docusate sodium

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docusate

 [dok´u-sāt]
any of a group of anionic surfactants widely used as emulsifying, wetting, and dispersing agents.
docusate calcium an ionic surfactant used as a stool softener.
docusate potassium an anionic surfactant used as a stool softener; administered orally.
docusate sodium an ionic surfactant used as a stool softener.

docusate sodium

Apo-Docusate Sodium (CA), Colace, Correctol, Correctol Stool Softener (CA), Diocto, Dioctyl (UK), Docusol (UK), Dom-Docusate Sodium (CA), D.O.S. Softgels, Docu-Soft, DOK, D-S-S, DulcoEase (UK), Dulcolax Stool Softener, Enemeez, Genasoft Softgels, Norgalax (UK), Novo Docusate (CA), PHL-Docusate Sodium (CA), PMS-Docusate Sodium, Ratio-Docusate Sodium (CA), Selax (CA), Silace

Pharmacologic class: Emollient

Therapeutic class: Stool softener, surfactant

Pregnancy risk category C

Action

Increases absorption of liquid into stool, resulting in softening of fecal mass. Also promotes electrolyte and water secretion into colon.

Availability

docusate calcium

Capsules: 240 mg

Capsules (soft gels): 240 mg

Rectal solution: 283 mg/5 ml

docusate sodium

Capsules: 50 mg, 100 mg, 250 mg

Capsules (soft gels): 100 mg, 250 mg

Liquid: 150 mg/15 ml

Syrup: 50 mg/15 ml, 60 mg/15 ml, 20 mg/5 ml, 100 mg/30 ml, 150 mg/15 ml

Tablets: 100 mg

Indications and dosages

Stool softener

Adults and children older than age 12: 240 mg (docusate calcium) or 50 to 200 mg (docusate sodium) P.O. daily until bowel movements are normal

Children ages 6 to 12: 40 to 120 mg (docusate sodium) P.O. daily

Children ages 3 to 6: 20 to 60 mg (docusate sodium) P.O. daily

Contraindications

• Hypersensitivity to drug
• Abdominal pain, nausea, or vomiting
• Intestinal obstruction

Precautions

Use cautiously in:
• pregnant or breastfeeding patients.

Administration

• Give tablets and capsules with full glass of water.
• Give liquid solution with milk or fruit juice.
• Be aware that excessive or long-term use may lead to laxative dependence.

Adverse reactions

EENT: throat irritation

GI: nausea, diarrhea, mild cramps

Skin: rash

Other: bitter taste, decreased appetite, laxative dependence

Interactions

Drug-drug.Mineral oil: increased mineral oil absorption, causing toxicity

Warfarin: decreased warfarin effects (with high doses)

Patient monitoring

• If diarrhea occurs, withhold drug and notify prescriber.
• Know that therapeutic efficacy usually becomes apparent 1 to 3 days after first dose.

Patient teaching

• Instruct patient to drink sufficient fluids with each dose and to increase fluid intake during the day.
• Advise patient to prevent constipation by increasing fluids and consuming more dietary fiber (as in fruits and bran).
• Inform patient that excessive or prolonged use may lead to laxative dependence.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.

docusate sodium/senna

(dok-yoo-sate soe-dee-um sen-na ) ,

Peri-Colace

(trade name),

Senna Plus

(trade name),

Senokot-S

(trade name)

Classification

Therapeutic: laxatives
Pharmacologic: stimulant laxatives
Pregnancy Category: C

Indications

Oral: Treatment of constipation associated with dry, hard stools and decreased intestinal motility.Prevention of opioid-induced constipation.

Action

Senna's metabolite acts as a local irritant on the colon stimulating peristalsis.
Docusate promotes incorporation of water into stool, resulting in softer fecal mass.

Therapeutic effects

Softening and passage of stool.

Pharmacokinetics

Absorption: Docusate: small amounts may be absorbed from the small intestine after oral administration.
Distribution: Unknown.
Metabolism and Excretion: Senna: metabolized in the liver and eliminated in bile and urine. Docusate: eliminated in bile.
Half-life: Unknown.

Time/action profile (softening of stool)

ROUTEONSETPEAKDURATION
PO6–12 hrunknownunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen; Concomitant use of mineral oil.
Use Cautiously in: Excessive or prolonged use may lead to dependence, fluid and electrolyte imbalance, and vitamin and mineral deficiencies.

Adverse Reactions/Side Effects

Fluid and Electrolyte

  • electrolyte imbalances
  • dehydration

Gastrointestinal

  • abdominal cramps
  • nausea
  • vomiting
  • diarrhea

Dermatologic

  • rashes

Genitourinary

  • urine discoloration

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Oral (Adults and Children >12 yr) 2 tablets once daily at bedtime; maximum 4 tablets twice daily.
Oral (Children 6–12 yr) 1 tablet once daily at bedtime; maximum: 2 tablets twice daily.
Oral (Children 2–6 yr) 1/2 tablet once daily at bedtime; maximum: 1 tablet twice daily.

Availability

Tablets: Docusate sodium 50 mg and sennosides 8.6 mgOTC

Nursing implications

Nursing assessment

  • Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
  • Assess color, consistency, and amount of stool produced.

Potential Nursing Diagnoses

Constipation (Indications)

Implementation

  • This medication does stimulate intestinal peristalsis.
  • Oral: Administer with a full glass of water or juice preferably in the evening.
    • Do not administer within 2 hr of other laxatives, especially mineral oil. May cause increased absorption.

Patient/Family Teaching

  • Advise patients that laxatives should be used only for short-term therapy. Long-term therapy may cause electrolyte imbalance and dependence.
  • Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake (6–8 full glasses/day), and increasing mobility. Normal bowel habits are variable and may vary from 3 times/day to 3 times/wk.
  • Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver).
  • Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present.

Evaluation/Desired Outcomes

  • A soft, formed bowel movement, usually within 6–24 hr.

docusate sodium

A faecal softening drug used to treat constipation. Brand names are Dioctyl, Docusol, Fletcher's Emenette, Molcer, Norgalax and Waxsol.