This document discusses laxatives and purgative drugs, detailing their classifications, mechanisms of action, dosage examples, uses, contraindications, and adverse effects. It highlights the importance of proper usage, such as taking them with sufficient water and monitoring for dehydration or electrolyte imbalance. Additionally, it emphasizes the nurse's role in client education and lifestyle modifications to prevent constipation.

1. Laxatives and purgative
drugs
Presented by
Mr. Praveen Jaiswal
MSN(CCN)
PG Tutor
Subharti University, Dehradun

2. Laxatives/Purgatives
• These drugs are combined known as purgatives, which
includes laxatives and cathartics these drugs are used to
overcome constipation and proper evacuation of bowels.
• They are used to thoroughly clean the intestines before
medical procedures or surgeries.

3. Classification
Laxatives
Osmotic
Stimulant
Lubricant
Stool
Softener

4. Mechanism of action
• Osmotic laxatives (Magnesium hydroxide) draw water into the
intestine to increase the mass of stool, stretching musculature which
results in peristalsis.
• Stimulant laxatives result in stimulation of intestinal
peristalsis.
• Lubricant laxatives increase water retention in the stool, and prevent
water absorption from the stool, and lubricate as well as soften
intestinal contents.
• Stool softener allows more fluid and fat to penetrate the faeces,
producing a softer faecal mass.

5. Drug example and doses
• Bilk forming laxatives (Methyl Cellulose) – 2 tablets 1000mg
orally with 8oz of liquid up to 6 times a day.
• Lubricant laxatives include mineral oil (Kondremal, Fleet
mineral oil enema.
• Hyperosmotic laxatives include lactulose. – 10mg BD
• Stimulant laxatives (Bisacodyl, Castor oil) – 5 -10 mg
sodium Pico sulfate 15-20 ml
• Stool softener (Docusate Calcium, Docusate potassium) – 240mg
50-400mg orally 1to 4 equally divided doses each day.

6. Indications / Uses
• To treat or prevent constipation.
• To prepare the bowel for radiologic or endoscopic procedures.
• Short-term treatment of constipation caused by high dose of
opioid use.
• Osmotic laxatives are used to rapid evacuation of the bowel after
ingestion of poison or following anti-helminthic therapy to rid the body of dead
parasites.
• Methyl cellulose and psyllium are used to many chronic diarrhoea.

7. Contraindications
• Contraindicated if patient with parasites.
• Severe abdominal pain of unknown cause.

8. Adverse effects
• GI irritation.
• Rectal burning sensation.
• Osmotic laxatives may cause Dehydration.
• Long-term use and abuse of laxatives may cause permanent
loss of colonic motility.

9. Adverse effects: cont.
• Laxative dependence and electrolyte imbalances.
• Nutritional deficiencies (with lubricant laxatives).
• Belching (with osmotic laxatives)
• Electrolyte imbalance. (With saline laxatives)

10. Drug interactions
• Laxative decreases intestinal transit time and reduces
absorption of orally administered drugs.

11. Nurses role and responsibility
Client Teaching
• Take as directed with at least 250 ml of water.
• Increase daily fluid intake.
• Prolonged use of laxatives can cause dependence.
Contact the health care provider:
• If constipation is unrelieved
• Signs or symptoms of dehydration or electrolyte imbalance.

12. Contd.
Lifestyle modifications
• Increase fiber-containing food, physical activity, and fluids
• Do not ignore the urge to defecate.
Osmotic laxatives-Follow each dose with 250 ml of water.

13. Contd.
• Bulk-forming agents- powder: take with a full 250 ml glass of water or juice, drink
right after mixing, and immediately follow with an additional 250 ml of water.
• Separate fiber laxative and other medications by 1–2 hours.
• Stimulant laxatives-Temporary discoloration in urine.
• Emollient laxatives (stool softeners)-May take up to three days for results.