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laxatives and purgatives. Pharma pptx by Mr. Praveen Jaiswal
- 1. Laxatives and purgative drugs Presented by Mr. Praveen Jaiswal MSN(CCN) PG Tutor Subharti University, Dehradun
- 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.
- 7. Contraindications • Contraindicated if patient with parasites. • Severe abdominal pain of unknown cause.
- 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.
- 9. Adverse effects: cont. • Laxative dependence and electrolyte imbalances. • Nutritional deficiencies (with lubricant laxatives). • Belching (with osmotic laxatives) • Electrolyte imbalance. (With saline laxatives)
- 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.