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GordyG
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When are Group I laxatives used?
- To clean out bowel for procedure or surgery
- Osmotic stimulant
- Creates a very watery bowel
- Effective in 2-6 hours
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When are Group II laxatives used?
- Stimulate gut after it has become sluggish
- Semi-fluid in 6-12 hours
- Osmotic stumulant
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When are Group III laxatives used?
- Used on a daily basis to keep stool soft
- Examples: bulk, surfactant, lactulose
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What is a bulk laxative similar to?
Dietary fiber
Group III
It acts to enlarge the mass and stretch the walls of the intestine to increase peristalsis
It also absorbs water to soften the stool
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How does surfactant work as a laxative?
Group III
Lowers surface tension
Allows for greater water absorption
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Stimulant laxatives
Increase movement
Increase water and electrolytes in the intestinal lumen
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Osmotic laxatives
Laxative Salts
Draw water into the gut
High doses can be harmful to cardiac patients
Used to pull water into the gut and empty the bowels quickly
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Mineral Oil
Laxative that acts as a lubricant
Taking orally, difficult to swallow, can lead to aspiration
Can decrease absorption of vitamins in the gut
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Lactulose
Osmotic diuretic
Enhances intestinal secretion of Ammonia
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Why do people with liver failure use Lactulose?
People with liver failure have high levels of ammonia
Lactulose enhances the intestinal secretion of ammonia
Will decrease ammonia levels by holding it in the stool
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For a patient receiving chemotherapy, what would you expect to see prescribed to treat the associated N/V?
Ondansetron (Zofran)
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If a patient taking Zofran is still experiencing CINV (Chemo induced nausea and vomiting), what else might be prescribed?
Aprepitant (Emend)
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What would you look at before passing Emend?
What other drugs might be effected by it
Emend can inhibit or increase drug metabolism by altering metabolizing liver enzymes
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What is the action of Emend?
It blocks Substance P
It is a neurokinin antagonist
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What can be given IV with chemo to prevent N/V short term?
Glucocorticoids
- Methylprednisolone (solumedrol)
- Dexamethasone (decadron)
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What is the drug of choice for Dopamine antagonists and what is it used for?
- Reglan
- Used as an antiemetic
- Has psychological effects, so not used much
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What drug is used for motion sickness and what class is it?
- Scopolamine
- It is a Muscarinic antagonist (anti-cholinergic)
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What is the strongest class of anti-diarrheals?
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Why is Lotronex bad for treating IBS?
It has a high mortality rate and requires special acknowledgements from the patient and the doctor to prescribe it
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What other drug besides Lotronex can be used for IBS?
Lubiprostone (Amitiza)
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Chron's disease is an _________ disorder
autoimmune
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What drugs can be used to treat Chron's
- Immunosuppresants
- Antibiotics
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Aminosalicylates can be used to treat _______, what are two examples?
Chron's
Sufasalazine/Azulfidine
- Mesalamine/Asacol
- & Pentasa
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For acute symptoms of IBD/Chron's, use what?
Glucocorticoids
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Long term treatment of IBD/Chron's can be treated with what?
Immunosuppressants
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Prokinetic drugs can be used to treat ______ and the drug of choice is __________
IBD/Chron's
Reglan
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When are pancreatic enzymes taken?
For someone who does not produce the enzymes to break down food, such as cystic fibrosis
It is taken with every meal
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Actigall is taken to treat what?
Gallstones
It has less side effects than Chenix, which include diarrhea and liver damage
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