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GI Drugs - Laxative and Antidiarrheals
Dr. Goldstein
18
Medical
Graduate
09/20/2010

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Cards

Term
Methycellulose, Psyllium, Polycarbophil
Definition

Bulk-forming laxatives

indigestible, hydrophilic colloids that absorb water and form a bulky, emollient gel to promote peristalsis

- usually include natural plant products

- increased bloating and flatus

Term
Docusate and Glycerin suppository
Definition

Stool surfactant agents (softeners)

soften stool material permitting water and lipids to penetrate.

- oral or rectal

- docusate used inpatient to prevent constipation

Term
Mineral Oil
Definition

Stool softener

clear, viscous oil that lubricates fecal material - preventing water absorption from the stool

- used to prevent and treat fecal impact in kids and debilitated adults


Term
Magnesium hydroxide (milk of magnesia)
Definition

nonabsorbable salt

-osmotic laxative

- risk for hypermagnesemia esp w/ renal insufficiency


Term
Sorbitol and lactulose
Definition

nonabsorbable sugars

-used to prevent/treat chronic constipation

- flatus, cramps

Term
Magnesium citrate and Sodium Phosphate
Definition

purgative osmotics

- prompt bowel evacuation w/in 1-3hrs. rapid movement of water into the distal small bowel and colon - leads to high volume of liquid stool

- be careful to maintain hydration

Term
Polyethylene glycol (PEG)
Definition

-used for colonoscopy prep

- designed so that there is no significant intravascular fluid or electrolyte shifts

Term
stimulant laxatives - cathartics
Definition

moa = unknown - possible direct stim of the enteric nervous system and colonic eletrolyte and fluid secretion. 

 

- used for neuro impaired and bed bound patient


Term
Aloe, Senna, Cascara
Definition

anthraquinone derivates

-poorly absorbed

- chronic use = brown pigmentation of colon = melanosis coli

Term
Lubiprostone
Definition

Cl- channel activator

- used for chronic constipation and IBS

- Minimal systemic absorption = good for long term use

Term
Methylnaltrexon and Alvimopan
Definition

Opiod receptor antagonist

- do not cross BBB

- methyl = txt for opiod induced constipation in pts receiving palliative care

- alvimpoan = shorten period of postop ileus

Term
Tegaserod
Definition

serotonin 5HT4 Receptor agonist

- chonic constipation and IBS

- causes cardiac problems

Term
Prucalopride
Definition

serotonin 5-HT4 Receptor agonist

- clinical development

Term
Loperamide
Definition

Opiod agonist for antidiarrheal

- nonprescription, does not cross BBB

- inhibits presynaptic cholinergic nerves

Term
Diphenoxylate
Definition

Opiod agonist for antidiarrheal

- prescription, higher doses of CNS effect - can lead to opiod dependence

- contains small amts of atropine to prevent dependence

- inhibit presynaptic cholinergic nerves

Term
Kaolin and Pectin
Definition

- act as absorbents of bacterial toxins and fluid - decrease stool liquidity and #.

- pectin = from apples


Term
Cholestyramine, colestipol, colesevelam
Definition

Bile salt-binding resins

- malabsorption of bile salts leads to diarrhea so these drugs decrease diarrhea caused by excess bile salts

- use: chrons, surgical resection of terminal ileum

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