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Name /bks_53161_deglins_md_disk/docusatesodiumsenna 02/12/2014 01:30PM 1 Plate # 0-Composite pg 1 # 1 Use Cautiously in: Excessive or prolonged use may lead to dependence, fluid and electrolyte imbalance, and vitamin and mineral deficiencies. docusate sodium/senna Adverse Reactions/Side Effects F and E: electrolyte imbalances, dehydration. GI: abdominal cramps, nausea, vomiting, diarrhea. Derm: rashes. GU: urine discoloration. (dok-yoo-sate soe-dee-um sen-na ) Peri-Colace, Senna Plus, Senokot-S Classification Therapeutic: laxatives Pharmacologic: stimulant laxatives, stool softeners Pregnancy Category C Interactions Drug-Drug: None significant. Route/Dosage Action PO (Adults and Children ⬎12 yr): 2 tablets once daily at bedtime; maximum 4 tablets twice daily. PO (Children 6– 12 yr): 1 tablet once daily at bedtime; maximum: 2 tablets twice daily. PO (Children 2– 6 yr): 1/2 tablet once daily at bedtime; maximum: 1 tablet twice daily. Senna’s metabolite acts as a local irritant on the colon stimulating peristalsis. Docusate promotes incorporation of water into stool, resulting in softer fecal mass. Therapeutic Effects: Softening and passage of stool. NURSING IMPLICATIONS Assessment Pharmacokinetics Absorption: Docusate: small amounts may be absorbed from the small intestine ● Assess color, consistency, and amount of stool produced. Indications PO: Treatment of constipation associated with dry, hard stools and decreased intestinal motility. Prevention of opioid-induced constipation. after oral administration. ● Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function. Distribution: Unknown. Metabolism and Excretion: Senna: metabolized in the liver and eliminated in Potential Nursing Diagnoses bile and urine. Docusate: eliminated in bile. Half-life: Unknown. TIME/ACTION PROFILE (softening of stool) Implementation ROUTE ONSET PEAK DURATION PO 6–12 hr unknown unknown Contraindications/Precautions Contraindicated in: Hypersensitivity; Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen; Concomitant use of mineral oil. ⫽ Canadian drug name. ⫽ Genetic Implication. Constipation (Indications) ● This medication does stimulate intestinal peristalsis. ● PO: Administer with a full glass of water or juice preferably in the evening. ● Do not administer within 2 hr of other laxatives, especially mineral oil. May cause increased absorption. Patient/Family Teaching ● Advise patients that laxatives should be used only for short-term therapy. Long- term therapy may cause electrolyte imbalance and dependence. ● Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake (6– 8 full glasses/day), and increasing mo- CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued. PDF Page #1 Name /bks_53161_deglins_md_disk/docusatesodiumsenna 02/12/2014 01:30PM Plate # 0-Composite pg 2 # 2 2 PDF Page #2 bility. Normal bowel habits are variable and may vary from 3 times/day to 3 times/ wk. ● Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). ● Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Evaluation/Desired Outcomes ● A soft, formed bowel movement, usually within 6– 24 hr. Why was this drug prescribed for your patient? 䉷 2015 F.A. Davis Company
