Constipation

Question 1

Name 2 osmotic laxatives.

Answer 1

Movicol
Lactulose

Question 1

Name 2 stimulant laxatives.

Answer 1

Senna
Sodium picosulfate

Question 2

Name a laxative that is a weak stimulant and osmotic.

Answer 2

Docusate - it is a surface active compound which works in the bowel like a detergent with some stool softening and stimulant effects.

Question 3

Why is lactulose used in liver failure?

Answer 3

Used to treat the hepatic encephalopathy seen in end-stage liver failure –> with lactulose, the gut contents have a lower pH than normal –> this decreases the activity of ammonium-producing organisms.

Question 4

Why should laxatives not be used in bowel obstruction?

Answer 4

Increased risk of perforation

Question 5

How do you manage hard stool in the rectum?

Answer 5

BOTH phosphate enemas + stool softener

If this doesn’t work then manual evacuation is used

Question 6

What laxatives are used for bowel prep?

Answer 6

Picolax - magnesium citrate with sodium picosulfate

These are strong - normal laxatives will not clear the bowel completely

Question 7

When and how is Picolax taken?

Answer 7

Day before investigation, 3 sachets taken
Acts in 3hrs

Advise them to drink plenty to avoid dehydration