Term
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Definition
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Term
| 2 or less successful bowel movements per week, straining 25% or more of the time, feeling of incomplete passing 25% or more of the time, hard consistency at least 25% of the time |
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Definition
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Term
| pt. experiencing at least 2 symptoms, symptoms present at least 1yr, pt. not taking laxative products |
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Definition
| definition of constipation designated for |
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Term
| anticholinergics, opioids, antidepressants, CCBs, Iron supplements, Aluminum antacids, antihistamines, benzos, dopamine agaonists, sucralfate, hyperlipidemia agents |
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Definition
| Drug-induced constipation |
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Term
| Colon cancer, external compression for malignant lesion, strictures, rectocele, megacolon, anal fissure |
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Definition
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Term
| diabetes mellitus, hypothyroidism, hypercalcemia, hypokalemia, hypomagnesemia, uremia, heavy metal poisoning |
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Definition
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Term
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Definition
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Term
| Parkinson's disease, spinal cord injury or tumor, cerebrovascular disease, MS |
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Definition
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Term
| mechanical obstruction, metabolic conditions, myopathies, neuropathies, depression, degenerative joint disease, autonomic neuropathy, cognitive impairment, immobility, cardiac disease |
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Definition
| medical conditions associated with constipation |
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Term
| absorbs liquids in the intestines and swells to form a soft, bulky stool |
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Definition
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Term
| draws water into the bowel from surrounding body tissues providing a soft stool mass |
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Definition
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Term
| encourage bowel movements by acting on the intestinal wall |
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Definition
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Term
| coats the bowel and the stool mass with a waterproof film so stool remains soft |
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Definition
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Term
| Helps liquids mix into the stool and prevent dry, hard stool masses |
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Definition
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Term
| Psyllium (Metamucil); Methylcellulose (Citrucel) |
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Definition
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Term
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Definition
| Stool Softeners(Emollients) |
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Term
| Lactulose, Sorbitol 70%, Polyethylene Glycol, Magnesium Hydroxide |
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Definition
| Saline and Osmotic Agents |
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Term
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Definition
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Term
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Definition
| Chloride Channel Activator |
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Term
| Best for prevention rather than treatment; may take up to 3 days to work; need to take with fluids; may decrease absorption of medications |
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Definition
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Term
| Bulk forming agents Adverse Reactions |
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Definition
| abdominal pain, cramping, diarrhea, nausea/vomiting |
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Term
Pros: Cheap, Prophylactice, Psyllium shown to improve cholesterol panel
Cons: Long-term treatment, Palatability, Obstruciton risk/dehydration |
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Definition
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Term
| act as wetting agents to soften stool, no motility effects |
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Definition
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Term
| Mainly prevention of constipation or for patients with painful defecation, no role in chronic constipation |
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Definition
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Term
| Emollients Adverse Reactions |
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Definition
| Diarrhea, abdominal pain, rash |
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Term
Pros: Generally safe; Good Prophylactic agent
Cons: Not considered effective in treating constipation, just prevention; require correction of other factors as well; not for immediate relief (All Mush with no Push) |
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Definition
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Term
| Onset 6-8 hours after oral administration; rectal 5 to 15 minutes; minimize use to no more than 7 days |
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Definition
| Mineral oil (liquid petrolatum) |
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Term
| Mineral Oil Adverse Reactions |
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Definition
| Aspiration -->Lipid pneumonia; diarrhea, N/V, Peri-anal irritation, cramps, weakness, dizziness |
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Term
Pros: Works quickly, good short term treatment, only approved use for impaction, cheap
Cons: LOTS of adverse effects and safety issues |
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Definition
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Term
| draws fluid into the intestinal lumen by osmotic action, thus increasing intraluminal pressure and stimulating gut motility |
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Definition
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Term
| can cause electrolyte imbalance |
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Definition
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Term
| safe and effective for treating CC in adult and elderly patients for periods up to 12 months |
