Nurs 3366 - Laxatives

What is Nonpharmacologic treatment of Constipation?

Dietary

• Diet (high fiber)

• Water

Behavioral

• Increase exercise

What is an example of a Bulk-forming laxative?

Psyllium

What is the MOA of Bulk-forming laxatives?

Soften fecal mass and increase bulk by supplying the colon with dietary fiber

• Results - 24 to 72 hours

How do you administer of Bulk-forming laxatives?

Administer with 8 ounces of water

• if it is not, it can result in worsening constipation or esophageal or intestinal obstruction.

What are examples of Surfactant Laxatives or Stool Softeners?

Docusate calcium, docusate sodium

What is the MOA of Surfactant Laxatives or Stool Softeners?

• Emulsifies stool

• Lowers surface tension of the stool

What is the indication of Surfactant Laxatives or Stool Softeners?

Prevent constipation

• reduce straining post-surgery or myocardial infarction

What are examples of Saline Laxatives?

milk of magnesia, magnesium citrate, fleet enema, epsom salts

What is the MOA of Saline Laxatives?

Draw water into the intestine to increase the mass of stool, stretching musculature, resulting in peristalsis

• Results: 3-6 hours

What are the contradictions of Saline Laxatives?

• causes impaired kidney function for the saline laxatives containing magnesium

• causes heart failure for those containing sodium, as they can cause fluid retention

What are examples of Stimulant Laxatives?

Bisacodyl and Senna

What is the MOA of Stimulant Laxatives?

Intensify peristalsis and increase the volume of intestinal water

• Results - Orally 6 to 12 hours, rectally 15 to 60 minutes

What are the side effects of Stimulant Laxatives?

GI issues, reddish brown urine, hypokalemia, hypocalcemia

What are examples of Osmotic laxatives?

Polyethylene glycol, lactulose, glycerin

What is the MOA of Osmotic laxatives?

Hyperosmolar salts pull water into colon and increase water in feces to

increase bulk, which stimulates peristalsis.

• Results - 30-60 minutes

What is the purpose of polyethylene glycol?

prescribed for bowel prep

• our goal is clear stools so you can see through the stool. A light yellow or green color.

What is the purpose of Lactulose?

used for hepatic encephalopathy

evaluating the ammonia level and should be decreasing

What are the Contradictions of laxatives?

• Acute surgical abdomen

• Intestinal blockage

• Fecal impaction

• Inflammatory disorders of the GI tract

  • Appendicitis, Crohn’s disease, diverticulitis, ulcerative colitis

• Use with caution in pregnancy