VOL: 101, ISSUE: 13, PAGE NO: 33
- Dioctyl (capsules).
- Docusol (adult/paediatric oral solutions).
- Fletcher’s Enemette, Norgalax Micro-enema (enemas).
- Legal: pharmacy.
- Functional: laxative.
- Chemical: anionic surfactant.
- Increases water penetration to soften stools for easier passage.
- Nurse prescriber: prevention and treatment of chronic constipation.
- Adjunct in abdominal radiological procedures.
- Pre- and postoperative in obstetrics, prior to proctoscopy, sigmoidoscopy or X-ray (Fletcher’s Enemette).
- Endoscopic examination (Norgalax).
- Mineral oil.
- Anthraquinones (increased absorption).
- Intestinal obstructions.
- Anal fissure.
- Inflammatory bowel disease.
- Anal bleeding.
- Abdominal pain.
- Prior to surgery or instrumentation, or in severe constipation, do not use unless obstruction, impaction and colonic dilatation have been excluded.
- Do not give with liquid paraffin.
- Rectal preparations not indicated with haemorrhoids or anal fissure.
- Prolonged use can precipitate onset of atonic non-functioning colon and hypokalaemia.
- Dioctyl and Norgalax not recommended for children.
- Docusol not recommended for children under six months.
- Fletcher’s Enemette not recommended for children under three years.
- Abdominal cramps.
- Local irritation (enema).
- Assess: cause of constipation - is fluid, fibre or exercise missing from lifestyle; fluid balance.
- Evaluate therapeutic response (decreased constipation).
- Drug should be discontinued if cramping, rectal bleeding, nausea or vomiting occur.
- Administer alone for better absorption.
- Do not administer within one hour of other drugs, antacids or milk.
- Tablets/solution to be taken with full glass of water.
- Do not use undue force when giving enema.
- Onset of action generally 1-2 days after oral administration, 5-20 minutes after enema.
- Swallow tablets whole, do not chew them.
- Health education: other possible means of avoiding constipation.
- Inform that normal bowel movements do not always occur daily.
- Do not use in the presence of abdominal pain, nausea, vomiting.
- Notify clinician if constipation is unrelieved or symptoms of electrolyte imbalance occur (muscle cramps, pain, weakness, dizziness).
- If diarrhoea occurs, discontinue use.
- Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines