Senokot


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Related to Senokot: sennosides

senna, sennosides

Argoral (CA), Black Draught, Ex-Lax Gentle, Fleet Pedia-Lax Quick Dissolve, Fletcher's, Maximum Relief Ex-Lax, Nu-Lax (CA), Perdiem, Senexon, Senna-Gen, Sennatural, Senokot, Senokot Granules, SenokotXTRA, Senolax, Sure-Lax (UK)

Pharmacologic class: Anthraquinone laxative

Therapeutic class: Laxative (stimulant)

Pregnancy risk category C

Action

Causes local irritation in colon, which promotes peristalsis and bowel evacuation. Softens feces by increasing water and electrolytes in large intestine.

Availability

Granules: 15 mg/tsp

Liquid: 8.8 mg/5 ml, 25 mg/5 ml, 33.3 mg/ml (concentrate)

Tablets: 8.6 mg, 10 mg, 15 mg, 17 mg, 25 mg

Strips (orally disintegrating): 8.6 mg

Tablets (chewable): 10 mg, 15 mg

Indications and dosages

Acute constipation; preparation for bowel examination

Adults and children ages 12 and older: For acute constipation, 12 to 50 mg P.O. daily or b.i.d. For bowel preparation, 105 to 157.5 mg (concentrate) 12 to 14 hours before scheduled procedure.

Children ages 6 to 11: 50% of adult dosage. Or, two orally disintegrating strips; don't exceed four strips in 24 hours.

Children ages 2 to 5: 33% of adult dosage. Or, one orally disintegrating strip; don't exceed two strips in 24 hours.

Contraindications

• Hypersensitivity to drug or its components
• GI bleeding or obstruction
• Suspected appendicitis or undiagnosed abdominal pain
• Acute surgical abdomen
• Fecal impaction
• Inflammatory bowel disease (such as Crohn's disease)

Precautions

Use cautiously in:
• pregnant or breastfeeding patients
• children.

Administration

• Give with a full glass of cold water.
• To prepare patient for bowel examination, give 12 to 14 hours before procedure, followed by a clear liquid diet.

Adverse reactions

GI: nausea, vomiting, diarrhea, abdominal cramps, nutrient malabsorption, yellow or yellowish-green feces, loss of normal bowel function (with excessive use), dark pigmentation of rectal mucosa (with long-term use), protein-losing enteropathy

GU: reddish-pink discoloration of alkaline urine, yellowish-brown discoloration of acidic urine

Metabolic: electrolyte imbalances (such as hypokalemia)

Other: laxative dependence (with long-term or excessive use)

Interactions

Drug-diagnostic tests.Calcium, potassium: decreased levels

Patient monitoring

• Assess bowel movements to determine laxative efficacy.
• In long-term use, monitor fluid balance, nutritional status, and electrolyte levels and watch for laxative dependence.

Patient teaching

• Tell patient using drug for constipation to take at bedtime with a glass of water.
• Instruct patient to place orally disintegrating strips on the tongue, allow strip to dissolve, then drink plenty of water.
• In long-term use, advise patient to watch for and report signs and symptoms of nutritional deficiencies and fluid and electrolyte imbalance.
• If patient will undergo bowel examination, advise him to take drug 12 to 14 hours before procedure, followed by a clear liquid diet.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the tests mentioned above.

sennosides

(sen-oh-sides) ,

Black-Draught

(trade name),

Ex-Lax

(trade name),

Ex-Lax Chocolated

(trade name),

Fletchers’ Castoria

(trade name),

Maximum Relief Ex-Lax

(trade name),

Sena-Gen

(trade name),

Senexon

(trade name),

Senokot

(trade name),

SenokotXTRA

(trade name)

Classification

Therapeutic: laxatives
Pharmacologic: stimulant laxatives
Pregnancy Category: C

Indications

Treatment of constipation, particularly when associated with:
  • Slow transit time,
  • Constipating drugs,
  • Irritable or spastic bowel syndrome,
  • Neurologic constipation.

Action

Active components of senna (sennosides) alter water and electrolyte transport in the large intestine, resulting in accumulation of water and increased peristalsis.

Therapeutic effects

Laxative action.

Pharmacokinetics

Absorption: Minimally absorbed following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile (laxative effect)

ROUTEONSETPEAKDURATION
PO6–12 hr†unknown3–4 days
†May take as long as 24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Abdominal pain of unknown cause, especially if associated with fever;Rectal fissures;Ulcerated hemorrhoids;Known alcohol intolerance (some liquid products).
Use Cautiously in: Chronic use (may lead to laxative dependence);Possible intestinal obstruction; Obstetric / Lactation: Safety not established.

Adverse Reactions/Side Effects

Gastrointestinal

  • cramping (most frequent)
  • diarrhea (most frequent)
  • nausea

Genitourinary

  • pink-red or brown-black discoloration of urine

Fluid and Electrolyte

  • electrolyte abnormalities (chronic use or dependence)

Miscellaneous

  • laxative dependence

Interactions

Drug-Drug interaction

May ↓ absorption of other orally administered drugs because of ↓ transit time.

Route/Dosage

Larger doses have been used to treat/prevent opioid-induced constipation. Consult labeling of individual OTC products for more speceific dosing information
Oral (Adults and Children >12 yr) 12–50 mg 1–2 times daily.
Oral (Children 6–12 yr) 6–25 mg 1–2 times daily.
Oral (Children 2–6 yr) 3–12.5 mg 1–2 times daily.

Availability (generic available)

Noted as sennoside content
Tablets: 6 mgOTC, 8.6 mgOTC, 15 mg OTC, 17 mgOTC, 25 mgOTC
Granules: 15 mg/5 mLOTC, 20 mg/5 mLOTC
Syrup: 8.8 mg/5 mLOTC
Liquid: 25 mg/15 mLOTC, 33.3 mg/mL senna concentrateOTC
In combination with: psyllium and docusateOTC. See combination drugs.

Nursing implications

Nursing assessment

  • Assess patient 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)
Diarrhea (Side Effects)

Implementation

  • Oral: Take with a full glass of water. Administer at bedtime for evacuation 6–12 hr later. Administer on an empty stomach for more rapid results.
    • Shake oral solution well before administering.
    • Granules should be dissolved or mixed in water or other liquid before administration.

Patient/Family Teaching

  • Advise patient that laxatives should be used only for short-term therapy. Long-term therapy may cause electrolyte imbalance and dependence.
  • Encourage patient to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake, and increasing mobility. Normal bowel habits are individualized and may vary from 3 times/day to 3 times/wk.
  • Inform patient that this medication may cause a change in urine color to pink, red, violet, yellow, or brown.
  • 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.

Senokot

(sĕn′ə-kŏt′)
An over-the-counter laxative containing senna.

Senokot

A brand name for SENNA.
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Senokot Products can provide effective yet gentle, overnight relief from occasional constipation.