Laxatives for the elderly

Intestinal constipation in old age is not uncommon, therefore, along with changes in the diet, doctors often prescribe laxatives for the elderly.

Such funds cause increased intestinal motility, accelerating the movement of feces and facilitating emptying.

[1], [2], [3]

Indications for the use of laxatives for the elderly

Laxative drugs in the elderly are used in the following situations:

• before surgery;
• in conjunction with the use of anthelmintic drugs;
• in case of poisoning;
• in case of constipation of various origins associated with weakness, inadequate food and fluid intake, thyroid diseases, atherosclerosis, intake of certain medications, spinal disorders, etc.

[4], [5]

Release form

Laxatives for the elderly are available in various convenient forms:

• powder for oral administration;
• oil for oral administration;
• oral solution;
• suppositories rectal;
• pills, capsules;
• vegetable fees for brewing.

[6]

Pharmacodynamics of laxatives for the elderly

Laxative drugs may have a different pharmacological mechanism of action. However, all the possibilities of such drugs are aimed at achieving one goal - the elimination of constipation and intestinal atony. How can this be achieved?

• The effect of irritation of intestinal receptors is created, the effect is directly on mucous tissues, due to which peristalsis is enhanced and the secretion of mucus into the large intestine increases (herbal remedies, bisacodyl, etc.);
• The volume of intestinal contents increases, which stimulates the intestinal walls and provokes increased peristalsis (salt preparations, seaweed);
• There is a softening of fecal accumulations, which contributes to the relief of bowel movements (oil preparations).

Salt preparations (lactulose, macrogol, magnesium sulfate) are not adsorbed into the systemic circulation, creating an increase in osmotic pressure and keeping fluid inside the intestine. This contributes to the mechanical stretching of the intestinal walls, which gives impetus to increased peristalsis and more frequent urge to defecate.

Suppositories are designed to irritate the mucous membranes of the rectum, stimulating the urge to defecate. However, this action makes the suppository undesirable with exacerbation of hemorrhoids or inflammatory processes in the anus and rectum.

[7], [8], [9], [10]

Pharmacokinetics of laxatives for the elderly

Phytopreparations with an antraglycoside composition are biotransformed in the liver, where chrysophanic acid and emodin are released. The latter are excreted through the kidneys, and are also found in breast milk and sweat secretions.

Buckthorn preparations can be slightly absorbed into the bloodstream and excreted by the urinary system: in this case, urine can change color to red or dark yellow.

Laxatives for older people are prescribed mainly at night, since the effect of the drugs is expected approximately 6-8 hours after their use.

[11], [12], [13]

Names of laxatives for the elderly

As we have said, laxatives of medical preparations are subdivided according to the mechanisms and methods of their effect:

• intestinal wall receptor stimuli (rhubarb, buckthorn, zhoster, senna, sabura, isafenin, phenolphthalein, castor oil, etc.);
• means of stretching intestinal walls (sodium and magnesium sulphates, salts, lactulose, flax, seaweed, etc.);
• fecal softening agents (oily preparations, antispasmodics).

A chair that is close in quality to the natural can be expected after taking Kafiol, petroleum jelly, seaweed, sulfur, etc.

More liquefied stools are expected after taking phytopreparations (rhubarb, senna, buckthorn), castorca, phenolphthalein, bisacodyl, oxyphenisatin, etc.

Stool like diarrhea can cause salt preparations (sulfates of magnesium and sodium).

Dosage and administration

Rhubarb rhizome - produced in tablets of 0.3 and 0.5 g, as well as in powder, used to treat chronic constipation. Apply orally before going to bed from 0.5 to 1.5 g at a time, or 0.5 g three times a day before meals. The drug is not recommended for children under one year. From the age of one, it can be applied in a dose of from 0.1 to 0.5 g according to the prescription of a doctor

Krushina, bark - is sold in packs of 100 g. It is used orally, 100 ml in the form of a decoction (40 g of raw material per 0.4 l of water) in the morning on an empty stomach and before going to bed. Can be combined with other laxative preparations, in particular, with salt.

Kushina, liquid extract - is used orally from 20 to 40 drops in the morning and evening.

Buckthorn tablets (dry extract) - apply 1-2 tablets immediately before going to bed.

Zhostera fruits - sold in a package of 100 g. It is used in the form of a decoction of 100 ml before bedtime (one tablespoon of raw materials is brewed in 200 ml of boiling water).

Senna, leaves - available in boxes of 100 g. The drug is used orally in a tablespoon of infusion three times a day (for preparing an infusion, take 10 g of leaves per 100 ml of water). The drug acts gently and effectively, so it is often used in children.

Kafiol is a combined medical preparation consisting of the leaf and the fruits of senna, as well as the fruit of the plum, fig, and vaseline oil. It is made in the form of briquettes for chewing. Use half or whole briquette at a time before bedtime. If the constipation is chronic and persistent, it is allowed to use kafiol twice a day. The maximum dose per day is 5 briquettes, the maximum duration of treatment is up to 2 weeks.

Highlander pochechuyny - produced in the form of dry raw materials in packs of 100 g. Consume the plant infusion (10 g of raw material per 100 ml of water) in a tablespoon three times a day with atony and bowel spasms.

