Constipation - answer✔infrequent BM (<3x/week)
difficulty passing stool
chronic idopathic constipation (IBS-C) - answer✔ctsp for several weeks or longer with an
unknown cause
what is idopathic constipation associated with - answer✔chronic/recurrent abd discomfort
relieved by defecation
medical conditions that cause constipation - answer✔IBS-C
MS
PD
DM
cerebrovascular events
anal disorders-fissures, fistulas, rectal prolapse
spinal cord tumors
hypothyroidism
non-drug constipation tx - answer✔increasing fluids (>64 oz day)
increasing physical activity
high fiber foods
drugs that cause constipation - answer✔antacids (aluminium/calcium containing)
antidiarrheals
clonidine
colesevelam
anticholinergic effects
--> antihistamines, antispasmodics, phenothiazines, TCAs, urge incontinence drugs
iron
non-DHP CCB (esp verapamil)
opioids
sucralafate (has aluminium)
how long do we treat constipation with OTC drugs - answer✔7 days
bulk-forming laxatives MOA - answer✔absorb water into intestine soaking up fluid and adding
bulk to stool
--> increases peristalsis and decreases stool transit time
bulk-forming laxative products - answer✔psyllium (metamucil)
calcium polycarbophil (fiberCon)
methylcellulose (citrucel)
wheat dextrin (benefiber)
bulk-forming laxatives ADR - answer✔flatulence
abd cramping
bloating
bulk-forming laxatives DDIs - answer✔calcium polycarbophil needs to be separated from other
drugs because of binding interactions
osmotic laxative MOA - answer✔contain large molecules that are poorly absorbed that draw
fluid into bowel lumen through osmosis
--> distends colon, stimulates peristalsis
osmotic laxative products - answer✔magensium hydroxide (milk of magnesia)
PEG (miralax)
glycerin (fleet liquid/supp)
lactulose (constulose, enulose)
sodium phosphates (fleet enema)
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