14120316
| Question | Answer |
| What is it? | An osmotic laxative |
| Trade names | Actilax, Duphalac, Genlac, Lac-Dol, Lactour |
| Pharmacological class | Glycoside |
| Indications | Chronic constipation hyperammonemia ( caused by hepatic encephalopathy) |
| Action | Produces an osmotic effect in colon; resulting distension promotes peristalsis. Also decreases blood ammonia level by drawing ammonia from circulation into the colon and through the GIT |
| Therapeutic effects | Softens stools and removes ammonia from circulation |
| Absorption and distribution | ABSORPTION: poorly absorbed by GIT DISTRIBUTION: primarily in the colon |
| Metabolism & excretion | metabolised in the colon by enteric bacteria. Fecal excretion |
| Half life | 1.7 - 2 hours |
| Precaution | Contraindicated in individuals on low-galactose or lactose-free diets Use cautiously in individuals with DM Be prepared to replace fluid loss |
| Side effects | Abdominal cramping, flatulence, nausea and vomiting, diarrhoea, dehydration and electrolyte disturbances |
| Interactions | Antacids, antibiotics: decreased effectiveness of lactulose. Avoid use together. |
| Education | Instruct patient not to take other laxatives Encourage person to exercise, as tolerated Advise patient to notify prescriber if diarrhoea occurs Educate patient regarding dietary fiber Tell patient to keep up fluids |
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