drugs used in treatment of constipation

1. QURATULAIN MUGHAL
BATCH IV
DOTOR OF PHYSICALTHERAPY
ISRA UNIVERSITY
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2.  These are drugs that promote defecation.
 They are also called laxatives and cathartics.
 Laxatives have milder action while cathartics
or purgatives have more powerful action.
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CLASSIFICATION
Bulk
laxatives
Fecal
softeners
Osmotic
purgatives
Stimulant
purgatives

4.  Absorbs water to increase bulk.
 Distends bowel to initiate reflex bowel activity.
 These include vegetable fiber and other
substances that are not digested but increase
the volume of intestinal contents forming a
large, soft, sold stool.
 Dietary fiber consists of cell walls and other
parts of the fruits and vegetables that are
unabsorbable.
 Adding fiber to the diet is a safe and natural way
of treating constipation in persons who are on
low-fiber diet.
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6.  Bran is the residue left when flour is made from
cereals and contains 40% fiber-but is
unpalatable.
 Ispaghula and plantago seeds contain natural
mucilage which absorb water to form a
gelatinous mass and are more palatable than
bran.
 Methylcellulose is a semisynthetic derivative of
cellulose. Adequate water should be taken along
with bulk laxatives.
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8.  Docusate sodium (dioctyl sodium
sulphosuccinate) softens feces by lowering the
surface tension of the intestinal contents. This
allows more water to be retained in the feces
which become soft.
 Liquid paraffin(emollients) is a mineral oil that
is not digested. It lubricates and softens feces. It
is unpalatable; aspiration may cause lipoid
pneumonia; it may leak out of the anus causing
discomfort. Hence not preferred.
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10.  These are solutes that are not absorbed in the
intestine, osmotically retain water and increase
the bulk of intestinal contents.They increase
peristalsis and expel a fluid stool.
 Magnesium hydroxide, magnesium sulphate,
sodium potassium tartrate, sodium sulphate,
and phosphate are some inorganic salts used as
osmotic or saline purgatives.They are used to
prepare the bowel before surgery and in food
poisoning.
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11.  Lactulose is a synthetic disaccharide that is not
absorbed, holds water and acts as an osmotic
purgatives.
 Flatulence and cramps may be accompanied. In
the colon, lactose is fermented to lactic and
acetic acids which inhibit the growth of
ammonia-producing bacteria in the colon.
 It also inhibits the absorption of ammonia by
lowering the pH and thus lowers the blood
ammonia level.
 It is used in hepatic coma for this effect (hepatic
coma is worsened by ammonia).
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12.  They increase intestinal motility and increase
the secretion of water and electrolytes by
mucosa.
 They may cause abdominal cramps.
 When cascara sagrada and senna (source
plants) are given orally, active anthraquinones
are liberated in the intestines which stimulates
the myenteric plexus in the colon.
 Evacuation takes 6-8hr. Long-term use cause
melanotic pigmentation of the colon.
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STIMULANT
PURGATIVES
PHENOLPHTHALEIN BISACODYL CASTOR OIL

14.  It is an indicator, acts on the colon after 6-
8hrs to produce soft, semiliquid stools.
 It undergoes enterohepatic circulation which
prolongs its actions.
 Allergic reactions including pink colored skin
eruption and colic limit its use.
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15.  It related to phenolphthalein is converted to
the active metabolites In the intestines.
 It can be given orally(5mg) but usually is used
as rectal suppositories(10mg) which results in
defecation in 15-30mints.
 It is safe except that prolonged use may
cause local inflammation.
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16.  It is hydrolyzed in the upper small intestine to
ricinoleic acid which is a local irritant and
increase intestinal motility.
 It is a powerful and one of the oldest
purgatives.
 Stool is semi-liquid and is accompanied by
gripping.
 It is not preferred.
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17.  PHARMACOLOGY FOR PHYSIOTHERAPIST
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