Drug Data Generic Name Bisacodyl Trade Name Dulcolax Patients Dose 1 tab BID Availability Enteric-coated tablets:

5 mg OTC Enteric-coated and delayed release: 5mg OTC Routes of administration P.O

Classification Pharmacologic Class: Stimulant laxatives Therapeutic Class: laxatives Pregnancy Risk Category: B

Mechanism of Action Stimulates peristalsis by directly irritating the smooth muscle of the intestine, possibly the colonic intramural plexus; alters water and electrolyte secretion producing net intestinal fluid accumulation and laxation. Pharmacokinetics Absorption: Minimal from the GI tract (oral, as entericcoated tablets/suppositories). Metabolism: Converted to bis(phydroxyphenyl)pyridyl2-methane by intestinal or bacterial enzymes. Excretion: Faeces; urine (as glucuronide). Onset: oral : 6 to 12 hours rectal: 20 to 60 minutes Drug Half Life: 8 hours

Indication General Indications -treatment for constipation Patients Actual Indication -treatment for constipation .

Contraindications Contraindications Hypersensitivity, abdominal pain, obstruction, N/V Precautions Use cautiously in severe cardiovascular disease, and or rectal fissures, excess or prolonged use, products containing tannic acid, should not be used as multiple enemas, may be used during pregnancy & lactation. Drug interactions Milk: may remove enteric coating at tablets, resulting in gastric irritation/dyspepsia

Adverse Reactions GI: abdominal cramps, nausea, diarrhea, rectal burning F&E: hypokalemia (chronic use) MS: muscle weakness (chronic use) MISC: proteinlosing enteropathy, tetany (chronic use)

Nursing Responsibilities Before -Check for the doctors order -Confirm patients identity -Prepare the medicine -Assess patient for abdominal distension, presence of bowel sounds and usual pattern of bowel function. -Assess patients and familys knowledge of drug therapy During -Administer at bedtime for morning results -P.O: taking on an empty stomach will produce more rapid results. -Do not crush or chew enteric coated tablets. Take with full glass of water or juice -Do not administer oral doses within 1 hr of milk or antacid causes gastric irritation -Consider rights of drug administration After -Advise patient that laxatives should be used only for short-term therapy. Prolonged use may lead to electrolyte imbalance & dependence. -Advise to increase oral fluid intake to 1500-2000 ml/day to prevent dehydration -Encouraged pt. to use other forms of bowel regulation -Advise pt. that bisacodyl should not be used when constipation is accompanied by abdominal pain, fever, N/V - Report any signs of unusualities

Source: Davis drug guide, 9th ed pg. 116

Source: Davis drug guide, 9th ed pg. 117

Source: Davis drug guide, 9th ed pg. 117

Source: Davis drug guide, 9th ed pg. 117

Source: Davis drug guide, 9th ed pg. 117

Source: Davis drug guide, 9th ed pg. 117

Source:Davis drug guide, 9th ed pg. 117118