BULK-FORMING LAXATIVES
Why do we use BULK-FORMING LAXATIVES?
What do they treat and how do they treat it?
CONSTIPATION!!
BULK-FORMING LAXATIVES treat constipation because they are INDIGESTIBLE COLLOIDS THAT ABSORB WATER, forming a BULKY EMOLIENT GEL that DISTENDS THE COLON and PROMOTES PASSING OF STOOLS (PARISTALSIS)
Why do we use STOOL SOFTENERS (STOOL SURFACTANT AGENTS)?
What do they treat or prevent and how do they do it?
STOOL SOFTENERS (STOOL SURFACTANT AGENTS) are used to:
PREVENT CONSTIPATION AND STRAINING
STOOL SOFTENERS (STOOL SURFACTANT AGENTS) CAUSE WATER AND LIPIDS TO BE ABSORBED INTO STOOLS AND LUBRICATE THE STOOL!
Why do we use STIMULANT LAXATIVES?
What do they treat and how do they treat it?
ACUTE and CHRONIC CONSTIPATION:
- STIMULANT LAXATIVES directly STIMULATE THE ENTERIC NERVOUS SYSTEM (they irritate the BOWEL MUCOSA)
- STIMULANT LAXATIVES enhances SMOOTH MUSCLE MOTILITY through direct stimulation of the enteric nervous system
Why do we use OSMOTIC LAXATIVES?
What do they treat and how do they treat it?
CONSTIPATION:
OSMOTIC LAXATIVES treat CONSTIPATION by DRAWING WATER INTO STOOLS, CREATING WATERY STOOL!
Why do we use OPIOID AGONISTS?
What do they treat and how do they treat it?
we utilize OPIOID AGONISTS to TREAT DIARRHEA!
think about what opioids do (cause CONSTIPATION)
OPIOID AGONISTS treat constipation by DIMINISHING PROPULSIVE PERILSTALSIS!
OPIOID AGONISTS also delay the passage of fecal mass and allows increased absorption of water!
What adverse effects can BULK-FORMING LAXATIVES cause in patients who take them?
- Increased BLOATING
- Gas Formation
- Abdominal Fullness
What adverse effects can STOOL SOFTENERS (STOOL SURFACTANT AGENTS) cause in patients who take them?
- Abdominal Cramping
- Nausea/Diarrhea
- Nutritional Deficiencies (caused by: Mineral Oil)
- Aspiration Pneumonia (caused by: Mineral Oil)
What adverse effects can STIMULANT LAXATIVES cause if patients are taking this med class?
- ABDOMINAL CRAMPING
- Nausea/Diarrhea
- Fainting
- FLUID AND ELECTROLYTE LOSS (WITH EXCESSIVE USE)
What adverse effects can OSMOTIC LAXATIVES cause in patients taking this med class?
- SEVERE FARTS
- Diarrhea
- Abdominal Cramping
- ELECTROLYTE DISTURBANCES
- RECTAL BLEEDING
What adverse effects can OPIOID AGONISTS cause in patients taking this med class?
DYSRHYTHMIAS!
- drowsiness
- light-headidness
- nausea
- dizziness
- dry mouth
- constipation
What is important for patients to do while taking BULK-FORMING LAXATIVES?
STAY HYDRATED!!
- Stay Hydrated to AVOID GI OBSTRUCTIONS!
What nursing considerations must we implement/educate to patients taking STOOL SOFTENERS (STOOL SURFACTANT AGENTS)?
IF TAKING MINERAL OIL (a stool softener) long-term: IT CAN IMPAIR ABSORPTION OF FAT-SOLUBLE VITAMINS (A - D - E - K)!
Do STIMULANT LAXATIVES WORK QUICKLY OR SLOWLY?
STIMULANT LAXATIVES WORK RAPIDLY!!
What are 2 important consideration that we must educate to our patients?
1. STOP THE MED, if constipation is NOT RESOLVED within 1 week. OSMOTIC LAXATIVES ARE NOT FOR LONG-TERM USE!
2. Take other meds either 2 hours BEFORE/AFTER taking OSMOTIC LAXATIVES
Which Opioid Agonist has NO ANALGESIC PROPERTIES or POTENTIAL FOR ADDICTION?
LOPERAMIDE
How should we give BULK-FORMING LAXATIVES?
GIVE BULK-FORMING LAXATIVES RIGHT AWAY, do NOT wait!
What is the MOST FREQUENTLY USED STOOL SOFTENER (laxative)?
DOCUSATE (COLACE):
most frequently used laxative to PREVENT CONSTIPATION (docusate is given when IRON and CALCIUM SUPPLEMENTS ARE PRESCRIBED)
STIMULANT LAXATIVES may be required on a LONG-TERM BASIS IF...
THEY ARE NEUROLOGICALLY IMPAIRED
What dietary considerations must we implement/educate to our patients taking OSMOTIC LAXATIVES?
- STAY HYDRATED (mix with at least 8oz. of water)
How should patients take Opioid Agonists?
Take after the patient has loose stool and then Q6H if loose stool continues.
How are BULK-FORMING LAXATIVES used? (onset?)
BULK-FORMING LAXATIVES have a SLOW ONSET!
BULK-FORMING LAXATIVES ARE NOT USED FOR RAPID RELIEF
What are the main differences between STOOL SOFTENERS AND OSMOTIC LAXATIVES?
STOOL SOFTENERS:
CAUSE WATER AND LIPIDS TO BE ABSORBED INTO THE STOOL, WHICH LUBRICATES THE STOOL
OSMOTIC LAXATIVES:
DRAWS WATER INTO FECAL MASS, CREATING WATERY STOOL!
What is an example of a STIMULANT LAXATIVE?
SENNA (SENOKOT)
If a patient has a question regarding how fast OSMOTIC LAXATIVES work, what is an appropriate response?
- OSMOTIC LAXATIVES will produce a BM WITHIN 1-3 DAYS!
Which Opioid Agonist have CNS effects if taken in HIGHER DOSES?
LOMOTIL:
prolonged use can lead to opioid dependence!
Combined with small amounts of atropine to discourage overdoses.