Lactulose (Brand Name: Colac)

Therapeutic Uses

• Laxative for Constipation:
  • Helps relieve constipation.
  • Memory aid: Lactulose = Laxative.
• Decreases Ammonia Levels:
  • Used in patients with liver cirrhosis.
  • Reduces ammonia levels to prevent brain dysfunctions (e.g., hepatic encephalopathy, confusion, sleepiness, coma).

Mechanism of Action

• Ammonia Reduction:
  • Ingested lactulose pulls ammonia from the bloodstream into the colon.
  • Rapid onset of diarrhea helps excrete ammonia through stool, returning serum ammonia levels to therapeutic range.
• Memory Trick: "Lacta loose" = Loosens the bowels.

Side Effects

• Loose Stools & Abdominal Pain:
  • Main side effect due to the rapid onset of diarrhea.
• Dehydration:
  • Dry mouth, thirst, low urinary output.
• Electrolyte Imbalances:
  • Muscle twitching and cramping.
• Cardiac Effects:
  • Increased heart rate or dysrhythmias due to dehydration.

Patient Education & Nursing Considerations

• Diet Modifications for Constipation:
  • Increase dietary fibers (fruits, vegetables, grains, beans).
  • Increase fluid intake.
  • Memory Trick: "Fluids, fiber, and fruits fill up the toilet" to help with constipation.
• Monitoring:
  • Ammonia levels should decrease.
  • Expect 2-3 soft bowel movements per day.
  • Monitor for dehydration and improved mental status.

Key Points

• Lactulose should produce 2-3 bowel movements daily.
• Decrease serum ammonia levels.
• Improve mental status.

Conclusion

• Understanding lactulose is crucial for managing constipation and ammonia levels in liver cirrhosis patients.
• Monitor patients closely for dehydration and mental status changes.
• Happy studying and good luck to future nurses!