- Body system
- Gastrointestinal
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Docusate, Senna, Bisacodyl, Polyethylene glycol, Psyllium, Loperamide, Rifaximin.
How laxatives and bowel drugs work
Bulk-forming agents (psyllium) add fiber; stool softeners (docusate) let water into the stool; osmotic laxatives (lactulose, polyethylene glycol) draw water into the bowel; stimulants (senna, bisacodyl) increase peristalsis.
Uses
- Constipation and its prevention with opioids
- Bowel preparation
- Hepatic encephalopathy (lactulose, often with rifaximin)
Adverse effects
- Cramping, bloating and gas
- Diarrhea
- Dehydration and electrolyte imbalance with overuse
- Esophageal or bowel obstruction if bulk-forming agents are taken without enough water
Nursing considerations
- Assess bowel sounds and rule out obstruction before giving.
- Monitor electrolytes and hydration with frequent stools.
- For hepatic encephalopathy, track mental status, stool count and ammonia.
Patient teaching
- Take bulk-forming laxatives with a full glass of water.
- Increase fiber, fluids and activity.
- Avoid long-term stimulant laxative use unless prescribed.
Laxatives and bowel drugs NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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What is the expected outcome of lactulose therapy for hepatic encephalopathy?
Show answer
Answer D: 2 to 3 soft stools a day and improved mental status Lactulose is titrated to 2 to 3 soft stools daily, which removes ammonia and improves mental status.
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Which instruction is essential when taking psyllium?
Show answer
Answer D: Mix it with a full glass of water and drink right away Without enough fluid, bulk-forming laxatives can swell and cause choking or obstruction.
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Before giving a laxative, which finding would cause the nurse to hold it and notify the provider?
Show answer
Answer C: Absent bowel sounds with abdominal distension and vomiting These findings suggest bowel obstruction, in which laxatives are contraindicated.
Frequently asked questions
What are laxatives and bowel drugs?
Laxatives treat and prevent constipation; lactulose also lowers ammonia in hepatic encephalopathy. Bulk-forming laxatives need plenty of water.
How do laxatives and bowel drugs work?
Bulk-forming agents (psyllium) add fiber; stool softeners (docusate) let water into the stool; osmotic laxatives (lactulose, polyethylene glycol) draw water into the bowel; stimulants (senna, bisacodyl) increase peristalsis.
What are examples of laxatives and bowel drugs?
Lactulose, Docusate, Senna, Bisacodyl, Polyethylene glycol, Psyllium, Loperamide and Rifaximin.
What are the nursing considerations for laxatives and bowel drugs?
Assess bowel sounds and rule out obstruction before giving. Monitor electrolytes and hydration with frequent stools.