Let's talk about lactulose, brand name Colac. Let's look at the therapeutic uses of this drug. This drug is used as a laxative to help relieve constipation.
You can remember this by thinking lactulose works as a laxative, but its main use is to decrease ammonia levels in patients with liver cirrhosis. When the liver is damaged, the liver can't excrete toxins such as ammonia, in the blood. Remember, ammonia is a toxin and too much ammonia can cause brain dysfunction such as hepatic encephalopathy, confusion, sleepiness, and even a coma.
Now let's look at the mechanism of action. When a patient ingests lactulose, it causes ammonia to be pulled from the bloodstream and put into the colon. This causes rapid onset of diarrhea. You can remember this by the memory trick, lactulose think. lacta loose because it loosens the bowels.
Since the ammonia was excreted through stool, the serum ammonia levels return back to therapeutic range. When you have loose stools, which is the main side effect of this medication, you will naturally have abdominal pain. Also know that diarrhea leads to dehydration, dry mouth, and thirst because fluid is leaving the body. With dehydration comes a low urinary output.
Whenever someone experiences diarrhea, it can lead to electrolyte imbalances, which can cause the body to have muscle twitching and cramping. There will also be an increase in heart rate or dysrhythmias because the body is trying to compensate for this dehydration and push fluids forward. Let's look at some patient education and nursing considerations.
You want to educate your patient on some diet modifications. If this medication is being used for constipation, they should increase natural dietary fibers such as fruits, vegetables, grains, and beans. They should also increase fluids. You can remember this by the memory trick, fluids, fiber, and fruits fill up the toilet, aka they help with constipation.
You as the nurse should monitor ammonia levels. Remember, lactulose should decrease ammonia levels. The number of stools.
Lactulose should produce two to three soft bowel movements each day. You also want to monitor for dehydration and mental status. Lactulose should improve their mental status because it's lowering serum ammonia levels.
Okay, let's review the most commonly tested on for lactulose. Lactulose should Produce 2-3 bowel movements each day, decrease serum ammonia levels, and improve mental status. That's all for lactulose.
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