Exam 4 Drugs Used to Treat Constipation and Diarrhea

Term Definition
Constipation • Definition –Symptom-based disorder of unsatisfactory defecation characterized by infrequent stools, difficult stool passage, or both
Chronic constipation –Symptoms present for at least 3 months
Causes of Constipation • Too little fluid intake •sedentary habits • Failure to respond to normal defecation impulses • Muscular weakness of colon •anemia, hypothyroidism • Frequent use of constipating meds • Tumors of the bowel • Diseases of the rectum
Diarrhea • Definition –Increase in the frequency or fluid content of bowel movements • Considered a symptom, not a disease • Chronic may indicate disease of the stomach or intestine • Complications if severe or prolonged • Dehydration, electrolyte depletion, exhaustion
Causes of Diarrhea • Intestinal infections • Spicy or fatty foods • Enzyme deficiencies • Excessive use of laxatives • Drug therapy • Emotional stress • Hyperthyroidism • Inflammatory bowel disease • Surgical bypass of the intestine
Treatment of Altered Elimination • Constipation • Constipation –High-fiber diet, adequate hydration, exercise –Avoid use of laxatives
Avoid laxatives in patients with –Severe abdominal pain or discomfort –Fever, nausea and vomiting –Preexisting conditions—DM, abdominal surgery –Taking medications that cause constipation –Laxative abusers –Previous use of laxative without success
Treatment of Altered Elimination (cont.) • Diarrhea –Treatment depends on specific cause of diarrhea –Indication of disease of stomach, small or large intestine –Psychogenic –Symptom of cancer of the colon or rectum
Stimulant laxatives –Action: directly on intestines; cause irritation that promotes peristalsis and evacuation
Osmotic laxatives –Action: hypertonic compounds draw water into the intestines from surrounding tissues, distending bowel and causing peristalsis
Stimulants: bisacodyl
–Osmotics: polyethylene glycol
Saline Laxatives • Magnesium hydroxide Actions: draw water into the intestine from surrounding tissues, distending the bowel, causing peristalsis • Uses: relieve acute constipation
• Stool softeners –Action: draw water into bowel to soften stools; do not cause peristalsis –Used routinely for prophylactic purposes
Bulk-forming laxatives –Action: cause water to be retained within the stool –Drug of choice for those who use laxatives routinely; they absorb irritating substances and soften stools –Give with full glass of water
• Lubricant laxatives –Action: lubricate intestinal wall, allowing for smooth passage of fecal contents –Used as prophylactic for patients who should not strain during defecation
Opioid antagonist – methylnaltrexone Action: binds to opioid receptors in the GI tract, inhibiting constipation –Used in treatment of opioid-induced constipation
Antidiarrheal Agents actions –Locally acting agents: absorb excess water to cause a formed stool and adsorb irritants or bacteria causing diarrhea
Antidiarrheal Agents –Systemic agents: lomatil act through autonomic nervous system to reduce peristalsis and motility of the GI tract, allowing the mucosal lining to absorb nutrients, water, and electrolytes, leaving a formed stool . schedule 5
Antidiarrheal Agents –Systemic agents: lomatil Uses –Treat sudden-onset diarrhea, inflammatory bowel disease, post-GI surgery
Antidiarrheal Agents –Systemic agents: lomatil Therapeutic outcomes –Relief of incapacitation and discomfort of diarrhea
Antidiarrheal Agents –Systemic agents: lomatil Common adverse effects –Abdominal distention, nausea, constipation • Serious adverse effects –Prolonged or worsened diarrhea • Don’t use to treat diarrhea caused by toxic substances; allows toxin to stay in GI tract

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