Gastrointestinal Medications: Laxatives

Introduction

• Presenter: Cathy with Level Up RN
• Topic: Gastrointestinal medications, specifically laxatives
• Essentials: Pharmacology 2nd Edition flashcards
• Quiz: At the end of the video to test key facts

General Tips for Treating Constipation

• Increase fluid intake
• Increase fiber intake
• Increase mobility to stimulate peristalsis

Types of Laxatives

Stool Softeners

• Examples: Docusate sodium, Docusate calcium
• Use: Prevent constipation
• Mode of Action: Draw water into the stool to soften it
• Side Effects: Mild cramping, diarrhea
• Administration Tip: Take with a full glass of water
• Mnemonic: The doc said if you ate more fiber, you wouldn’t need docusate to soften your stool.

Bulk-Forming Laxatives

• Examples: Psyllium, Methylcellulose
• Use: Constipation, management of chronic watery diarrhea
• Mode of Action: Combine with water in intestines to soften and bulk up stool
• Side Effects: Mild cramping, nausea, vomiting
• Administration Tip: Take with a full glass of water, then another glass

Stimulant Laxatives

• Examples: Bisacodyl, Senesides
• Use: Constipation, bowel prep before surgery/procedure
• Mode of Action: Stimulate peristalsis
• Side Effects: Cramping, nausea, vomiting
• Administration Tip: Take with a full glass of water
• Mnemonic: Bisacodyl will help you do your business (BM)

Osmotic Laxatives

• Examples: Magnesium hydroxide, Magnesium citrate, Polyethylene glycol (Miralax)
• Use: Constipation, bowel prep before surgery/procedure
• Mode of Action: Draw water into the intestine, stimulate peristalsis
• Side Effects: Cramping, bloating, diarrhea
• Administration Tip: Monitor magnesium levels for magnesium hydroxide or magnesium citrate (risk of hypermagnesemia)
• Additional Example: Lactulose
  • Use: Treatment of hepatic encephalopathy due to ammonia buildup
  • Mode of Action: Lowers pH in the colon to promote ammonia excretion
  • Mnemonic: Lactulose will cause you to lose stool as it gets rid of excess ammonia (L-O-S-E)

Quiz Questions

1. Instructions for taking psyllium: Take with a full glass of water, then another glass
2. Laxatives that can cause hypermagnesemia: Magnesium hydroxide, Magnesium citrate
3. Laxative for treating hepatic encephalopathy: Lactulose

Conclusion

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