lactulose


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lactulose

 [lak´tu-lōs]
a synthetic disaccharide used as a cathartic and to enhance the excretion of ammonia in treatment of hepatic encephalopathy.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

lactulose

Apo-Lactulose (CA), Constulose, Duphalac (UK), Enulose, Euro-Lac (CA), Generlac, Gen-Lac (CA), GPI-Lactulose (CA), Kristalose, Lactugal (UK), Lactulax (CA), Lemlax (UK), PMS-Lactulose (CA), Ratio-Lactulose (CA), Regulose (UK)

Pharmacologic class: Osmotic

Therapeutic class: Laxative

Pregnancy risk category B

Action

Produces osmotic effect, which increases water content in colon and enhances peristalsis. Breakdown products in colon lead to acidification of colonic contents, softening of feces, and decreased ammonia absorption from colon to systemic circulation. These effects reduce blood ammonia level in portal-system encephalopathy.

Availability

Powder (single-use packets): 10 g, 20 g

Syrup: 10 g/15 ml

Indications and dosages

Constipation

Adults: 10 to 20 g (15 to 30 ml) P.O. daily; may increase to 60 ml daily p.r.n.

Portal-system encephalopathy

Adults: 20 to 30 g (30 to 45 ml) P.O. three or four times daily until two or three soft stools are produced daily. Therapy may continue over long term. Or, 300 ml P.O. with 700 ml of water or normal saline solution. Or, as retention enema by rectal balloon catheter, repeated q 4 to 6 hours.

Contraindications

• Patients requiring low-galactose diet

Precautions

Use cautiously in:

• diabetes mellitus

• elderly patients

• pregnant or breastfeeding patients

• children.

Administration

• Don't give concurrently with other laxatives.

• Dissolve contents of single-use packet in 4 oz of water or juice.

• Dilute syrup with water or fruit juice to mask taste.

Adverse reactions

GI: nausea, vomiting, diarrhea, intestinal cramps, abdominal distention, flatulence

Metabolic: hyperglycemia (in diabetic patients), hypokalemia, hypernatremia

Interactions

Drug-drug. Anti-infectives: decreased lactulose efficacy

Other laxatives: interference with response to lactulose (in patients with hepatic encephalopathy)

Drug-diagnostic tests. Blood ammonia: 25% to 50% decrease

Glucose: increased level (in diabetic patients)

Potassium: decreased level

Sodium: increased level

Patient monitoring

• Watch for adverse GI reactions.

• Check stool consistency and frequency.

• Monitor electrolyte levels, especially in elderly patients.

• Check blood glucose level in diabetic patients.

Patient teaching

• Instruct patient to dissolve contents of single-use packet in 4 oz of water or juice.

• Suggest that patient dilute syrup with water or juice to mask taste.

• Tell patient drug may cause flatulence and intestinal cramps at first, but these symptoms usually subside.

• Inform patient that excessive use may cause diarrhea and excessive fluid loss.

• Encourage patient to drink adequate fluids and to report signs and symptoms of dehydration.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

lac·tu·lose

(lak'tū-lōs),
A synthetic disaccharide used to treat hepatic encephalopathy and chronic constipation.
Farlex Partner Medical Dictionary © Farlex 2012

lactulose

A synthetic disaccharide used to treat hepatic encephalopathy, which is administered by mouth, acting as a laxative; lactulose reduces intraluminal NH3 which, via the extracellular fluid, reduces NH3 in the blood.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

lac·tu·lose

(lak'tū-lōs)
A synthetic disaccharide used to treat hepatic encephalopathy and chronic constipation.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012

lactulose

A disaccharide sugar that acts as a gentle but effective LAXATIVE. It is not absorbed or broken down but remains intact until it reaches the colon where it is split by bacteria and helps to retain water, thereby softening the stools. Brand names are Duphalac, Lactugal and Regulose.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
It is a unique, proprietary, crystalline form of lactulose, with no restrictions on length of therapy or patient age.
Despite chronic diarrhea owing to lactulose use, she did not have other symptoms to suggest celiac disease.
To date, only two nonblinded studies have evaluated oral administration of lactulose versus placebo, demonstrating that lactulose is an effective therapy to prevent the development of HE after an AVB [13,14].
Louis, MO, USA) and oral administration of DW; DMN with Lac: IP injection of DMN and oral administration of lactulose; and DMN with Cur: IP injection of DMN and oral administration of curcumin.
(27) Probiotics had no impact on the overall mortality compared to either lactulose or no treatment/placebo.
Group 1 rats received lactulose 5 g/kg/day (Duphalac syrup, Abbott), and group 2 rats received saline (% 0.9 NaCl) 1 ml/kg/day.
Lactulose content can be determined according to an enzymatic [11] or an HPLC ISO method [12].
The measurement of exhaled hydrogen after the administration of lactulose (lactulose-[eH.sub.2]test) has been accepted for measuring gastrocecal transit time (GCTT) in both adults and children [11-13].
The objective of this study was to determine the efficacy of rifaximin and lactulose versus lactulose alone for the treatment of hepatic encephalopathy.
One hundred twenty patients with cirrhosis of the liver and minimal hepatic encephalopathy were randomly assigned to receive standard treatment (lactulose, 30-60 ml per day) or a probiotic preparation (VSL#3, 450 billion colony-forming units per day) for 2 months.
Paul, MN, has patented a solid detergent composition comprising a first alkalinity source consisting essentially of at least one alkali metal silicate; at least one saccharide comprising sucrose, fructose, inulin, lactulose, maltose or combinations thereof or at least one sugar alcohol comprising sorbitol; at least one polycarboxylic acid polymer; water; optionally a secondary alkalinity source comprised of sodium carbonate; and a nonionic surfactant.
Even the lactulose content, which is the second major indicator of milk freshness, is equivalent to that of pasteurized milk.