Docusate

INTRODUCTION

Indications

PO: Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Rectal: Used as enema to soften fecal impaction.

Action

Promotes incorporation of water into stool, resulting in softer fecal mass. May also promote electrolyte and water secretion into the colon. Therapeutic Effects: Softening and passage of stool.

Adverse Reactions/Side Effects

EENT: throat irritation. GI: mild cramps. Derm: rashes.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Monitor any rashes or other abnormal skin responses. Report excessive or prolonged skin reactions to the physician.

Interventions

• Instruct patient how to breathe and avoid straining during bowel movements to prevent a Valsalva maneuver.

Patient/Client-Related Instruction

• Advise patient to avoid overuse of laxatives. Encourage patient to use other forms of bowel regulation, such as increasing fiber and bulk in the diet, increasing fluid intake, and regular exercise.

• Advise patient to report other troublesome side effects such as prolonged or severe throat irritation or abdominal cramps.

Pharmacokinetics

Absorption: Small amounts may be absorbed from the small intestine after oral administration. Absorption from the rectum is not known.

Distribution: Unknown.

Metabolism and Excretion: Amounts absorbed after oral administration are eliminated in bile.

Half-life: Unknown.

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen.

Use Cautiously in: Excessive or prolonged use may lead to dependence; Should not be used if prompt results are desired; OB/Lactation: Has been used safely.

Interactions

Drug-Drug: None significant.

Route/Dosage

Docusate Calcium

PO (Adults): 240 mg once daily.

Docusate Sodium

PO (Adults and Children >12 yr): 50–400 mg in 1–4 divided doses.

PO (Children 6–12 yr): 40–150 mg in 1–4 divided doses.

PO (Children 3–6 yr): 20–60 mg ...