Gastrointestinal System Disorders Q 280 - Gyan Darpan : Learning Portal
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Monday, 11 April 2022

Gastrointestinal System Disorders Q 280

To avoid fecal impaction, psyllium (Metamucil) should be administered with at least how many ounces of fluid?
    A. 4
    B. 6
    C. 8
    D. 10

Correct Answer: C. 8

Bulk-forming laxatives must be given with at least 8 ounces of liquid plus additional liquid each day to prevent intestinal obstruction. Bulk-forming laxatives retain fluid in the stool and increase stool weight and consistency. Psyllium, dietary fiber, carboxymethylcellulose, and methylcellulose are common examples. It is important to take ample amounts of water for bulk-forming agents to work. Lack of water, in turn, leads to bloating and can cause bowel obstruction.

Option A: Most laxatives are safe when used appropriately and in patients without contraindications. Bulk-forming agents like lactulose can have adverse effects like bloating, nausea, vomiting, and diarrhea. With prokinetic agents, adverse effects like a headache, nausea, and diarrhea have been described.
Option B: Stimulant laxatives are known to cause abdominal pain. Cisapride and tegaserod were withdrawn from the market after cardiovascular adverse effects, including prolonged QT interval that increases the risk for Torsades de Pointes. Mineral oil can cause aspiration and lipoid pneumonia.
Option D: Osmotic agents like magnesium can cause metabolic disturbances, especially in the presence of renal involvement. Also, magnesium excretion depends on renal function, and its use requires caution in renal impairment. Osmotic agents result in volume load and should be used with caution in renal or cardiac dysfunction.

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