Term
|
Definition
Adsorbents
Antimotility drugs (anticholinergics and opiates)
Probiotics (bacterial replacement drugs) |
|
|
Term
|
Definition
1. Coat the walls of the gastrointestinal (GI) tract
2. Bind to the causative bacteria or toxin, which is then eliminated through the stool
3. Examples: bismuth subsalicylate (Pepto Bismol), activated charcoal, aluminum hydroxide, others
4. Antimotility drugs: anticholinergics - decrease intestinal muscle tone and peristalsis of GI tract, result: slows the movement of fecal matter through the GI tract - examples - belladonna alkaloids
5. Antimotility drugs - opiates - decrease bowel motility and reduce pain by relief of rectal spasms; decrease transit time through the bowel, allowing more time for water and electrolytes to be absorbed; examples - paregoric, opium tincture, codeine, loperamide (over the counter), diphenoxylate |
|
|
Term
| Antidiarrheals - MOAs Card 2 |
|
Definition
| 1. Probiotics - also known as intestinal flora modifiers and bacterial replacement drugs; bacterial cultures of Lactobacillus organisms work by: supplying missing bacteria to the GI tract and suppressing the growth of diarrhea causing bacteria. example - L. acidophilus (Bacid) |
|
|
Term
| The antidiarreal drug Lomotil contains both diphenoxylate, a synthetic opiate agonist and atropine an anticholinergic. The purpose of the atropine in this combination is to |
|
Definition
discourage recreational use of the opiate diphenoxylate
discourages recreational use because if taken in large doses a person will experience unpleasant anticholinergic effects such as dry mouth, abdominal pain, blurred vision, and tachycardia |
|
|
Term
Antidiarreals Adverse Effects
Adsorbents |
|
Definition
1. increased bleeding time
2. constipation, dark stools
3. confusion
4. tinnitus
5. metallic taste
6. blue tongue |
|
|
Term
Antidiarrheals Adverse Effects
Anticholinergics |
|
Definition
1. urinary retention, impotence
2. headache, dizziness, confusion, anxiety, drowsiness, confusion
3. dry skin, flushing
4. blurred vision
5. hypotension, bradycardia |
|
|
Term
Antidiarrheals Adverse Effects
Opiates |
|
Definition
1. drowsiness, dizziness, lethargy
2. nausea, vomiting, constipation
3. respiratory depression
4. hypotension
5. urinary retention
6. flushing |
|
|
Term
| Antidiarrheals - Interactions |
|
Definition
1. adsorbents decrease the absorption of many drugs including digoxin, quinidine, and hypoglycemic drugs
2. adsorbents cause increased bleeding time and bruising when given with anticoagulants (warfarin)
3. Toxic effects of methotrexate are more likely when given with adsorbents |
|
|
Term
| Antidiarrheals - Nursing Implicaitons |
|
Definition
1. Obtain thorough history of bowel patterns, general state of health, and recent history of illness or dietary changes; assess for allergies
2. DO NOT give bismuth subsalicylate to children or teens with chickenpox or influenza because of risk of Reye's syndrome |
|
|
Term
| Before administering belladonna alkaloids, it is most important for the nurse to assess the pt for a history of which condition? |
|
Definition
Myasthenia gravis
Use of belladonna alkaloid preparations is contraindicated in pts who have shown a hypersensitivity to anticholinergics and in pts with narrow-angle glaucoma, GI obstruction, myasthenia gravis, paralytic ileus, and toxic megacolon |
|
|
Term
Nursing Implications - Card 2
Antidiarrheals |
|
Definition
1. Use adsorbents carefully in elderly patients or those with decreased bleeding time, clotting disorders, recent bowel surgery, confusion
2. DO NOT administer anticholinergics to pts with a history of narrow angle glaucoma, GI obstruction, myasthenia gravis, paralytic ileus, and toxic megacolon |
|
|
Term
Nursing Implications = Card 3
Antidiarrheals |
|
Definition
1. Teach pts to take medications exactly as prescribed and to be aware of their fluid intake and dietary changes
2. assess fluid volume status, I&O, and mucous membranes before, during and after initiation of treatment
3. teach pts to notify their prescriber immediately if symptoms persist
4. monitor for therapeutic effect |
|
|
Term
| Which antidiarrheal does the nurse associate with the development of adverse effects of urinary retention, headache, confusion, dry skin, rash and blurred vision? |
