Laxatives Flashcards
lactulose
Osmotic action
lactulose
Osmotic action
Action:
- increases eater content and softens stool
2. Decreased blood ammonia levels with improved mental status in portal systemic(hepatic) encephalopathy PSE
lactulose
Osmotic action
Route:
PO 15-30ml/day
up to 60ml/day
lactulose
Osmotic action
Side effects:
GI: belching, cramps, distention, flatulence, diarrhea
Endo: hyperglycemia
lactulose
Osmotic action
Lab monitoring:
Decreased blood ammonia by 25-50%
may increase blood glucose in diabetics
watch serum electrolytes may cause diarrhea with imbalances to sodium and potassium
lactulose
Osmotic action
Precautions:
Do GI assessment on patients.
assess stool color and type
watch lab values for Na K and glucose
PSE assess mental state during and after for PSE
Magnesium salts
- Magnesium citrate
2. magnesium hydrochloride
Magnesium salts
Agent:
Saline
Magnesium salts
Action:
treatment or prevention of hypomagnesemia
laxative osmotically draws water into the lumen causing peristalsis
Magnesium salts
Route:
PO adults mag citrate: 240ml
milk of magnesia (adults): 5-15 ml
Magnesium salts
Side effects:
Diarrhea
Derm: flushing, sweating
Magnesium salts
lab monitoring:
monitor for hypermagnesemia, hypocalcemia
Magnesium salts
precautions:
contradicted in hypermagnesemia, hypocalcemia, anuria, heart block, active or 2 hours of labor.
any level of renal deficiency.
bisacodyl
Agent:
Bowl stimulant
bisacodyl
Action:
stimulates bowls to evacuate.
bisacodyl
route:
PO adults 5-15mg up to 30mg/day
rect 12 and up 10mg single dose
bisacodyl
Side effects:
Abdominal cramps, nausea, diarrhea, rectal bleeding
bisacodyl
lab monitoring:
monitor potassium levels. may cause hypokalemia with chronic use.
bisacodyl
precautions:
apply at bedtime for morning results.
Do GI assessment.
advice patients to increase fluid intake from 1500ml/day to 2000ml/day for dehydration
only should be used chronically for spinal cord injuries.
docusate sodium
Agent:
Emollient or wetting
docusate sodium
Action:
promotes incorporation of water into stool, may promote electrolyte and water secretions into the colon.
docusate sodium
Route:
PO 50-400mg in 1-4 divided doses
rect: 50-100mg or 1 unit with 283mg
docusate sodium
Side effects:
throat irritation, GI: mild cramps
Derm: rashes
docusate sodium
Lab monitoring:
monitor electrolyte for normal values
docusate sodium
precautions:
do not use with abdominal pain, nausea, or vomiting
apply on empty stomach for quicker results
do not apply within 2 hours of other laxatives
Castor oil
Agent:
Bowl stimulant
Castor oil
Action:
increases peristalsis
Castor oil
Route:
15-60ml PO not at bedtime
Castor oil
Side effects:
dizziness, electrolyte disorders, abdominal pain, nausea, diarrhea
Castor oil
Lab monitoring:
monitor electrolyes
Castor oil
precautions:
contradicted in:
fecal impactions
menstruation
sennoside
Senokot-S
Brand name
sennoside
Agent:
grouped as a sennoside
sennoside
Senokot-S
Action:
8.6mg
2-4 tabs PO qd-bid
start 2 tabs PO
max 4 tabs PO bid
sennoside
Senokot-S
Side effects:
nausea, abdominal bloating, abdominal cramps, flatulence, diarrhea, urine discoloration
sennoside
Senokot-S
Lab monitoring:
N/A
sennoside
Senokot-S
precuations:
potential for laxative abuse
psyllium
Agent:
Bulk forming
psyllium
Action:
increases stool bulk
psyllium
Route:
1-2tsp PO qd-tid
psyllium
Side effects:
esophageal obstruction
bowl obstruction
diarrhea, constipation, abdominal cramps
bronchospasm
psyllium
Lab monitoring:
N/A
psyllium
Precautions:
contradicted with
suspected appendicitis
intestinal obstruction
polyethylene
glycol
Action:
causes retention of water in stool,
producing laxative effect
polyethylene
glycol
Agent:
Osmotic laxative
polyethylene
glycol
Route:
17g PO qd
may take 2-4 days for BM
caution in longer than 2 weeks
polyethylene
glycol
Side effects:
electrolyte disorders
laxative dependence
polyethylene
glycol
Lab monitoring:
monitor for disturbances in potassium and sodium levels.
polyethylene
glycol
Precautions:
contradicted in
bowl obstructions
caution in elderly