Constipation stimulant laxatives

Opiates Monitor patients for sedation and depressed cognition. Address constipation with use of stimulant laxatives. 

When prescribing strong opioids as analgesics for severe pain, it is even recommended to combine the treatment with prophylactic use of laxatives to avoid constipation. The effect of opioids on the bowel is to cause almost no movement at all in the bowels and therefore it is unavoidable to use stimulating laxatives sometimes combined with bulk forming preparations. 

Co-codamol is a combination of paracetamol (nonnapioid analgesic) and codeine (opioid analgesic). One of the side-effects of opioids is constipation. Naprosyn is a proprietary (trade name) preparation of the non-steroidal antiinflammatory drug naproxen Adalat is a proprietary preparation of the calcium-channel blocker nifedipine Amoxil is a proprietary preparation of the beta-lactam amoxicillin and Dulco-lax is the brand name of the stimulant laxative bisacodyl. 

Bisacodyl is a stimulant laxative that does not take long to act and is therefore useful in acute constipation. The bulk-forming laxative ispaghula husk takes longer to act when compared with bisacodyl but is useful for long-term administration. Lactulose, which is an osmotic laxative, has a lag time of about 48 hours before onset of action. Loperamide and kaolin and morphine mixture are antidiarrhoeals used in acute diarrhoea. 

One of the main side-effects of opioid analgesics, such as codeine and tramadol, is constipation. Amitriptyline (tricyclic antidepressant) and orphenadrine tend to have antimuscarinic properties, resulting in side-effects such as constipation. Senna is a stimulant laxative indicated in constipation. 

Constipation bulk-forming laxatives by increasing faecal mass tend to soften stools and relieve constipation, and have value in a range of symptomatic problems associated with anal fissure, haemorrhoids, and with ileostomy and colostomy dysfunction. Faecal softeners, lactulose and macrogols (polyethylene glycol) retain fluid in the bowel. Stimulant laxatives, such as the anthraquinone, senna, and bisacodyl, increase motility and can cause colic verdoses can cause diarrhea and electrolyte depletion. Chronic treatment for constipation is seldom needed, but may be in children with a tendency to faecal impaction, specialist advice should be sought. 

These are among the most powerful, but prolonged use can aggravate constipation. Mechanisms of action are muitipie and not well studied. They include increased permeability of the mucosa leading to accumuiation of water in the lumen, inhibition of intestinal Na+,K-i-ATPase, and increased synthesis of prostagiandins and cAMP. Stimulant laxatives include the following. 

Opioid-induced constipation is more troublesome in older patients, and it should be anticipated by instituting laxative therapy along with the narcotic. A typical laxative regimen consists of psyllium and a stool softener. A mild stimulant laxative such as bisacodyl (Dulcolax) can be added if constipation becomes problematic. 

Indications Constipation Category Stimulant laxative Half-life N/A... 

The gum that has exuded solidifies to semitransparent, colourless droplike structures, which have a weak smell of acetic acid. The sterculia gum is insoluble in water, but swells considerably 1 g gum can bind more than 40 g water, and thus decreases water reabsorption from the colon, and increases in volume. This volume—increasing effect (bulk effect) contributes to an increased intestinal motility. In the treatment of patients with chronic constipation sterculia gum is preferred to stimulant laxatives. 

One study showed aloe to be an effective treatment in patients with chronic constipation in combination with psyllium and celandine, a stimulant laxative obtained from the Chelidonium majus plant (Odes and Madar, 1991). An earlier study showed aloin to be effective alone, and even more effective in combination with phenolphthalein (Chapman and Pittelli, 1974). Gas and cramps were the major adverse effects with treatment. 

The client is prescribed the stimulant laxative senna (Senokot) for constipation. The client calls the clinic and reports yellow-green-colored feces. Which action should the clinic nurse implement ... 

The nurse can recommend an over-the-counter stimulant laxative to help evacuate the bowel because the nurse is aware that constipation is a side... 

Stimulant laxatives are agents used to relieve constipation by local stimulation and contraction of the smooth muscle... 

Laxatives, both natural and synthetic, have been used for centuries by man at least dating back to the ancient Egyptians (1). Today, the medicinal objective of laxative use is to loosen stool and/or induce bowel movements for relief of constipation, medical procedures, or to ease the strain of defecation. There currently exist approximately seven classes of laxatives based on their pharmacological action. These classes include stimulant laxatives, bulk-producing... 

Regulatory Status. Regulated in the United States as a dietary supplement not recognized as safe and effective as OTC laxative ( 310.545(12)(iv)). Allowed for sale in Germany as a botanical stimulant laxative for the short-term treatment of constipation only sold with a license restricted to pharmacies (wichtl). 

A laxative is most often prescribed for the short-term relief or prevention of constipation. Certain stimulant, emollient, and saline laxatives are used to evacuate the colon for rectal and bowel examinations. Fecal softeners or mineral oil are used prophylactically in patients who should not strain during defecation, such as after anorectal surgery or a myocardial infarction. Psyllium may be used in patients with irritable bowel syndrome and diverticular disease. Fblycarbophil may be prescribed for constipation or diarrhea associated with irritable bowel syndrome and diverticulosis. Mineral oil is... 

Slow-transit constipation can be treated with chronic administration of osmotic laxatives. Tegaserod maleate 6 mg orally twice daily is an acceptable treatment. Senna, bisacodyl, and other stimulants should be used only when the others fail to deliver the desired effect. 

N.A. Cinnamic acid, gallic acid, emodin, rhein, rhein anthrones, catechin, anthraquinone compounds, tannin, calcium oxalate.99-100-107-510-511 Treat diarrhea, stimulate appetite, chronic constipation, laxative, cathartic. 

The tendency for these drugs to produce constipation is another side effect that could have important implications for patients receiving physical rehabilitation. Opioid-induced constipation is especially problematic in patients with spinal cord injuries or other conditions that decrease gastrointestinal motility. In such patients, opioids are often administered along with laxatives and GI stimulants (see Chapter 27) to minimize the constipating effects and risk of fecal impaction. Therapists should therefore be aware of these constipating effects and help educate patients and their families so that these effects do not result in serious problems. 

Caster oil is a harsh laxative (purgative) that acts on the small bowel and produces a watery stool within 2 to 6 hours. Therefore, this shouldn t be taken at bedtime. Caster oil is used mainly for bowel preparation and seldom used to correct constipation. Caster oil should not be used in early pregnancy because it stimulates uterine contractions and spontaneous abortion can occur. Prolonged use of Caster oil can damage nerves resulting in loss of intestinal muscular tone. 

Precaution Probably combustible Storage May be sensitive to prolonged exposure to light protect from light store refrigerated Uses Pharmaceuticals (stimulant in laxative prods. purgative cathartic treatment of constipation)... 

Figure 106,2. Opioid-induced bowel dysfunction (OBD). Opioids increase intestinal fluid absorption, inhibit intestinal secretions and peristalsis, and block propulsive movements in the colon. Constipation and other symptoms associated with OBD occur in 15-90% of cancer patients and may be more distressful and debilitating than pain. Tolerance rarely develops to these symptoms and traditional therapy including stimulants, lubricants, arxf bulk laxatives may not be effective.

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