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

 

LUBRICANTS

• 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