Colace; Docusate Sodium

Classification: Stool Softener Dosages and Routes: Tablets: 100mg, 50mg Capsules 50mg, 100mg, 240mg, 250mg Oral Liquid 150mg/15ml Syrup: 20mg/5ml, 50mg/15ml, 60mg/15ml Enema concentrate: 18g/100ml (must be diluted) Action: A stool softener that reduces surface tension of interfacing liquid contents of the bowel. This detergent activity promotes incorporation of additional liquid into stools, thus forming a softer mass. Contraindications: Contraindicated in patients with intestinal obstructions, undiagnosed abdominal pain, vomiting or other signs of appendicitis, fecal impaction, acute surgical abdomen, or hypersensitivity to drug. Nursing Implication: Giving liquid in milk, fruit juice, or infant formula to mask bitter taste. Before giving for constipation, determine if patient has adequate fluid intake, exercise, and diet. Know that drug is not for use in treating existing constipation but prevents constipation from developing. Be aware that drug is laxative of choice for patients recovering from MI or rectal surgery; for those with rectal or anal disease that makes passage of firm stools difficult; and for those with postpartum constipation. Store drug at 59 to 86 F and protect liquid from light.

Glyburida; glibenclamide
Classification: sulfonylureas Dosage and Routes: Tablets: 1.25mg, 5mg Tablets (micronized): 1.5mg, 3mg, 6mg Action: A sulfonylurea that probably stimulates insulin release from the pancreatic beta cells and reduces glucose output by the liver. An extrapancreatic effect increases peripheral sensitivity to insulin and causes a mild diuretic effect. Contraindication: Contraindicated in patients hypersensitive to drug or in those with diabetic ketoacidosis with or without coma, and during pregnant or breast-feeding women. Nursing Implications: Use cautiously in patients with hepatic or renal impairment, or in debilitated, malnourished, or elderly patients. Know that elderly patients may be more sensitive to adverse effects. Alert: Know that micronized glyburide (Glynase PresTab) contains drug in a smaller particle size and is not bioequivalent to regular glyburida tablets. Patients who have been taking Micronase or DiaBeta need to be retitrated. Know that although most patients may take glyburide once daily, those taking more than 10mg daily may achieve better results with twice-daily dosage. Know that glyburide is a second-generation sulfonylurea. The frequency of adverse effects appears to be lower than with first-generation drugs, such as chlorpropamide. During periods of increased stress, such as infection, fever, surgery, or trauma, patients may require insulin therapy. Monitor patients closely for hyperglycemia in these situations. Know that patient transferring from insulin to an oral antidiabetic agent requires blood glucose monitoring at least three times daily before meals. Patient may require hospitalization during transition.

Senokot; Senna
Classification: Laxative Dosages and Routes: Tablets: 187mg, 217mg, 600mg Granules: 326mg/tsp, 1.65g/1/2tsp Suppositories: 652mg Syrup: 218mg/5ml Action: A stimulant laxative that increases peristalsis probably by direct effect on the smooth muscle of the intestine. Thought to either irritate the musculature or stimulate the colonic intramural plexus. Also promotes fluid accumulation in the colon and small intestine. Contraindications: Contraindicated in patients with ulcerative bowel lesions; nausea, vomiting, abdominal pain, or other symptoms of appendicitis or acute surgical abdomen; fecal impaction; or intestinal obstruction or perforation. Nursing Implications: Before giving for constipation, determine if patient has adequate fluid intake, exercise, and diet. Limit diet to clear liquids after X-Prep Liquid is taken. Avoid exposing product to excessive heat or light. Know that drug is used for short-term therapy. Know that senna is one of the most effective laxatives for counteracting constipation caused by narcotic analgesics.