Gastroenterology & Hepatology — Flashcards

Flashcard 431: If the oral route is not tolerated in palliative care, switch to _____

Answer: subcutaneous infusion

Flashcard 432: What are the most common stimulant laxatives? _____

Answer: Senna (senokot), Bisacodyl (dulcolax), Sodium picosulfate

Flashcard 433: What are the most common osmotic laxatives? _____

Answer: Lactulose & macrogol

Flashcard 434: Palliative patients with metastatic disease and symptoms of constipation may require an _____ to look for signs of bowel obstruction

Answer: AXR

Flashcard 435: When prescribing a strong opioid, _____ should always be co-prescribed and anti-emetics should be prescribed if nausea persists

Answer: laxatives

Flashcard 436: Red flag symptoms of constipation include: _____, weight loss, bleeding or iron deficiency anaemia

Answer: sudden change in bowel habit

Flashcard 437: What non-opioid adjuvants can be used for intestinal colic pain? _____

Answer: Antispasmodics (e.g. buscopan)

Flashcard 438: What is the best laxative for use in palliative patients? _____

Answer: Whichever the patient finds most palatable

Flashcard 439: 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 440: Patients with chronic constipation refractory to typical laxatives should be considered for management with _____ for 4 weeks

Answer: prucalopride