Osmotics saline

Osmotic laxatives (hyperosmolar) are salts or saline products, lactulose, and glycerin. The saline products are composed of sodium or magnesium, and a small amount is systemically absorbed. They pull water into the colon and increase water in the feces to increase bulk, which stimulates peristalsis. Saline cathartics cause a semiformed-to-watery stool depending on dose. However, they are contraindicated for patients who have congestive heart failure.

Osmotic laxatives contain three types of electrolyte salts: sodium salts (sodium phosphate or phospho-soda, sodium biphosphate), magnesium salts (magnesium hydroxide (milk of magnesia), magnesium citrate, magnesium sulfate (Epsom salts), and potassium salts (potassium bitartrate, potassium phosphate). Serum electrolytes should be monitored to avoid electrolyte imbalance. Good renal function is needed to excrete any excess salts.

High doses of salt laxatives are used for bowel preparation for diagnostic and surgical procedures. Also used for bowel preparation is polyethylene glycol (PEG) with electrolytes, commonly referred to as Colyte or GoLYTELY. PEG is administered in amounts of 3 to 4 liters over 3 hours. Patients may be advised to keep GoLYTELY refrigerated to make it more palatable. PEG is an isotonic, nonabsorbable osmotic substance that contains sodium salts. Therefore, patients with renal impairment or cardiac disorder can use potassium chloride.

Lactulose, another saline laxative, is not absorbed and draws water into the intestines and promotes water and electrolyte retention. Lactulose decreases the serum ammonia level and is useful in liver diseases such as cirrhosis. Glycerin acts like lactulose by increasing water in the feces in the large intestine. The bulk that results from the increased water in the feces stimulates peristalsis and defecation. Patients who have diabetes mellitus should avoid lactulose because it contains glucose and fructose.

Adequate renal function is needed to excrete excess magnesium. Patients who have renal insufficiency should avoid magnesium salts. Hypermagnesemia can result from continuous use of magnesium salts, causing symptoms such as drowsiness, weakness, paralysis, complete heart block, hypotension, flushing, and respiratory depression. Side effects from excess use are flatulence, diarrhea, abdominal cramps, nausea, and vomiting.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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