Please enable JavaScript.
Coggle requires JavaScript to display documents.
Laxatives / Antidiarrhoeal Agents - Coggle Diagram
Laxatives / Antidiarrhoeal Agents
Constipation
Reduced frequency of defaecation from the normal for an individual
Elderly
Immobile
Pregnant women
Cause
DEhydration
Inadequate dietry fibre
GIT disease
Malignancy
Surgery
Drug induced
1st Line
Exercise
Fluid intake
Laxatives
Use
Short term relief
Stopping straining that exacerbate othe conditions
Prep for investigations
Colostomy Control
Terminally ill patients
Chronic Use
Dependance, constipation
Types
Bulk Forming Agents
Faecal Softeners
Lubricants
Osmotic Laxatives
GI Stimulants / Irritants
Diarrhoea
Compensatory mechansim - must eliminate cause where possible
Cause
Infectious agents
Drugs
Anxiety
Nutrient malabsorption
Endocrine disease
Obstruction
Carcinoma
1st Line
Fluid and electorlyse replacement
Oral / IV glucose / salt solution
Antidiarrhoeal Agents
Opioid drugs
Locally acting drugs
Bulk Forming Laxative
Methylcellulose
MOA
Ingestible hydrophilic substances. Induce water retention in the intestinal tract to increase mass of material, to promote peristalsis through mechanical distension of wall
Use
Acute MI :<3:
Cerebral aneurysm :face_with_head_bandage:
Avoiding Eye straining :eye:
Faecal Softeners
Dioctyl sodium sulphosuccinate (docusate)
:boat:
MOA
Lower surface tension allowing water and fats to penetrate the stool
Stimulates electrolyte and fluid secretion from intestine
Use
Recent MI / Cardiac surgery :<3:
Disease of anus or recetum :horse:
Water penetrating docked canoe - Penetration of water into stool due to docusate
Lubricants
Glycerol, Liquid Parafin
MOA
Lubricates stool and instestinal mucosa
Prevents Water reabsorption from lumen stimulating peristalsis
Osmotic Laxatives
Lactulose
Semi synthetic disaccharide which is not absorbed from GIT
MOA
Attracts and retains water in intestinal lumen
Increases intraluminal pressure to stimulate perastalsis
Use
Surgery :hocho:
Diagnostic exams :page_facing_up:
Drug overdose / poisoning :pill:
GI Stimulants / Irritants
Senna
Use
Surgery :hocho:
Diagnostic exam :page_facing_up:
MOA
Irritates intestinal mucosa
Increases fluid secretion and stimulates peristalsis
Stimulating suntan lotion - Senna is GI stimulant
Anti-Motility Opioid Drugs
Most effective antidiarrhoeal agent
Loperamide :rabbit:
MOA
Inhibits ACh release through presynaptic opiod receptor in enteric Nervous System to allow sustained contraction of intestines (prevents normal peristalisis)
μ receptor agonist
Does not cross BBB
Selective for Enteric NS not CNS
Lop-eared rabbit - Loperamide
Increases phasic segmenting activity
μtopia - μ receptor
Does not cross BBB
VIPoma + Carcinoma cause diarrhoea
Locally Acting Drugs
Kaolin-Pectin
MOA
Absorbent
Absorbs water + binds bacteria toxins & other irritants
Decreases intestinal pH providing soothing effect
Use
Moderat / mild diarrhoea
Bismuth Subsalicylate
MOA
Antisecretory :sweat_drops:
Inhibits intestinal secrections - unknown mechanism
Use
Infectious diarrhoea
