen
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What are FIVE ways in which we classify laxitives?
- 1. Bulk-forming
- 2. Surfactants
- 3. Stimulants
- 4. Osmotics
- 5. According to time effect
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What is an example of a bulk-forming lax?
psyllium (metamucil)
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What is an example of a surfactant?
Docusate soidum (colace)
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What is an example of a stimulant?
Bisacodyl (Dulcolax)
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What is an example of an osmotic?
Milk of Magnesia
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What are the three groups of time effect?
- Group I: 2-6 hours
- Group II: 6-12 hours
- Group III: 1-3 days
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What is lactulose?
Misc lax that is not given as a primary lax. Removes ammonia in chronic liver disease
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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.
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What is Opiod Antagonist Methylnaltrexone bromide?
relistor
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What does relistorr do?
treats opioid induced constipation. Is opioid. Used when other laxitives are not successful.
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How id relistor administered?
Adminitered sub-q, every other day?
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What are typical BM responses to relistor?
1/3 have BM within 30 min, 60% have BM within 4 hours.
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What is important to know about relistor in regards to those with renal failure?
Reduce dose by half
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What are two other important things to do about relistor-hint: vial, opioids?
- Don't resuse vial!
- Discontinue if patient stops taking opioids
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What are FIVE adverse reactions to laxatives?
- Abdominal pain
- Flatualence
- Nausea
- Dizziness
- Diarrhea
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Why are laxatives abused?
- Think should have a BM everyday
- Continued use->perpetuates use
- Leads to dimished defecatory reflexes: e'lyte impalance, dehydration, colitis
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What is diarrhea?
Stools of excessive volume, fluidity, increased frequency
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What causes diarrhea?
- Infection
- Maldigestion
- Inflammtion and functional disorders of the intestine
- Complication of dehydration and depletion of electrolytes
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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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