Bulk-forming laxatives

indigestible, hydrophilic colloids that absorb water and form a bulky, emollient gel to promote peristalsis

- usually include natural plant products

- increased bloating and flatus

Stool surfactant agents (softeners)

soften stool material permitting water and lipids to penetrate.

- oral or rectal

- docusate used inpatient to prevent constipation

Stool softener

clear, viscous oil that lubricates fecal material - preventing water absorption from the stool

- used to prevent and treat fecal impact in kids and debilitated adults

nonabsorbable salt

-osmotic laxative

- risk for hypermagnesemia esp w/ renal insufficiency

nonabsorbable sugars

-used to prevent/treat chronic constipation

- flatus, cramps

purgative osmotics

- prompt bowel evacuation w/in 1-3hrs. rapid movement of water into the distal small bowel and colon - leads to high volume of liquid stool

- be careful to maintain hydration

- 

-used for colonoscopy prep

- designed so that there is no significant intravascular fluid or electrolyte shifts

moa = unknown - possible direct stim of the enteric nervous system and colonic eletrolyte and fluid secretion. 

- used for neuro impaired and bed bound patient

anthraquinone derivates

-poorly absorbed

- chronic use = brown pigmentation of colon = melanosis coli

Cl- channel activator

- used for chronic constipation and IBS

- Minimal systemic absorption = good for long term use

Opiod receptor antagonist

- do not cross BBB

- methyl = txt for opiod induced constipation in pts receiving palliative care

- alvimpoan = shorten period of postop ileus

serotonin 5HT4 Receptor agonist

- chonic constipation and IBS

- causes cardiac problems

serotonin 5-HT4 Receptor agonist

- clinical development

Opiod agonist for antidiarrheal

- nonprescription, does not cross BBB

- inhibits presynaptic cholinergic nerves

Opiod agonist for antidiarrheal

- prescription, higher doses of CNS effect - can lead to opiod dependence

- contains small amts of atropine to prevent dependence

- inhibit presynaptic cholinergic nerves

- act as absorbents of bacterial toxins and fluid - decrease stool liquidity and #.

- pectin = from apples

Bile salt-binding resins

- malabsorption of bile salts leads to diarrhea so these drugs decrease diarrhea caused by excess bile salts

- use: chrons, surgical resection of terminal ileum