Reuben Notes


Bulk Laxatives

  • Usually takes 2-3 days for response
  • Psyllium (Metamucil, Fiberall)
    • 1tsp in water PO qd-tid
  • Polycarbophil (Mitrolan, FiberCon, Equalactin)
    • 1g PO qid
  • Methylcellulose (Citrucel)
    • 1tbs in water qd-tid


Stool Softeners

  • Water drawn into intestines through osmotic pressures
  • Docusate (Colace)
    • 100mg PO qd/bid, peds <3yrs 10-40mg, 3-6yrs 60mg
    • Weak laxative
    • Can take up to 3 days for therapeutic response
  • Magnesium Hydroxide (MOM, Milk of Magnesia)
    • 15-40ml PO
    • also an antacid
  • Fleet Enema
  • Lactulose (Cephulac, Cholac, Chronulac, Constilac)
    • 10-20mg (15-30ml) PO qd
    • hepatic encephalopathy 20-30mg (30-45ml) PO tid/qid
    • also used to reduce ammonia levels in the blood
  • Polyethylene Glycol (Colovage, CoLyte, NuLytely, OCl, PEG-ES, Golytely)
    • 4 Liters PO q4h
    • used for bowel cleansing in preparation for GI exam
  • Salts (Epsom salt, MgSO4, KPO4, NaPO4)
    • gut becomes hypertonic and causes water to move into the gut by osmosis


Stimulant Laxatives

  • promote peristalsis
  • Castor oil (Purge)
    • 15-30ml PO qhs
    • Peds 5-15ml
    • works in 1-6 hrs
    • active ingredient - ricinoleate
  • Phenolphalein (Ex-Lax, Modane)
    • 30-270mg qd/bid
    • peds: 6-11yrs 30-60mg qd/bid, 2-5yrs 15-30mg qd/bid
  • Bisacodyl (Dulcolax, Deficol)
    • 10mg PO/PR
    • 5mg if 6-12y/o



  • Mineral Oil (Fleet Mineral Oil, Milkinol, Nujol)
    • 5-45ml PO qhs
    • Peds 5-20ml PO qhs
    • coats surface of stool and intestine with a lubricant film