pharmacology for bowel elimination

Fleet's Enema (Sodium Phosphate)

Drug Class: Saline laxative

Use / Indication: Relieves constipation or used to empty the bowel before procedures

Mechanism or Action: Draws water into the intestines → stimulates bowel movement

Key Nursing Considerations / Side Effects: May cause dehydration, electrolyte imbalance; contraindicated in kidney disease

Polyethylene Glycol (MiraLAX)

Drug class: Osmotic laxative

Use / Indication: Treats occasional constipation

Mechanism or Action: Retains water in stool → increases stool frequency

Key Nursing Considerations / Side Effects: Can cause bloating, nausea, cramping; encourage fluid intake

Sennosides (Senna)

Drug Class: Stimulant laxative

Use / Indication: Treats constipation

Mechanism or Action: Stimulates intestinal muscle contractions

Key Nursing Considerations / Side Effects: Can cause abdominal cramping, diarrhea; not for long-term use

Psyllium (Metamucil)

Drug Class: Bulk-forming laxative

Use / Indication: Adds fiber for mild constipation

Mechanism or Action: Absorbs water → forms soft bulky stool → stimulates bowel

Key Nursing Considerations / Side Effects: Give with full glass of water; safe for long-term use; may cause bloating

Loperamide (Imodium)

Drug Class: Antidiarrheal

Use / Indication: Treats acute or chronic diarrhea

Mechanism or Action: Slows intestinal motility → more water absorbed

Key Nursing Considerations / Side Effects: Do not use with infectious diarrhea; may cause constipation or drowsiness

Pantoprazole (Protonix)

Drug Class: Proton pump inhibitor (PPI)

Use / Indication: GERD, ulcers, heart burn

Mechanism or Action: Reduces stomach acid by blocking H⁺/K⁺ ATPase enzyme

Key Nursing Considerations / Side Effects: Give before meals; long-term use → ↑ risk of fractures, low magnesium

Famotidine (Pepcid)

Drug Class: H₂ receptor blocker

Use / Indication: GERD, ulcers, acid reflux

Mechanism or Action: Blocks histamine in stomach → decreases acid secretion

Key Nursing Considerations / Side Effects: Fewer side effects than PPIs; can cause headache or confusion (elderly)

Calcium Carbonate (Tums)

Drug Class: Antacid

Use / Indication: Relieves heartburn, acid indigestion

Mechanism or Action: Neutralizes stomach acid

Key Nursing Considerations / Side Effects: May cause constipation or kidney stones; avoid excessive use

Misoprostol (Cytotec)

Drug Class: Prostaglandin analog

Use / Indication: Prevents gastric ulcers from NSAIDs; induces labor (OB use)

Mechanism or Action: Protects stomach lining by increasing mucus and bicarbonate

Key Nursing Considerations / Side Effects: Contraindicated in pregnancy (causes miscarriage); causes diarrhea, cramping