Laxative/Purgative

Definition-
Laxatives (or purgatives) are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation.

Basic Concept-
1. Laxatives work to hasten the elimination of undigested remains of food in the large intestine and colon.
2. In many casses of intermittent constipation, it is best prevented by high fiber diet, adequate fluid intake, regular exercise and the heeding of nature's call.
3. If the above failed to do so, medical treatment can be an option.

Group of Laxatives

1. Bulk forming laxatives. Preparation include plant product- psyllium, methylcellulose, and synthetic fiber- polycarbophil.

Mode of action(MOA)- ( indigestible, hydrophilic colloids that) Absorb water, forming a bulky, emmolient gel that distend the colon and promote peristalsis.

2. Stool Surfactant Agents/ Softners. Preparation include Docusate ( oral, rectal ), glycerin suppository, and mineral oil

MOA- Agents soften stool materia, permitting water and lipid to penetrate.

Route of administration(ROA)- oral, rectal

Side effects(SE)- Long term ak Chronic use can impair absorpton of fat soluble vitamins-A,D,E,K

Contraindication(CI)- Severe Lipid Pneumonitis, can cause aspiration.

3. Osmotic Laxativeves
Concept- Increase in stool liqidity due to obligate increase in fecal fluid.

a.Non-absorbable Sugar or Salt
Preparation include Magnesium oxide aka milk of magnesia (commonly used), Sorbitol and Lactulose.

Most commonly used of Purgatives ( Agents that prompt bowel evacuation ) is magnesium citrate and sodium phosphate ( hyperosmolar agents)

MOA-
Sorbitol and lactulose are metabolized by the colonic bacteria, producing severe flatus and cramps
Hyperosmollar agents induce rapid movement of water into the distal small bowel and colon leads to a high volume of liquid stool followed by rapid relief of constipation

AE-
Cramps- Sorbitol and Lactulose
Intravascular volume depletion and electrolyte fluctuations- Hyperosmollar agent

CI-
Patient with hypermagnesemia-Milk of magnesia
Patient who are frail, elderly renal defect and significant cardiac disease-Hyperosmollar agents

b. Balanced Polyethylene Glycol(PEG)
Used for complete cleansing prior to GIT endoscopic procedures.

MOA- Balanced the isotonic solutions in the bowel. Solution are designed so that no significant shift of intravascular fluid or electrolyte occur. Hence it is safe for all patient.
No significant cramps or flatus reported.

4. Stimulant Laxatives

a. Anthraquinone derivatives. Prepation include aloe, senna and cascara-ocur naturally in plant.
Chronic use leads to Melanosis Coli- brown pigmentatio of colon.

b. Diphenylmethane derivatives.
Preparation include Phenolphthalein.
SE- Cardiac toxicity. Removed from the market

c. Castor Oil
MOA- It is hydrolyzed in upper intestine to ricinoleic acid, a local irritant that stimulates intestinal motility.

5. Serotonin 5-HT4 Receptor Agonist
Preparation include Tegaserod- Serotonin 5HT4 partial agonist.



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Constipation...

1.I had a very severe bad constipation a couple of days ago. The conditioned get worsened as when the gas get accummulated in my stomach and failure of flatulance. Huhu...

2. Initially, I refused to use any drugs or going to see the doctor to rectify my problem as I hope that my own body can battle with it till the last drop of blood. But as time progressed, my body didn't show any sign of relief, and the situation worsened.

3. On day 4, I opened up my Pharmacology Tara Shanbhag Textbook and looked for solution. Actually I haven't learn the G.I.T-Gastrointestinal - block yet, but after having a glance on that page, I knew that the solution is Laxatives/Purgatives.

4. Due to my problem, I missed my Football game yesterday evening and my Futsal game yesterday night. Fuh...

5. I hope that by having this drug, my condition can improve!



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Study Planning Discussion

A few things that I would like to revise, or re-think about my exam result...Hoho...Overall, I could say its a kind of 'OK' for me as the second block-aka 2nd Sessional Exam- were concern. If you ask me and my batchmates, we'll surely say that the exam were really damn, damn difficult!

1. I think for the upcoming exam ( 3rd and 4th block) I need to pay a little more attetion in the class, prevent 'day dreaming' and increase the level of understanding of what the lecturer is teaching. See, some of the things are very tough to understand in an hour lecture class, but, what to do.

2. May Friday Night Futsal Game. I hope that I won't consider this in my list, but, if I'm too damn busy, I have 2 options, either I cancelled the the schedule-this is highly unlikely, huhu..OR,just after finishing the game, I have get back at my desk. It is not necessary for me to study the present syllabus, maybe I can revised back the block 1 or 2 subjects for the sake of my 2nd Year MBBS Examination.

3. To increase the level of understanding, I should the Internat more frequetly as, what are described by the lecturer, some of it we can't easily understand. Google Images might help. Credit to Google!

4. Increase the frequency of Question-Answer Session not only for the upcoming blocks, but also for the previous two blocks. I had made an agreement with Arip aka 'Yeripuddin SoY!' and we can do it during our leisure time as during the weekly English Premier League game. It helps a lot in Multi True False-MTF...You bet it!!!

