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Draw water into the intestine s through osmosis

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Draw water into the intestine s through osmosis > increase in intraluminal pressure >increase in intestinal motilityContraindicationsoExercise caution in young children & > 55yo, renal diseaseAdverse events :DehydrationInteractions:Tetracycline and quinolone abx, antifungalsBulk Forming laxativesMost commonly usedoMethylcellulose (Citrucel), psyllium (Metamucil)Mechanism of actionoWork by binding to the fecal contents and pulling water into the stool- softens andlubricates the stool; stimulate movement of the intestines13
ContraindicationsoNot useful for opioid induced constipationoHx of SBO, acute surgical abdomen, decreased PO intake of fluids, GI ulcerationsAdverse events : Overall well tolerated- increased flatulence, bloatingInteractions:Wheat gluten is by-product, should avoid in gluten intoleranceLubricant LaxativesMost commonly usedoMineral oil (liquid paraffin)Mechanism of actionoCoats and softens the stool and prevents reabsorption of water from the stool by thecolonoPrevent straining in high risk patients (post-op, L&D, CVA, hemorrhoids, hernia, MI)ContraindicationsoIf aspirated can cause liquid PNA (Do not admin before bedtime)Adverse eventsoUnpleasant tasteInteractionsoSurfactant laxatives (liver toxicity), Warfarin (increase levels of Vitamin K > increaseeffects of anticoagulant)Surfactant LaxativesMost commonly usedoDocusate sodium (Colace)Mechanism of actionoReduces the surface tension of the liquid contents of the bowel > promotesincorporation of additional liquid into the stool, forming a softer mass and promoteseasier defecationContraindicationsoGood for patients on low sodium diets- good for patients with HTN, CHFAdverse events :Well tolerated > stomach upset, cramping, diarrheaInteractions: If taken with mineral oil, can increase risk of liver toxicityHyperosmolar laxativesMost commonly usedoLactulose (Cephulac), sorbitol, polyethylene glycol (Miralax)Mechanism of action14
oMetabolized to solutes in intestinal tract > osmotic pressure by drawing fluid from lessconcentrated gradient to a more concentrated gradient. Increase in osmotic pressurestimulates intestinal motility and propulsion of fecal contentsContraindicationsAdverse events : Abdominal cramping and nauseaInteractions: Very few. Avoid antacids with lactulose (interferes with mechanism of action)SecretagoguesChloride Channel ActivatorsGuanylate Cyclase-C AgonistPeripherally Acting Mu-Opioid Receptor Antagonist (PAMORA)Chloride Channel ActivatorsMost commonly usedoLubiprostone (Amitiza)Mechanism of actionoEnhancing chloride-rich intestinal fluid without altering serum sodium and potassiumconcentrations > pulls waterContraindicationsoMechanical obstruction, severe diarrhea, pregnant women and childrenAdverse events : nauseaInteractions: NoneGuanylate Cyclase-C AgonistMost commonly usedoLinaclotide (Linzess)Mechanism of actiono

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Term
Fall
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Irritable bowel syndrome

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