Pharm

Laxative

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Laxative

  • Types
  • Laxative Types
  1. Bulk Laxative
    1. Preferred agents (effective with few adverse effects)
    2. Psyllium (e.g. Metamucil)
    3. Methylcellulose (e.g. Ctrucel)
    4. Calcium Polycarbophil (Fibercon)
    5. Dietary Fiber
  2. Emollient Laxative (Stool Softener)
    1. DocusateSodium (Colace) - questionable efficacy
    2. Glycerin
    3. Mineral Oil (not recommended)
      1. Aspiration risk
      2. Depletes fat soluble Vitamins
  3. Osmotic Laxative
    1. Poorly absorbed saccharides (Lactulose, Sorbitol)
    2. Magensium Laxatives (Milk of Magnesia)
    3. Sodium bisphosphate (Fleets Phospho-Soda)
    4. Polyethylene glycol lavage solution (GoLytely)
  4. Stimulant Laxative (Risk of Laxative abuse)
    1. Other Laxative types are preferred over these
    2. Anthraquinone Laxative
      1. Cascara sagrada Extract (Casanthranol)
      2. Senna Extract (Senokot)
    3. Diphenylmethane Laxative
      1. Bisacodyl (Dulcolax)
      2. Phenolphthalein (OTC, Correctol, Ex-Lax)
  5. Combination Agents
    1. Peri-Colace contains Cascara and Docusate
    2. Senekot-S contains senna and Docusate
  6. Enemas and suppositories
    1. Never use hot water, soap, or hydrogen peroxide enema
    2. Tap water enema or saline enema (safest)
    3. Sodium Bisphosphate enema (Fleet Enema)
    4. Pink Lady Enema (1/2 Fleet Enema, 100 ml Docusate, 60 ml Mineral Oil, 60 ml Magnesium Citrate)
    5. Mineral Oil enema
    6. Glycerine suppository
    7. Bisacodyl suppository (dulcolax suppository)
  7. Prokinetic agents
    1. Tegaserod (Zelnorm)
      1. Indicated only in IBS for Constipation in women