NURS 8024 FINAL PAPER 2025 QUESTIONS AND ANSWERS
RATED A+
✔✔Polyethylene Glycol (PEG)(Miralax) - ✔✔powder medication mixed in 120-240 mL of
fluid
not absorbed systemically or metabolized by colonic bacteria (incidence of ADEs is
lower than other osmotics)
can be used low dose daily for 6 months or in large doses as bowel prep
ADEs: n/v, flatulence, and abd cramping
✔✔Describe magnesium salts. - ✔✔osmotic saline laxatives
hydroxide, phosphate, citrate, and sodium phosphate attracts and retains water
(osmotic effect)
E.g. Mg hydroxide (Milk of Magnesia)
not for routine use, limited efficacy
ADEs: F&E depletion, hyperMg or hyperNa in tose with renal dysfunction or HF
✔✔Describe stimulant/irritant laxatives. - ✔✔MOA: increase peristalsis via several
mechanisms
may cause abd cramping
E.g. senna, cascara, bisacodyl (Dulcolax)
✔✔Lubiprostone (Amitza) - ✔✔FDA approved stimulant laxative for chronic idiopathic
constipation
MOA: acts locally in gut, opens chloride channels, increases intraluminal fluid secretion,
soften stool, and accelerate GI transit time
ADE: nausea, HA, diarrhea
$$$ - use after failing 1st line agents
✔✔Linaclotide (Linzess) - ✔✔FDA approved stimulant laxative for treatment of
constipation and IBS-C
MOA: activates a receptor on intestinal epithelium, increases intestinal fluid secretion,
and increases intestinal motility
, ADE: diarrhea, flatulence, abd pain
BBW: avoid in <18 years, contraindicated in <6 years
$$$ - use after failing 1st line agents
✔✔Describe some patient variables to consider when using laxatives. - ✔✔Geriatrics:
incidence of constipation increases with age, more susceptible to dehydration and
electrolyte imbalances
Peds: multifactorial etiologies (emotional, environmental, dietary), dosage adjustments
for specific drugs, contraindications and warnings for specific products
✔✔Describe serotonin 5-HT3-RAs. - ✔✔MOA: 5-HT3 receptor blocking in GI and CNS
clinically used for prevention of chemotherapy-induced and post-op n/v
available orally and parenterally
ADEs: HA, fatigue, constipation, diarrhea, ***small prolongation of QT interval***
all have extensive hepatic metabolism, renal & hepatic excretion
✔✔Prochlorperazine (Compazine) - ✔✔dopamine receptor blocker
MOA: blocks D2 receptors in chemoreceptor trigger zine and other areas of the brain
ADEs: drowsiness, dizziness, constipation, HA, tardive dyskinesia
BBW: dementia related psychosis, increased mortality in elderly
✔✔Promethazine (Phenergan) - ✔✔dopamine receptor antagonist
MOA: antagonises central and peripheral histamine H1 receptors
ADe: sedation, dizziness, confusion, photosensitivity
BBW: contraindicated in <2 years - respiratory depression, tissue injury and gangrene
from PIV extravasation
✔✔Metoclopramide (Reglan) - ✔✔prokinetic agent, dopamine receptor antagonist
MOA: prevents stimulation of CTZ, accelerates gastric emptying
RATED A+
✔✔Polyethylene Glycol (PEG)(Miralax) - ✔✔powder medication mixed in 120-240 mL of
fluid
not absorbed systemically or metabolized by colonic bacteria (incidence of ADEs is
lower than other osmotics)
can be used low dose daily for 6 months or in large doses as bowel prep
ADEs: n/v, flatulence, and abd cramping
✔✔Describe magnesium salts. - ✔✔osmotic saline laxatives
hydroxide, phosphate, citrate, and sodium phosphate attracts and retains water
(osmotic effect)
E.g. Mg hydroxide (Milk of Magnesia)
not for routine use, limited efficacy
ADEs: F&E depletion, hyperMg or hyperNa in tose with renal dysfunction or HF
✔✔Describe stimulant/irritant laxatives. - ✔✔MOA: increase peristalsis via several
mechanisms
may cause abd cramping
E.g. senna, cascara, bisacodyl (Dulcolax)
✔✔Lubiprostone (Amitza) - ✔✔FDA approved stimulant laxative for chronic idiopathic
constipation
MOA: acts locally in gut, opens chloride channels, increases intraluminal fluid secretion,
soften stool, and accelerate GI transit time
ADE: nausea, HA, diarrhea
$$$ - use after failing 1st line agents
✔✔Linaclotide (Linzess) - ✔✔FDA approved stimulant laxative for treatment of
constipation and IBS-C
MOA: activates a receptor on intestinal epithelium, increases intestinal fluid secretion,
and increases intestinal motility
, ADE: diarrhea, flatulence, abd pain
BBW: avoid in <18 years, contraindicated in <6 years
$$$ - use after failing 1st line agents
✔✔Describe some patient variables to consider when using laxatives. - ✔✔Geriatrics:
incidence of constipation increases with age, more susceptible to dehydration and
electrolyte imbalances
Peds: multifactorial etiologies (emotional, environmental, dietary), dosage adjustments
for specific drugs, contraindications and warnings for specific products
✔✔Describe serotonin 5-HT3-RAs. - ✔✔MOA: 5-HT3 receptor blocking in GI and CNS
clinically used for prevention of chemotherapy-induced and post-op n/v
available orally and parenterally
ADEs: HA, fatigue, constipation, diarrhea, ***small prolongation of QT interval***
all have extensive hepatic metabolism, renal & hepatic excretion
✔✔Prochlorperazine (Compazine) - ✔✔dopamine receptor blocker
MOA: blocks D2 receptors in chemoreceptor trigger zine and other areas of the brain
ADEs: drowsiness, dizziness, constipation, HA, tardive dyskinesia
BBW: dementia related psychosis, increased mortality in elderly
✔✔Promethazine (Phenergan) - ✔✔dopamine receptor antagonist
MOA: antagonises central and peripheral histamine H1 receptors
ADe: sedation, dizziness, confusion, photosensitivity
BBW: contraindicated in <2 years - respiratory depression, tissue injury and gangrene
from PIV extravasation
✔✔Metoclopramide (Reglan) - ✔✔prokinetic agent, dopamine receptor antagonist
MOA: prevents stimulation of CTZ, accelerates gastric emptying
