This presentation contains information about the commonly used laxative and purgative drugs. This presentation can be used to teach nursing and allied health students.
2. Laxatives/Purgatives
• These drugs are combined known as purgatives, which
includes laxatives and cathartics these drugs are used to
overcome constipation and proper evacuation of bowels.
• They are used to thoroughly clean the intestines before
medical procedures or surgeries.
4. Mechanism of action
• Osmotic laxatives (Magnesium hydroxide) draw water into the
intestine to increase the mass of stool, stretching musculature which
results in peristalsis.
• Stimulant laxatives result in stimulation of intestinal
peristalsis.
• Lubricant laxatives increase water retention in the stool, and prevent
water absorption from the stool, and lubricate as well as soften
intestinal contents.
• Stool softener allows more fluid and fat to penetrate the faeces,
producing a softer faecal mass.
5. Drug example and doses
• Bilk forming laxatives (Methyl Cellulose) – 2 tablets 1000mg
orally with 8oz of liquid up to 6 times a day.
• Lubricant laxatives include mineral oil (Kondremal, Fleet
mineral oil enema.
• Hyperosmotic laxatives include lactulose. – 10mg BD
• Stimulant laxatives (Bisacodyl, Castor oil) – 5 -10 mg
sodium Pico sulfate 15-20 ml
• Stool softener (Docusate Calcium, Docusate potassium) – 240mg
50-400mg orally 1to 4 equally divided doses each day.
6. Indications / Uses
• To treat or prevent constipation.
• To prepare the bowel for radiologic or endoscopic procedures.
• Short-term treatment of constipation caused by high dose of
opioid use.
• Osmotic laxatives are used to rapid evacuation of the bowel after
ingestion of poison or following anti-helminthic therapy to rid the body of dead
parasites.
• Methyl cellulose and psyllium are used to many chronic diarrhoea.
8. Adverse effects
• GI irritation.
• Rectal burning sensation.
• Osmotic laxatives may cause Dehydration.
• Long-term use and abuse of laxatives may cause permanent
loss of colonic motility.
10. Drug interactions
• Laxative decreases intestinal transit time and reduces
absorption of orally administered drugs.
11. Nurses role and responsibility
Client Teaching
• Take as directed with at least 250 ml of water.
• Increase daily fluid intake.
• Prolonged use of laxatives can cause dependence.
Contact the health care provider:
• If constipation is unrelieved
• Signs or symptoms of dehydration or electrolyte imbalance.
12. Contd.
Lifestyle modifications
• Increase fiber-containing food, physical activity, and fluids
• Do not ignore the urge to defecate.
Osmotic laxatives-Follow each dose with 250 ml of water.
13. Contd.
• Bulk-forming agents- powder: take with a full 250 ml glass of water or juice, drink
right after mixing, and immediately follow with an additional 250 ml of water.
• Separate fiber laxative and other medications by 1–2 hours.
• Stimulant laxatives-Temporary discoloration in urine.
• Emollient laxatives (stool softeners)-May take up to three days for results.