Gastroenterology & Hepatology — Flashcards

Flashcard 451: 1st line pharmacological management of acute or chronic constipation is with a _____ laxative. If that does not work, consider changing to a osmotic (e.g. macrogol) laxative

Answer: bulk-forming (e.g. ispaghula husk)

Flashcard 452: True or False: The long-term use of stimulant laxatives for chronic constipation is contraindicated because it _____

Answer: leads to permanent loss of bowel function (cathartic colon)

Extra: Management of constipation follows a stepped approach: 1. Lifestyle: Fiber, fluid, exercise. 2. Bulk-forming laxatives (Psyllium). 3. Osmotic laxatives (PEG, Lactulose). 4. Stimulant laxatives (Senna, Bisacodyl) if needed. The myth of permanent bowel damage (melanosis coli is benign) should not prevent proper treatment.

Flashcard 453: What non-opioid adjuvants can be used for intestinal colic pain? _____

Answer: Antispasmodics (e.g. buscopan)

Flashcard 454: What are the different categories of laxatives? _____, Osmotic, Stimulant, Stool softner

Answer: Bulk-forming

Flashcard 455: _____ are usually ineffective for opioid-induced constipation. Osmotic or stimulant laxatives should be used instead

Answer: Bulk-forming laxatives (e.g. ispaghula husk)

Flashcard 456: Palliative patients with metastatic disease and symptoms of constipation may require an _____ to look for signs of bowel obstruction

Answer: AXR

Flashcard 457: What are the most common stool softener laxatives? _____

Answer: Docusate or Arachis oil

Flashcard 458: What are the most common osmotic laxatives? _____

Answer: Lactulose & macrogol

Flashcard 459: What are the most common bulk-forming laxatives? _____

Answer: Ispaghula husk & methylcellulose

Flashcard 460: Nausea and vomiting in palliative patients mediated by _____ may be caused by constipation or oral candidiasis

Answer: visceral/serosal mechanisms