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.
References in periodicals archive ?
Peri-Colace Tablets, the third member of the Colace family, offers a 2-in-l option, combining a stool softener with a stimulant laxative for overnight relief of occasional constipation.
Besides Colace capsules and Senokot tablets, these two laxative product families include Senokot-S tablets, SenokotXTRA tablets and Peri-Colace tablets.
Purdue's laxative portfolio also includes Colace and Peri-Colace products, brands built on the trust and recommendations of doctors and pharmacists.
The Purdue Family Care Center includes products from such digestive health brands as Senokot laxatives, Colace capsules and Peri-Colace tablets.
In addition, Colace capsules and Peri-Colace tablets continue to be among the leading products in their respective categories.
Amidst the 50th anniversary of Senokot laxatives, Purdue's Colace and Peri-Colace brands also continue to be among the leading products in the laxatives category.
And when patients need more than just a stool softener, she says, many turn to Peri-Colace tablets, a dual-acting laxative formulated with an ingredient for overnight relief plus a stool softener that helps make relief more comfortable.
Other laxative brands available from Purdue include Colace and Peri-Colace.
Colace is joined by its sister brand, Peri-Colace, which is a laxative plus stool softener, for those people who need more than just a softener.
Late last year Purdue Frederick acquired the over-the-counter product portfolio of Shire Pharmaceuticals Group PLC, including Colace stool softeners, Peri-Colace capsules and Slow-Mag tablets.
Peri-Colace supplements the flagship Colace brand by addressing people who need more than just a softener.