Drugs used for Constipation PDF

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Drugs for Constipation...

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Drugs used for Constipation Bulk-forming Laxatives:  Calcium polycarbophil (fiber Con)  Psyllium (Metamucil)  Methylcellulose (Citrucel) MOA: these fiber supplements increase bulk and promote passage of stool, may also be used for treating diarrhea Nursing Considerations:  Taken 2 hours before or after other medications  Always take with sufficient water  Increase bloating and abdominal pain  NOT to be taken long term

Stimulants:  Bisacodyl (Dulcolax, Senokot) MOA: Stimulants cause rhythmic muscle contractions in the intestines Nursing Considerations:  May increase risk of cancer  Produce bowel movement in 6-12 hours  NOT to use within one hour of taken an antacid or milk  Can cause stomach discomfort, nausea, diarrhea cramps, and fluid and electrolyte imbalance

Osmotic and Saline Laxatives:  Lactulose (Chronulac)  Polyethylene glycol (MiraLAX)  Magnesium hydroxide (milk of Mg)  Sodium biphosphate MOA: increase the amount of water in the intestines and soften stool Nursing Considerations:  Used with idiopathic constipation  Can cause abdominal cramping and diarrhea

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With diabetes, monitor for electrolyte imbalance Bowel movement within 24-72 hours Interfere with antibiotics Can have effects on cardiac and respiratory function (magnesium hydroxide)

Stool Softeners:  Docusate (Colace, Dulcolax) MOA: moisten the stool and help prevent dehydration Nursing Considerations:  Used for patients who should avoid straining  Prolonged use can cause electrolyte imbalance  Bowel movement with 12-72 hours

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DO NOT use with bowel obstruction

Lubricants:  Mineral Oil MOA: grease the stool allowing it to move along the intestine more quickly Nursing Considerations:  Stimulate bowel movement within 8 hours  Used for constipation related to dry and hard stools  Orally or rectally  May increase aspiration and pneumonia in older patients who are frail

Herbal Agents:  Castor Oil  Senna MOA: lubricated feces to facilitate bowel movement, irritates the lumen of the bowel, which stimulates peristalsis Nursing Considerations:  Can cause abdominal cramping and diarrhea

Chloride Channel Activators:  Lubiprostone MOA: activate chloride channels to promote fluid release into the intestines Nursing Considerations:  Can be used safety for 6 – 12 months  Used to treat chronic idiopathic constipation and IBS in women  DO NOT use if bowel obstruction is suspected  Bowel movement within 24 hours of first dose

MISC:  

Naloxegol Methylnaltrexone MOA: block mu receptor in GI tract without affecting opioid induced analgesia

Nursing Considerations:  May cause N/V diarrhea and gas  Used for patients who are in advanced stages of illness requiring opioid pain control

Enemas: 

Fleet (saline or mineral oil) MOA: inserted into rectum to draw water into the colon and promote bowel movement Nursing Considerations:  Embarrassment for patient  Self administered are available  Used to clear bowels for procedures  Used for specific constipation or fecal impaction on short term basis

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Ducusate Glycerin MOA: stimulates muscles in the bowel to promote defecation Nursing Considerations:  Bowel movement in 15 minutes to an hour  Only used for rectal use...