complete solutions 2024/2025
constipation - ANSWER-infrequent BM (<3x/week)
difficulty passing stool
chronic idopathic constipation (IBS-C) - ANSWER-ctsp for several weeks or
longer with an unknown cause
what is idopathic constipation associated with - ANSWER-chronic/recurrent abd
discomfort
relieved by defecation
medical conditions that cause constipation - ANSWER-IBS-C
MS
PD
DM
cerebrovascular events
anal disorders-fissures, fistulas, rectal prolapse
spinal cord tumors
hypothyroidism
non-drug constipation tx - ANSWER-increasing fluids (>64 oz day)
increasing physical activity
high fiber foods
drugs that cause constipation - ANSWER-antacids (aluminium/calcium
containing)
antidiarrheals
clonidine
colesevelam
, anticholinergic effects
--> antihistamines, antispasmodics, phenothiazines, TCAs, urge incontinence
drugs
iron
non-DHP CCB (esp verapamil)
opioids
sucralafate (has aluminium)
how long do we treat constipation with OTC drugs - ANSWER-7 days
bulk-forming laxatives MOA - ANSWER-absorb water into intestine soaking up
fluid and adding bulk to stool
--> increases peristalsis and decreases stool transit time
bulk-forming laxative products - ANSWER-psyllium (metamucil)
calcium polycarbophil (fiberCon)
methylcellulose (citrucel)
wheat dextrin (benefiber)
bulk-forming laxatives ADR - ANSWER-flatulence
abd cramping
bloating
requires adequate fluids
bulk-forming laxatives onset of action - ANSWER-12-72 hours
bulk-forming laxatives DDIs - ANSWER-calcium polycarbophil needs to be
separated from other drugs because of binding interactions
osmotic laxative MOA - ANSWER-contain large molecules that are poorly
absorbed that draw fluid into bowel lumen through osmosis
--> distends colon, stimulates peristalsis
osmotic laxative products - ANSWER-magensium hydroxide (milk of magnesia)
PEG (miralax)
glycerin (fleet liquid/supp)
lactulose (constulose, enulose)
sodium phosphates (fleet enema)
osmotic laxative onset of action - ANSWER-30 min-96 hours