Drugs for Bowel Disorders and GI Conditions
Introduction
- Focus on drugs for bowel disorders and other GI conditions
- Lower digestive tract: small and large intestines
- Duodenum receives chyme, a mix of partially digested food, bile, and pancreatic enzymes
- Most nutrient and drug absorption occurs in the small intestine
Anatomy and Function
- Small Intestine: Duodenum, Jejunum, Ileum
- Jejunum: Main site for nutrient absorption
- Ileum: Empties into the large intestine
- Large Intestine
- Reabsorption of water, excretion, and synthesis of vitamins
- Colonized with protective bacteria
Regulation of Digestion
- Controlled by autonomic nervous system
- Parasympathetic: Speeds up digestion
- Sympathetic: Slows digestion
- Impact of sympathetic and parasympathetic systems on medication effect
Disorders and Treatments
Peptic Ulcers
- Common disorder affecting digestion; can cause bleeding and decreased absorption
Constipation
- Infrequent passage of hard stools
- Causes: Lack of exercise, insufficient fiber, diminished fluid intake, slow motility
- Treatments: Laxatives or cathartics to accelerate stool passage
- Types: Bulk-forming agents, surfactants, saline or osmotic laxatives
- Prototype: Psyllium (Metamucil)
Diarrhea
- Increased frequency or fluidity of bowel movements
- Body's defense to eliminate toxins
- Risks: Fluid, electrolyte, acid-base imbalances
- Treatment depends on severity and cause
- Opioids for severe diarrhea
- Anti-diarrheals: Diphonoxinate with atropine
Irritable Bowel Syndrome (IBS)
- Symptoms: Recurrent abdominal pain, diarrhea, constipation
- No detectable disease
- Treatment: Dietary changes, relaxation therapy, bulk-forming laxatives
Inflammatory Bowel Disease (IBD)
- Conditions: Ulcerative colitis, Crohn’s disease
- Symptoms: Abdominal cramping, diarrhea
- Treatment: 5-aminosalicylic acid agents, glucocorticoids, immunosuppressants
Nausea and Vomiting
- Causes: Infections, psychological factors, drugs
- Risks: Dehydration, weight loss, acid-base disturbances
- Treatments: Over-the-counter drugs, prescription medications
Emetics
- Induce vomiting in emergencies
- Used when patient is alert
Pancreatitis
- Inflammation of pancreas
- Associated with gallstones, alcoholism
- Treatment: Enzyme replacement
Nursing Considerations
- Assess patient history, symptoms, and medication effects
- Monitor nutritional status, hydration, electrolyte balance
- Educate patients on proper medication use and potential side effects
These notes provide an overview of the key concepts and treatments related to bowel disorders and GI conditions, emphasizing the pharmacotherapy options and nursing considerations.