LAXATIVES

MOA Indication S/E

1. Bulk- forming attract water from intestine which constipation flatulence

a. Dietary fiber (bran) causes water retention & distention decrease reabsorption of cardiac glycosides
b. methycellulose ----> increase GI peristaltic activity CI: GI ulcers, stenosis, adhesions
c. psyllium (Metamucil)

2. Saline laxatives retain water --> softens stool constipation dehydration

a. Mg hydroxide (MOM) ---> increase peristaltic activity colonic lavage electrolyte imbalance
b. Mg citrate elimination of parasites CI; CHF, impaired renal function
poisoning

3. Osmotic Laxatives retain water

--> stimulate peristaltic activity
a. glycerin constipation
b. lactulose constipation flatulence, abdominal cramps, N&V, diarhea
chronic hepatic encephalopathy
c. polyethylene glycol colonic lavage diarrhea

4. Stimulant Laxatives
a. bisacodyl (Dulcolax)
b. senna (Senokot)
c. phenolphthalein
d. casarca sagrada
increase secretion of water
Into lumen---> perist. Act.
constipation
Evacuation of bowel prior to
surgery or dx exams
F/E imbalances, abdominal cramps
pink coloration of urine & feces
nephritis & melanotic pigmentation in large dose

5. Surfactants soften stool & increase diarrhea, nausea

a. docusate Ns water secretion into lumen constipation abdominal cramps
(Colace)
b.castor oil severe constipation dehydration
preparation for radiographic exams electrolyte imbalance
colic
uterine contractions