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Senna, bisacodyl, danthron, docusate, glycerol, sodium picosulphate
These laxatives increase the motility of the large intestine by inducing peristaltic activity. They are particularly used to treat constipation caused by prolonged bed rest, neurologic dysfunction of the colon, and constipating drugs. They should be used in the short term or intermittently.
Contraindications
- Senna, bisacodyl and co-danthromer should all be avoided in intestinal obstruction or undiagnosed abdominal pain.
- Co-danthramer use has been associated with a carcinogenic risk in rodents and long term exposure to this drug should be avoided. It may be suitable for treatment of constipation in the elderly or the terminally ill (Laurence and Bennett 1992). It should, however, only be prescribed in consultation with a physician.
Side effects
- Use of over a long period of time can cause fluid and electrolyte imbalance and colonic atony.
- Senna, bisacodyl and co-danthramer may all cause griping and abdominal cramps.
- Bisacodyl suppositories may cause some local irritation to the rectum.
Nursing points
- A laxative effect is seen within 8-12 hours. Therefore, take at night to produce a morning bowel movement.
- Bisacodyl should be taken after food and not within one hour of other drugs.
Faecal softeners and lubricants
Docusate sodium, arachis oil retention enema
These products assist mucus in the
lubrication of faeces to promote easier passage as well as softening faeces. Docusate
sodium also possesses some stimulant activity. Softeners should be used in clients that
need to avoid straining during defaecation (e.g. after myocardial infarction, surgery, or
in clients with hernias or anorectal problems).
Contraindications
- Oral docusate sodium should not be prescribed in intestinal obstruction or clients with nausea, vomiting and abdominal pain.
- Rectal preparations should be avoided in clients with haemorrhoids and anal fissure.
Side effects
- Oral docusate sodium may cause nausea, anorexia, and cramp.
Nursing points
- Increased absorption occurs when oral docusate sodium is taken alone and not within an hour of other drugs.
- Adequate water should be consumed at the same time.
- A laxative effect is seen in 1-2 days.
- The arachis oil enema is likely to be most effective if warmed and retained by the client for as long as possible.
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