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Definition
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Term
| Osmotic Laxatives Adverse Effects |
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Definition
| diarrhea, abdominal discomfort, flatulence |
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Term
| For acute bowel evacuation |
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Definition
| Magnesium citrate, sodium phosphate |
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Term
| Saline Laxatives Adverse Reactions |
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Definition
| Electrolyte imbalance, bloating, N/V, Abdominal pain |
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Term
Pros: Fast, effective, cheap
Cons: intermittent use only, dehydration, electrolyte depletion, magnesium accumulation: renal failure, sodium retention: CHF |
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Definition
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Term
| osmotic effects plus sodium stearate (irritating effects) |
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Definition
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Term
| safest for infants and children, onset 30 min rectally, draws water to GI tract |
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Definition
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Term
| Hyperosmotics (MiraLax) adverse reactions |
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Definition
| diarrhea, dehydration, cramping, flatulence |
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Term
| Disaccharide that is metabolized by gastrointestinal bacteria to lactic, formic, and acetic acids |
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Definition
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Term
| Lactulose Adverse Effects |
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Definition
| Flatulence, Cramps, Diarrhea, Electrolyte imbalance |
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Term
Pros: Daily use for longer periods of time, good maintenance medication, no electrolyte abnormalities
Cons: Time: 2-3 days for response, about 20% occurrence of distention and flatulence |
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Definition
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Term
| MOA: stimulates nerve plexus of intestines, increases peristalsis, increases secretion of fluid and electrolytes |
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Definition
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Term
| Useful in opioid-induced constipation; chronic use leads to tolerance |
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Definition
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Term
| NEW stimulant + osmotic laxative |
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Definition
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Term
| Use is for bowel cleansing before colonoscopy |
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Definition
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Term
| Onset begins after 6-8 hours (oral) and 15-60 minutes (rectal); Intermittent use only, space 3 weeks apart |
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Definition
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Term
| Bisacodyl Adverse Reactions |
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Definition
| Abdominal pain, cramps, electrolyte imbalance, N/V, Diarrhea |
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Term
Pros: quick, effective treatment, cheap, available as suppository
Cons: dependence?, electrolyte disturbance (prolonged use), short-term only |
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Definition
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Term
| Stimulation of GI motility, alteration of cell wall permeability |
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Definition
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Term
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Definition
| Diarrhea, dehydration, electrolyte imbalance, N/V |
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Term
Pros: Effect in 6-24 hours, "natural" laxative
Cons: dependence? electrolyte disturbance (prolonged use), short-term only, melanosis coli |
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Definition
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Term
| Chloride channel activator on the luminal surface of the small intestine; softens stool; increases transit time |
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Definition
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Term
| Lubiprostone adverse reactions |
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Definition
| abdominal pain, flatulence, N/V, headache, diarrhea |
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Term
Pros: tolerance not observed through 12 month trials, Long-term use (12 months) studied with success
Cons: Cost about $190 for 1 month supply, no rebound effect but decrease in bowel movement may occur, no pediatric data |
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Definition
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Term
| New class of drug used for IBS with constipation and chronic idiopathic constipation in ADULTS |
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Definition
| Linaclotide capsules (Guanylate cyclase-c agonist) |
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Term
| acts locally to increase cyclic guanosine monophosphate (cGMP) that stimulates secretion of intestinal fluid and intestinal transit |
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Definition
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Term
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Definition
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Term
| Opioid-induced constipation |
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Definition
| use regular doses of senna and stool softener in combo w/ lactulose or sorbitol as indicated. Add prunes or prune juice to diet |
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Term
| Opioid-induced constipation: if no bowel movement in 2-3 days: |
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Definition
| milk of magnesia, a bisacodyl suppository or enema; reduce analgesic if feasible or reduce other drugs that affect bowel motility |
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Term
| peripherally acting mu-receptor antagonist |
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Definition
| Methylnaltrexone (Relistor) |
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Term
| administered subQ for txt of opioid-induced constipation; no reversal of analgesia; may also decrease N/V by blocking CTZ |
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Definition
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