5. Start doing the MTF more regularly for the upcoming blocks, and the previous blocks too. Yeah I got many of them in my laptop. Better I make sure that I use it 100%.

6. As far as the essay question are concern, I think I need to look at it from day one. For me, some of the questions are keep repeating for the past 10 blocks.

7. Make sure that my body is healthy. Jogging, swimming, football...
The Arab says " al-Aql as-Salim, Fil Jism al-Salim"- Good thinking can be achieved in a healthy body!!

8. Maintain my diet programme. I bet I have to...I have managed to reduced 10 kilos in a space of 4 months and the weight is maintaining right now, that should be a good sign, but I still have around 20 kilos to go to get an optimum BMI!!! Please pray for me!!!
Actually by having an ideal weight, it can help me to gain an extra self confidence! Haha...

9. I think of using this blog as a medium to discuss the upcoming block's syllabus or to revise the previous blocks and to make my studies more enjoyable. In addition, I can also share my knowledge with those who read my blog.

10. MOm's advise- WORK HARD!!! Don't forget to call Mom and Dad minimum of a time per week. Insyallah...




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12 and 12 things that I can write about...

I am sure that, it is already 12th March 2009 in Malaysia Bcoz while I'm writing here in India it is still 27minutes to go to reach that 'keramat' date...

1. When I was 12 years old, I took my UPSR with just 1 month of full preparation since I juzz came back from La Spezia, Italy.

2. Thierry Henry wear the Number 12 jersey of France...Are any one of you who don't know Thierry Henry? You bet not to...Huh..



3. A year we have 12 month...I think I'm not suppose to write all of it- but you can complete it by sending me 'comment'.

4. I only have 12 month time left to complete my course in INDIA- INSYAALLAH!!!

5. Yesterday, Bayern Munich advanced to the Quarter Final Champions League 2008/09 by margin of 12 goals on aggregate. Poor Sporting Lisbon, they just manage to score only a consolation goal. That was a tournament record!!!



6. My Sister's Birthday will be at 12th of June- but still long way to go...lalalalalala....

7. I took my SPM with 12 Subjects, by just manage to get lack of an A of all the 12...huhu...

8. Today, 12 of March, my BIG brother will wake up early ( I hope so dude!- )and with all my prayers, and all the confidence inside you-, you'll walk straight to the STAR Hall and take your Result bravely! May Al-Mighty God be with YOU!

9. We just Celebrate the Maulidurrasul-'12 RabiulAwal'. As far as I'm concern, after reading the SS al Fadhil Dr MAZA Minda Tajdid, It's quite unclear whether it is exactly the date Our Holy Prophet, Nabi Muhammad S.A.W was born. But as far as for the Muslim of the Malaysia are concern, we were tought in PAI( Pendidikan Agama Islam), that date, our Beloved Prophet S.A.W, was born in the year of Elephant!!

10. The first time I arrived in India the Auto Fees around Manipal was 12 rupees. Now, it is impossible to get that rate around Manipal. If you can afford to bargain for that rate, you're lucky enough!!!- DAMN EXPENSIVE RIGHT NOW!!!-

11. Today the Keramat Day For my 'Fratellino'!!! 17 years back, on 12th March 1991 he was born!!! Yeah! Happy Birthday Syahmi!!!May GOD Bless YOU!!!



12. Haha, this time, I left it for you guys to write it!!! Please send to my 'comment' box! Hihi...



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Good Luck My Bro!!!

Just a short post, just wanna wish my bro-Muhammad Syahmi Bin Mahamud Sayuti-
GOOD LUCK during the release of SPM result!! Maa Taufiq Wan Najah!!!
1. I'll always pray that you have a very very good result.

2.Hopefully you can break my own record as I knew that you are much more better than me.

3. I hope that you have a clear vision of the route that you will choose for the next stage of your studies.

4. Whatever the outcome will be don't forget that Allah S.W.T, our creator's plan is the best, and the very best for us, as the humanbeings.








I AM PROUD OF YOU!!!

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Selamat Pengantin Baru!!!

SELAMAT PENGANTIN BARU!!! Kepada Saudara Khalis Amali Bin Mohamed Zuki dengan pasangannya Saudari Afzan Harrison!!! Moga ikatan suci ini berkekalan ke anak cucu!!!

P/s- Lepas nie, Supremo 2009, diharap Abang Khalis -aka- Koipten Khalis dapat terus membimbing pasukan bola sepak Batch 21 menjuarai kejohanan kali ke 3 berturut-turut, supaya kita dapat mencipta sejarah di bumi MANIPAL...
Saya harap Abg dapat score lebey banyak goal-sebab orang dah kawen, bak kata orang tua-ada tenaga tambahan!!!


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"Pergi Jahanam ISRAEL!!!!!!!!"

In this post, I would like to remember myself and all my friend who would read this post that The Zionist Israel was/is such bloody bastard creature in this world.

I couldn't believe how the bloody bastard Israel can bomb, kill , and murder the innocent Palestinian- which of course, as a MUSLIM is my own brother and sister also!

As a MUSLIM, I want to make it clear that, we must, with our very best to take some part in 'counter attacking' them via boycotting their stuff!!!





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