|
Definition
Anticholinergics
Anticholinergics work by decreasing GI Peristalsis through their parasympathetic blocking effects. Adverse effects include urinary retention, headache, confusion, dry skin, rash, and blurred vision. |
|
|
Term
Laxatives
Bulk-forming - MOA |
|
Definition
1. high fiber
2. absorb water to increase bulk
3. distend bowel to initiate reflex bowel activity
4. examples: psyllium (Metamucil) and methylcellulose (Citrucel) |
|
|
Term
|
Definition
1. stool softeners and lubricants
2. promote more water and fat in the stoools
3. lubricate the fecal material and intestinal walls
4. examples - Stool softeners: docusate salts (Colace, Surfak) and lubricants: mineral oil |
|
|
Term
Laxatives
Hyperosmotic - MOA |
|
Definition
1. increase fecal water content
2. results in bowel distention, increased peristalsis and evacuation
3. examples: Polyehtylene glycol (PEG); sorbitol, glycerin; lactulose (also used to reduce elevated serum ammonia levels) |
|
|
Term
|
Definition
1. increase osmotic pressure within the intestinal tract, causing more water to enter the intestines
2. results in bowel distention, increased peristalsis, and evacuation
3. examples - magnesium hydroxide (milk of magnesia); magnesium citrate (Citroma) |
|
|
Term
|
Definition
1. increases peristalsis via intestinal nerve stimulation
Examples - senna (Senekot); bisacodyl (Dulcolax) |
|
|
Term
| Peripherally Acting Opiod - Antagonists |
|
Definition
1. treatment of constipation related to opioid use and bowel resection therapy
2. block entrance of opioid into bowel
3. strict regulations for use
4. allow bowel to function normally with continued opioid use.
5. examples methylnaltrexone (Relistor) and alvimopan (Entereg) |
|
|
Term
Laxatives - Indications
Bulk forming |
|
Definition
| Acute and chronic constipation, irritable bowel syndrome, diverticulosis |
|
|
Term
Laxatives - Indications
Emollient |
|
Definition
| Acute and chronic constipation, fecal impaction, facilitation of bowel movements in anorectal conditions |
|
|
Term
Laxatives - Indications
Hyperosmotic |
|
Definition
| Chronic constipation, diagnostic and surgical preps |
|
|
Term
Laxatives - Indications
Saline |
|
Definition
| Constipation, diagnostic and sugical preps |
|
|
Term
|
Definition
| Acute constipation, diagnostic and surgical preps |
|
|
Term
| A pt is receiving lactulose four times a day but does not have a history of constipation. In fact he has had bowel movements every day. What is the probable reason for the lactulose? |
|
Definition
| Reduction of high ammonia levels associated with liver failure |
|
|
Term
Laxatives - Adverse Effects
Bulk forming |
|
Definition
1. impaction
2. fluid overload
3. electrolyte imbalances
4. esophageal blockage |
|
|
Term
Laxatives - Adverse Effects
Emollient |
|
Definition
1. skin rashes
2. decreased absorption of vitamins
3. electrolyte imbalances
4. lipid pneumonia |
|
|
Term
Laxatives - Adverse Effects
Hyperosmotic |
|
Definition
1. abdominal bloating
2. electrolyte imbalances
3. rectal irritation |
|
|
Term
Laxatives - Adverse Effects
Saline |
|
Definition
1. magnesium toxicity (with renal insufficiency)
2. cramping
3. electrolyte imbalances
4. diarrhea
5. increased thirst |
|
|
Term
Laxatives - Adverse Effects
Stimulant |
|
Definition
1. nutrient malabsorption
2. skin rashes
3. gastric irritation
4. electrolyte imbalances
5. discolored urine
6. rectal irritation |
|
|
Term
|
Definition
|
|
Term
| Laxatives - Nursing Implications |
|
Definition
1. obtain a thorough history of presenting symptoms, elimination patterns, and allergies
2. assess fluid and electrolytes before initiating therapy
3. inform pts not to take a laxative or cathartic if they are experiencing nausea, vomiting, and/or abdominal pain |
|
|
Term
| Laxatives - Nursing Implications - Card 2 |
|
Definition
1. a healthy, high-fiber diet and increased fluid intake should be encouraged as an alternative to laxative use
2. long-term use of laxatives often results in decreased bowel tone and may lead to dependency
3. all laxative tablets should be swallowed whole, not crushed or chewed, especially if enteric coated