Licorice root, powder - used orally for 1 -2 tsp. Powder up to 3 times a day, in children - by a quarter or half a teaspoon.

Gastric collection - a vegetable mixture consisting of buckthorn, mint, nettle, calamus and valerian. Used for brewing (one tablespoon per 200 ml of boiling water). Drink half a glass in the morning and at night.

Glycerin suppositories - available in the form of suppositories for adults and children. Using the method of introduction into the rectum and 1 suppository per day in the morning, 20 minutes after eating. If there are signs of irritation, the drug is canceled.

Phenolphthalein - can be produced in powder or tablet form (0.1 and 0.05 g). The drug is administered orally from 1 to 2 tablets at bedtime (2 hours after the last meal), or 1 tablet twice a day after breakfast and dinner. The maximum allowable daily dosage is 0.3 g. Use in children: up to 3 years, the use of the drug is not recommended; Starting from 3 years of age, use from 0.05 g to 0.15 g per day.

Izafenin - produced in the form of a powder or tablets of 0.01 g. It is used orally one tablet twice a day after meals, or 2 tablets at a time before bedtime.

Izaman - use orally 1-2 tablets after a meal, the first three days daily, then every other day or once or twice a week.

Karlovy Vary salt - produced in 125 mg sachets. It is used orally for 1-2 tsp., Previously dissolved in warm water. Take before bedtime or during the day on an empty stomach.

Castor oil - produced in bottles of 30 or 50 ml, as well as in a capsulated form of 1 g. Is taken orally after a meal from 1 to 2 tsp. At once. Capsules take in quantities of 10 pieces for 1 hour.

Vaseline oil - used for oral administration from 1 to 2 tablespoons per day between meals.

Seaweed powder - used orally in half or a whole teaspoon of powder once a day after meals.

Bisacodyl - comes in the form of dragees of 0.005 g and suppositories of 0.01 g. They are used internally from 1 to 3 pills at night, or in the morning 30 minutes before meals. In the form of rectal suppositories used from 1 to 2 per day. In childhood, the drug is used from 1 year, prescribing one dragee or ½ or the whole suppository per day.

Lactulose (dufalak) - used in the morning during breakfast, 15-30 ml. In childhood use 5 ml of the drug per day at a time.

Forlax (macrogol) - produced in the form of sachets of powder. Use 1 sachet, pre-dissolving it in a glass of water. Maximum use up to 4 sachets per day.

[17], [18]

Contraindications to the use of laxatives for the elderly

The most frequent contraindications to the use of laxatives for the elderly are:

• individual cases of intolerance to any components of the drug;
• suspected intestinal obstruction;
• the presence of strangulated hernia, as well as inflammatory processes of internal organs in the acute stage;
• stomach, intestinal and uterine bleeding;
• electrolyte metabolism disorders;
• appendicitis;
• abdominal pain of unexplained origin;
• inflammation of the bladder.

[14], [15]

Side effects of laxatives for the elderly

When prescribing laxatives, the elderly should especially pay attention to the possible side effects of the proposed drugs, so carefully read the instructions before using the drug.

The most common laxatives can cause the following side effects:

• increased gas, diarrhea, nausea and vomiting;
• colicky abdominal pain;
• convulsions;
• fluid and electrolyte balance disorders;
• allergic manifestations, skin rash.

If any side effects occur, be sure to inform your doctor.

[16]

Overdose

Sometimes when taking high doses of laxative medications, constipation can be replaced by diarrhea, which usually does not require additional therapeutic measures and is completely stopped within 24 hours after stopping the use of the drug.

With long-term intake of laxative drugs, it is possible to increase the adverse events, as well as the breakdown of water-electrolyte metabolic processes, atonic phenomena in the large intestine, dehydration.

Treatment with the development of signs of overdose is symptomatic.

[19], [20], [21], [22], [23], [24]

Laxative interactions for the elderly

Laxative drugs are not used simultaneously with agents that lower intestinal motility (loperamide, imodium): such a combined use can provoke intestinal obstruction.

The use of laxatives may interfere with the absorption of other medications. It is especially necessary to revise the dosage of oral hypoglycemic agents, anti-epileptic drugs and antibiotics.

The use of agents provoking electrolyte disorders and blood acidosis (calcium channel blocking agents, lithium preparations, diuretics) is used with caution.

With the combined use of laxatives and antihypertensive drugs, a decrease in serum potassium concentration may be observed.

[25]

Storage conditions laxatives for the elderly

Tablets laxatives can be stored at t ° C– 7-25 ° C. Shelf life - up to 3 years.

Suppositories and suppositories should be stored only in the refrigerator.

Oils and solutions must be protected from direct sunlight.

Do not allow children to storage facilities for medical drugs.

Do not use drugs after the expiration date.

Means that regulate and stimulate bowel movement can be purchased in the pharmacy chain, without prescription from the doctor. But it must be borne in mind that the abuse of such drugs can harm the patient's health. For this reason, do not ignore the consultation of a specialist and carefully read the annotation to medical preparations.

The use of laxative drugs in old age may be less effective due to the presence of age-related changes and existing diseases. This is especially true for patients who have been in bed for a long time. In such situations, laxatives for the elderly should be combined with massage treatments, light gymnastics, physiotherapy techniques, as well as diet and appropriate drinking regimen.

[26],