gi drugs (motility) -> brain boost

class for bisacodyl

stimulant laxative

prototype for stimulant laxative

bisacodyl (senna, castor oil)

bisacodyl mech

increases gi motility

bisacodyl therapeutic effect

short-term constipation relief

bisacodyl adverse effects

SEVERE diarrhea, dehydration, rectal burning, cramping

bisacodyl nursing considerations

monitor I&O, bowel patterns, discourage long-term use

bisacodyl client instructions

drink 2-3L/day, increase fiber/exercise

class for psyllium

bulk-forming laxatives

prototype for bulk-forming laxatives

psyllium

psyllium mech

absorbs water to stimulate peristalsis/ forms stool

psyllium therapeutic effect

prevents constipation

psyllium adverse effects

bloating, cramping, esophageal obstruction if taken dry

psyllium nursing considerations

mix with >8oz of fluid, monitor difficulty swallowing and reflux pain

class for polyethylene glycol

osmotic laxatives

prototype for osmotic laxatives

polyethylene glycol

polyethylene glycol mech

draws water into intestines to soften stool and increase motility

polyethylene glycol therapeutic effect

relives constipation + bowel prep before procedures

polyethylene glycol adverse effects

diarrhea, cramping, nausea, electrolyte imbalance

polyethylene glycol nursing considerations

mix with 4-8oz of liquid, report persistent diarrhea or use beyond 7 days

class for docusate, glycerin, mineral oil

lubricant laxatives

prototypes for lubricant laxatives

docusate, glycerin, mineral oil

docusate mech

softens stool by coating fecal mass/ lowers surface tension

docusate therapeutic effect

prevents straining

docusate adverse effects

mild cramps, throat irritation, diarrhea

docusate nursing considerations

give with 8oz fluid on empty stomach

class for metoclopramide

prokinetic agents/ dopamine antagonists

prototype for prokinetic agents/ dopamine antagonists

metoclopramide

metoclopramide mech

sensitizes GI tract to increase motility/ dopamine blockade

metoclopramide therapeutic effect

GERD, n/v from chemo, diabetics

metoclopramide adverse effects

SEDATION, restlessness, diarrhea, EPS (tardive dyskinesia)

metoclopramide nursing considerations

give PO 30 min before meals

metoclopramide client instructions

avoid driving, report facial spasms, rigid muscles

class for loperamide and bismuth subsalicylate

antidiarrheals

prototypes for antidiarrheals

loperamide, bismuth subsalicylate

loperamide mech

slows peristalsis

loperamide therapeutic effect

decrease diarrhea, reduces ileostomy output

loperamide adverse effects

constipation, dizziness, cardiac arrhythmias

loperamide nursing considerations

max 16 mg/day, stop after 48 hr if no improvment

loperamide instructions

avoid caffeine, hydrate, don’t use in children under 2