4. pts should take laxative tablets with 6-8 oz of water
5. pts should take bulk forming laxatives as directed by the manufacturer with at least 240 mL (8 oz) of water |
|
|
Term
| Laxatives - Nursing Implications - Card 3 |
|
Definition
1. Give biscodyl with water because of interactions with milk, antacids, and juices
2. inform pts to contact their prescriber if they experience severe abdominal pain, muscle weakness, cramps, and/or dizziness, which may indicate possible fluid or electrolyte loss
3. monitor for therapeutic effect |
|
|
Term
| A 48 yr old pt has been admitted with abdominal pain, and states that she has not had a BM in 4 days. Her abdomen is distended and slightly tender. Which laxative would be appropriate for this pt? |
|
Definition
No laxative should be given at this time -
These laxatives are contraindicated in the presence of undiagnosed abdominal pain, as taking a laxative in cases of intestinal obstruction could be very harmful to the pt. No laxatives should be given if the pt has undiagnosed abdominal pain. |
|
|
Term
|
Definition
1. Chronic intestinal discomfort characterized by cramps, diarrhea, and/or constipation
2. Pts usually cope with the symptoms by avoiding irritating foods and/or taking OTC Laxatives and antidiarrheals |
|
|
Term
| Nursing Implications - IBS |
|
Definition
1. perform a general assessment and additional assessment of liver functioning as well as for any underlying cardiac disease
2. follow admin. guidelines
3. assess for therapeutic response |
|
|
Term
| diphenoxylate with atropine |
|
Definition
1. antidiarrheal
2. diphenoxylate is a sythetic opiate agonist
3. acts on smooth muscle of intestinal tract
4. inhibits GI motility and excessive GI propulsion
5. little or no analgesic activity but because it is an opiod abuse and physical dependence can occur
6. combined with atropine because of anticholinergic effects deter abuse
7. contraindicated in pts with diarrhea associated with pseudomembranous colitis or toxigenic bacteria
8. only oral use |
|
|
Term
|
Definition
1. antidiarrheal
2. inhibits both peristalsis in the intestinal wall and intestinal secretion, thereby decreasing the number of stools and their water content
3. physical dependence has not been reported even though an opioid
4. only opioid available as an otc
5. contraindicated in pts with severe ulcerative colitis, pseudomembranous colitis, and acute diarrhea associated with E. Coli |
|
|
Term
|
Definition
1. natural bulk forming laxative obtained from the plantoago psyllium plant
2. It has many characteristics of methycellulose
3. contraindicated in pts with intestinal obstruction or fecal impaction
4. also contraindicated in pts with abdominal pain and/or nausea and vomiting
5. wafer or powder |
|
|
Term
|
Definition
1. stool softening emollient laxatives
2. facilitate the passage of water and lipids into fecal mass
3. used to treat constipation, soften fecal impactions, facilitate bms in pts with hemorroids or other painful anorectal conditions.
5. contraindicated in pts with intestinal obstruction, fecal impaction or nausea and vomiting |
|
|
Term
|
Definition
1. hyperosmotic laxative
2. increases osmotic pressure in the intestine, which draws water into colon
3. often used in children
4. rectal solution in both adult and pediatric suppositories |
|
|
Term
|
Definition
1. hyperosmotic laxatives
2. synthetic derivatives of the natural sugar lactose
3.is not digested in the stomach or absorbed in the small bowel, passes unchanged into the large intestine where it is metabolized
4. colonic bacteria digest lactulose to produce lactic acid, formic acid and acetic acid which creates a hyperosmotic environment that draws water into colon and produces a laxative effect
5. reduces blood ammonia levels by converting ammonia to ammonium.
6. effect is helpful to reduce serum ammonia levels in pts with hepatic encephalopathy
7. contraindicated in pts on a low galactose diet
8, oral or rectal use |
|
|
Term
|
Definition
1. OTC stimulant laxative
2. obtained from dried leaves of Cassia acutifolia plant
3. acute constipation and bowel preparation for surgery examination
4. may cause abdominal pain
5. may produce complete bowel evacuation in 6-12 hours
6. tablets, syrup, granules |
|
|
