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Lactulose.

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VOL: 102, ISSUE: 05, PAGE NO: 31

Generic and Proprietary Names

- Lactulose.

- Duphalac.

- Lactugal.

- Regulose.

Action

- Lactulose is a semisynthetic disaccharide that is not absorbed from the gastrointestinal tract.

- Increases the amount of water in the large bowel, softening stools and acting as a laxative.

- Prevents absorption of ammonia in the colon.

Classification

- Osmotic laxative.

Indications

- Chronic constipation.

- Systemic encephalopathy in patients with hepatic disease.

Contraindications

- Intestinal obstruction.

- Galactosaemia.

Cautions

- Intolerance to lactose.

- Pregnancy.

- Diabetes.

- Older people.

- Debilitation.

Side-effects

- Abdominal cramps.

- Abdominal discomfort.

- Abdominal distension.

- Flatulence.

- Belching.

- Diarrhoea.

- Nausea and vomiting.

Interactions

- Decreased effects if used with neomycin or with other oral anti-infectives.

Administration

- Oral.

Nursing considerations

- Mix with half a glass of water, milk or fruit juice to improve taste.

- May take up to 48 hours to act.

- Diarrhoea may indicate the dose is too high.

- Evaluate therapeutic response: decreased constipation or blood ammonia level.

- Assess amount, colour and consistency of stool.

Patient teaching

- Advise to drink plenty of fluid while taking this medicine.

- Advise to store in a cool environment.

- Explain that lactulose may take 2-3 days to take effect. Advise that if symptoms do not begin to improve, or if they worsen, to seek medical attention.

- Lactulose powder can be placed on the tongue and washed down with water or sprinkled onto food. Alternatively it can be mixed with water before swallowing.

- Patients with constipation should be advised on prevention such as eating a balanced diet containing fibre, fresh fruit and vegetables, drinking 6-8 full glasses of liquid each day and taking daily exercise.

- If lactulose is given to children in the long term, parents should be advised to pay particular attention to their dental hygiene.

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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