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  1. 1. PURGATIVES-Classification& OsmoticPurgatives
  2. 2. CLASSIFICATION• 1)Bulk forming Dietary fibre: Bran,phyllium(plantago) Isphagula,Methyl cellulose• 2)Stool softener Docusates(DOSS),Liquid paraffin• 3)Stimulant purgatives A.Diphenylmethanes- Phenolphthalein,Bisacodyl,Sodium picosulfate B.Anthraquinones(Emodins)-
  3. 3. Contd.... -Senna,Cascara sagrada C) 5-HT4 agonist Tegaserod D) Fixed oil Castor oil • 4)Osmotic purgatives Mg salts- Mg(SO)4,Mg(OH)2 Na salts-Na2(SO)4,Na3(PO)4 Na.K.tartarate LACTULOSE
  4. 4. Osmotic PurgativesSolutes not absorbed in the intestine→RetainH2O osmotically→distent thebowel→increasing peristalsis indirectly(basisof osmotic purgatives)All inorganic salts used as osmotic pugatives have similar action- differ only indose,palatability&risk of systemic toxicity
  5. 5. Mg++ ions release cholecystokinin which may aid purgative action of Mg salts.• Mg(SO)4(Epsom salt):5-15g,bitter in taste• Mg(OH)2(as 8% w/w suspn-milk of magnesia) :30 ml , bland in taste, also used as antacid• Na2(SO)4(Glauber’s salt):10-15g,bad in taste.• Na3(PO)4:6-12g, taste is not unpleasant.• Na.K.tartrate(Rochelle salt):8-15g, relatively pleasant tasting.
  6. 6. LACTULOSEA semi synthetic disaccharide of fructose and lactose.Neither digested nor absorbed in the small intestine.It is broken down in the colon by bacteria to osmotically more active products• Dose-10g BD taken with planty of water
  7. 7. The breakdown products of lactulose are acidic→NH3 produced by bacteria in colon is converted to ionised NH4+ salts and is not absorbedSo it causes redn in bld NH3 conc. By 25-50%in patients with hepatic encephalopathy. (for this purpose,dose shud b increased to 20g TDS or more)
  8. 8. • C/I of osmotic purgatives:- Mg. Salts are contr. Indicated in RENAL INSUFFICIENCY Na. Salts shud not b given to patients of CONGESTIVE HEART FAILURE and other Na+ retaining states.• Uses-preparation of bowel b4 surgery& colono- scopy,in food/drug poisoning& as after purge in treatment of tapeworm infestation. They r practically not used 4 the treatment of constipation bcoz afterconstipation is common.
  9. 9. THANK U....