Tema 37. Fármacos indicados en el manejo de la motilidad intestinal: Laxantes y Antidiarreicos.

Summary

The video script provides an in-depth exploration of medications for intestinal motility, focusing on laxatives and anti-diarrheal drugs. It discusses various types of laxatives, including bulk-forming, osmotic, lubricating, and stimulant laxatives, each with its specific uses and potential side effects. The script also covers anti-diarrheal medications, such as opioids like loperamide, absorbents, and inhibitors of intestinal secretion, highlighting their roles in treating acute and chronic diarrhea. Emphasis is placed on individualized treatment approaches, the importance of diet and exercise, and the need for careful management to prevent complications.

Takeaways

• 😀 The definition of constipation can vary, but it is generally agreed that it involves fewer than 3 to 5 bowel movements per week.
• 😀 The immediate goal of constipation therapy is to determine and address its underlying cause, often with symptomatic treatment.
• 😀 Dietary recommendations and physical exercise should always be considered as part of the treatment plan for constipation.
• 😀 Laxatives are the main drugs used to treat constipation and are divided into several categories, including bulk-forming, softeners, lubricants, osmotic laxatives, and stimulants.
• 😀 Bulk-forming laxatives increase the volume of intestinal contents, stimulating motor activity, and include substances like bran, cellulose, and plantago.
• 😀 Softeners or lubricants, such as glycerol, sodium docusate, and mineral oil, are used when bulk-forming agents cannot be used or in patients with anal fissures or hemorrhoids.
• 😀 Osmotic laxatives, such as magnesium salts and lactulose, attract water into the intestines, facilitating motility and elimination.
• 😀 Sugar-derived osmotic laxatives like lactulose and sorbitol are not absorbed in the small intestine and can cause flatulence and abdominal discomfort.
• 😀 Stimulant laxatives act by inhibiting the absorption of electrolytes and water in the intestines, which increases fluid content and stimulates peristalsis.
• 😀 Anti-diarrheal drugs are used to treat diarrhea, which is characterized by increased stool volume, fluidity, or frequency, and can be acute or chronic.
• 😀 Anti-diarrheal treatments include opioid inhibitors, intestinal absorbents, and drugs that modify electrolyte transport, with loperamide and codeine being common anti-motility agents.

Q & A

What is the general definition of constipation, and how is it measured?

Constipation is generally defined as having fewer than 3 to 5 bowel movements per week. It can be influenced by dietary and cultural habits, and determining the cause of constipation is crucial for treatment.

What is the primary goal of constipation therapy?

The primary goal of constipation therapy is to identify and resolve the underlying cause. Treatment is often symptomatic, but dietary recommendations and physical exercise should not be overlooked.

What are the main types of laxatives used to treat constipation?

The main types of laxatives include bulk-forming laxatives, stool softeners, lubricants, osmotic laxatives, sugar-based laxatives, mixed products, and stimulant laxatives.

How do bulk-forming laxatives work, and what are their main components?

Bulk-forming laxatives work by increasing the volume of intestinal contents, which stimulates motor activity. They often absorb water and expand, increasing the mass. Common substances include bran, cellulose-rich products, methylcellulose, and plantago.

What are the main drawbacks of bulk-forming laxatives?

Bulk-forming laxatives can cause intestinal obstruction in patients with intestinal diseases, and they may lead to gas production or flatulence.

How do stool softeners or lubricants help with constipation?

Stool softeners or lubricants, such as glycerol, sodium docusate, and paraffin oil, help soften and lubricate stool, making it easier to pass. They are mainly used rectally, especially for patients with anal fissures or hemorrhoids.

What are osmotic laxatives, and how do they function?

Osmotic laxatives are poorly absorbed in the intestines and work by drawing water into the intestines through osmotic pressure. This facilitates bowel movements and is used for quick effects, often through rectal administration.

What are sugar-based laxatives, and what side effects might they cause?

Sugar-based laxatives, such as lactulose and sorbitol, are not absorbed in the small intestine and are metabolized in the colon. They can lead to flatulence, abdominal discomfort, nausea, and diarrhea.

What is the role of stimulant laxatives, and how do they work?

Stimulant laxatives work by increasing intestinal motility. They inhibit the absorption of electrolytes and water, thus stimulating peristalsis. They are used when a rapid evacuation is needed.

What are the main types of anti-diarrheal medications, and how do they function?

Anti-diarrheal medications include motility inhibitors (like loperamide and codeine), intestinal absorbents (like activated charcoal), and inhibitors of intestinal hypersecretion (such as bismuth salicylate). They reduce diarrhea symptoms by slowing motility, absorbing toxins, or reducing fluid secretion.

What are the potential risks of treating acute diarrhea pharmacologically?

Acute diarrhea should only be treated pharmacologically when there is a risk of dehydration or electrolyte imbalance. It is a natural process the body uses to eliminate the causative agent, and inappropriate use of anti-diarrheal drugs can hinder this process.

What is the role of absorbent intestinal medications in diarrhea treatment?

Absorbent intestinal medications, like activated charcoal, work by absorbing water and toxins in the digestive tract, reducing fluid loss. They can be used to prevent toxin absorption or as a mild anti-diarrheal.

How do inhibitors of intestinal hypersecretion aid in treating diarrhea?

Inhibitors of intestinal hypersecretion, such as bismuth salicylate, are useful in treating acute diarrhea by reducing the excessive secretion of fluids into the intestines, helping to restore normal bowel function.