USUAL DOSE.— Available in adult and children sizes. Insert 1 suppository rectally as needed. Retain for 15 minutes; it does not need to melt to produce laxative action.
Bisacodyl (Ducolax)
ACTION AND USE.— Bisacodyl is a relatively non-toxic irritant cathartic that reflexively stimulates the. colon on contact. It usually produces softly formed stools in 6 to 12 hours and is normally taken at bedtime. It is often used as a preparatory agent prior to some surgeries and radiological examinations.
USUAL DOSE.— 10 to 30 mg in one dose for adults. It is available in tablets and suppositories.
Magnesium Citrate (Citrate of Magnesia)
ACTION AND USE.— Magnesium citrate is a saline irritant laxative that also inhibits the absorption of water from the intestine. It is preferred by radiology departments for use prior to special x-rays.
USUAL DOSE.— 200 ml in one dose is the official recommendation. Magnesium citrate is most often provided to the patient in a kit containing 10 fluid ounces of magnesium citrate, 2 tablets of phenophthalein (a contact irritant) and a suppository of either glycerin or bisacodyl.
Psyllium Hydrophilic Mucilloid (Metamucil)
ACTION AND USE.— This is a bulk laxative that works by absorbing water. The effect occurs within 12 to 72 hours. It is provided as a dry powder that is stirred into water or fruit juice. Drink immediately upon mixing while the material is in suspension.
USUAL DOSE.— One rounded teaspoonful stirred or mixed with a glass of cool liquid or juice one to three times daily.
Ducosate Calcium (Surfak)
ACTION AND USE.— Ducosate calcium is a stool softener that promotes water retention in the fecal mass.
USUAL DOSE.— 240 mg daily. For children, give up to 100 mg daily.
Ducosate Sodium (Colace)
ACTION AND USE.— This drug has the same action as ducosate calcium.
USUAL DOSE.— Adult dose ranges from 50 to 240 mg daily.
ANTIDIARRHEALS
Kaolin Mixture with Pectin (Kaopectate)
ACTION AND USE.— Kaolin mixture with pectin is used in the symptomatic treatment of diarrhea. The pectin portion absorbs excess fluid and consolidates the stool. The kaolin portion adsorbs irritants and forms a protective coating on the intestinal mucosa.
USUAL DOSE.— 30 ml after each bowel movement.
Diphenoxylate Hydrochloride (Lomotil)
ACTION AND USE.— Diphenoxylate hydrochloride is used for the symptomatic treatment of diarrhea. It works by direct action on the smooth muscles in the intestine reducing peristalsis and intestinal motility. Because diphenoxylate is a chemical analog of meperidine hydrochloride, it is classed as a schedule V narcotic. To prevent abuse, a sub-therapeutic amount of atropine is added.
USUAL DOSE.— 1 or 2 tablets four times daily until symptomatic control is achieved, then the dose is reduced.
DIURETICS
The kidney is the primary organ that excretes water-soluble substances from the body. Diuretics are agents that increase the rate of urine formation. The term diuresis has two separate connotations: one refers to the net loss of solute and water, the other to the increase in volume per se. Sometimes maintenance of an adequate urine volume is justification for using diuretics. The most important indication is for the production of a negative extracellular fluid balance. Diuretics are useful in the treatment of hypertension, edematous conditions, i.e., congestive heart failure, and acute pulmonary edema.