- Body system
- Gastrointestinal
- Brand names
- Enulose, Kristalose, Generlac
What is Lactulose used for?
- Hepatic encephalopathy (prevention and treatment)
- Chronic constipation
How Lactulose works
Nonabsorbed sugar broken down by colon bacteria: it acidifies the colon, traps ammonia as ammonium for excretion, and draws water into the stool.
Common side effects
- Bloating, gas and cramping
- Diarrhea
- Dehydration and hypokalemia with excess stools
Report right away
- More than 3 or 4 loose stools a day, dizziness or weakness
- New confusion, drowsiness or hand flapping (worsening encephalopathy)
Nursing considerations for Lactulose
- In hepatic encephalopathy, the dose is usually adjusted to produce 2 to 3 soft stools a day.
- Monitor mental status, stool count, ammonia level, electrolytes and fluid balance.
Patient teaching
- Mix it with juice, water or milk to improve the very sweet taste.
- For constipation, it can take 24 to 48 hours to work.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Laxatives and bowel drugs practice questions
NCLEX-style questions on the class Lactulose belongs to.
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 is Lactulose used for?
Hepatic encephalopathy (prevention and treatment); Chronic constipation.
What drug class is Lactulose?
Lactulose belongs to the class laxatives and bowel drugs. Nonabsorbed sugar broken down by colon bacteria: it acidifies the colon, traps ammonia as ammonium for excretion, and draws water into the stool.
What are the nursing considerations for Lactulose?
In hepatic encephalopathy, the dose is usually adjusted to produce 2 to 3 soft stools a day. Monitor mental status, stool count, ammonia level, electrolytes and fluid balance.
What should patients report while taking Lactulose?
more than 3 or 4 loose stools a day, dizziness or weakness; new confusion, drowsiness or hand flapping (worsening encephalopathy).