GI drugs

• Psyllium is a bulk-forming laxative; its works by absorbing the water to increase stool bulk, causing stool to swell and stimulate peristalsis
• Psyllium should be administered with a full glass of water or juice; without proper fluid intake it can cause esophageal or intestinal obstruction
• Adverse effects of Psyllium include abdominal cramps, nausea, vomiting, diarrhea, and gas
• Docusate sodium is a surfactant laxative; it works by facilitating water into the stool to soften the stool
• Docusate sodium is commonly used by patients who are taking an opioid and have constipation
• Adverse effects of Docusate sodium include nausea, vomiting, diarrhea, and abdominal cramps
• Bisacodyl is a stimulant laxative; it works by directly stimulating peristalsis
• A major concern when using stimulant laxatives is fluid and electrolyte imbalance
• Adverse effects of Bisacodyl are abdominal cramps, nausea, vomiting, and diarrhea
• Polyethylene glycol is an osmotic laxative; it works by drawing water into the stool, causing stool to soften and swell, which increases peristalsis
• Polyethylene glycol is a common bowel prep for colonoscopies
• Adverse effects of polyethylene glycol include abdominal cramps, nausea, vomiting, gas, diarrhea, and dehydration
• Lactulose is an osmotic laxative used to lower ammonia levels in patients with liver disease
• Nursing interventions for laxatives include monitoring intake and output, noting any watery stools, encouraging patient to increase water intake, and advising patients to avoid overusing laxatives
• Ondansetron is used for chemotherapy-induced nausea/vomiting; it works by blocking serotonin receptors on afferent vagal nerves
• Patients should take Ondansetron 30 min- 1 hr before chemotherapy; its better at preventing nausea not treating
• Adverse effects of Ondansetron include headaches, dizziness, diarrhea, and prolonged QT interval
• Scopolamine is a cholinergic antagonist that is used to treat motion sickness
• Before giving an anti-diarrheal, you need to find out the underlying cause of the patient's diarrhea
• A priority for patients with diarrhea should be to replace fluid and electrolytes
• Loperamide (imodium) is an OTC anti-diarrheal medication
• Diphenoxylate-Atropine (Lomotil) is an anti-diarrheal; it works by reducing GI motility
• Atropine in Diphenoxylate-Atropine prevents drug abuse; levels high enough to produce euphoria will cause unpleasant Atropine side effects