Pharmacology, Lactulose Essay
Pharmacology, Lactulose Essay
Lactulose acts as a laxative commonly used to treat constipation and reduce ammonia content in people with liver disease. For constipation, the guideline for oral administration is 15-45 ml 2- times until a soft stool is formed. The drug can also be administered through the rectal route. Lactulose can be used off-label for infants and is recommended by the manufacturer for older children at 27–60 g daily (Mukherjee & John, 2020). If the initial dose causes diarrhea, the administration guidelines recommend the dose and stop if diarrhea persists. However, the drug is not recommended for use in the adult population because of evidence of increased risk of nausea compared to other laxatives such as Sorbitol. Similarly, it can cause hyperglycemia in patients with diabetes (Mukherjee & John, 2020).
Lactulose is made of galactose and fructose, forming a non-absorbable disaccharide. As a result, it remains intact until it reaches the large bowel, where the colonic bacteria metabolize it into a monosaccharide. Consequently, the monosaccharide is converted into hydrogen, volatile fatty acids, and methane. This increases the osmolality and formation of intraluminal gas, giving it the laxative effect, reducing intraluminal pH and transit time needed to finish constipation (Mukherjee & John, 2020). Common side effects are nausea, diarrhea, bloating, and increased bowel sounds. The medication has possible drug interactions with other laxatives, antacids, and anti-infective drugs. However, the drug has no documented interaction with Complementary and Alternative Medicines such as herbal medicines. Finally, monitoring of body’s fluid and electrolyte status when using the drug is necessary
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Data shows that constipation is common among some ethnic groups; for example, in America, non-whites have a 30% prevalence of chronic constipation compared to whites (Oh et al., 2020). Similarly, people who adapt to the western dietary culture are more likely to experience chronic constipation. Additionally, there is a genetic predisposition to the occurrence of constipation. Hence, when treating constipation, it is important to consider these factors, which may influence the efficacy of the medication. Lactulose also reduces the risk of diarrhea related to C. difficile (Maltz et al., 2020). Finally, Piche & Dapoigny 2020) show the safety and efficacy benefits of lactulose in treating functional constipation.
References
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Maltz, C., Miskovitz, P. F., & Hajifathalian, K. (2020). Lactulose may reduce Clostridium difficile-related diarrhea among patients receiving antibiotics. JGH open, 4(6), 1088–1090. https://doi.10.1002/jgh3.12390.
Mukherjee, S., & John, S. (2020). Lactulose. Treasure Island (FL): StatPearls Publishing.
Oh, S. J., Fuller, G., Patel, D., Khalil, C., Spalding, W., & Nag, A. (2020). Chronic constipation in the United States: Results from a population-based survey assessing healthcare seeking and use of pharmacotherapy, The American Journal of Gastroenterology, 115(6), 895-905. https://doi.10.14309/ajg.00000000000.
Piche, T., & Dapoigny, M. (2020). Comparative efficacy and safety of lactulose plus paraffin vs polyethylene glycol in functional constipation: a randomised clinical study. United European gastroenterology journal, 8(8), 923–932. https://doi.10.1177/2050640620937913.
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Select a medication and apply the available evidence and treatment guidelines to determine appropriate therapeutic options used for the treatment of constipation or diarrhea. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions, including interactions with CAM. Discuss any ethnic, cultural, and genetic differences in patients that should be considered in the treatment of constipation or diarrhea in order to ensure the safety and efficacy of the medication. Be sure to comment on your agent related to C. difficile. In addition, include a peer-reviewed article showing benefit of your agent. Include the name of the medication in the subject line so that the medications can be follower