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DRUG NAME Generic name: Lactulose Brand name: Constulose, Kristalose, Chronulac, Cephulac, Constilac, Cholac, Duphalac, Evalose, Heptalac, Enulose, Generlac Dosage: 120 ml 3.35/5ml syrup Route: Oral Frequency: OD
MECHANISM OF ACTION Reduces blood ammonia by acidifying colon contents, thus retarding diffusion of non-ionic ammonia from colon to blood while promoting its migration from blood to colon. In the acidic colon, NH₃ is converted to nonabsorbable ammonium ions and is then expelled in feces.
INDICATION Prevention and treatment of portalsystemic encephalopathy (PSE), including stages of hepatic precoma and coma, and by prescription for relief of chronic constipation.
ADVERSE REACTION (≥1%) GI: Flatulence, borborygmi, belching, abdominal cramps, pain, and distention (initial dose); diarrhea (excessive dose); nausea, vomiting, colon accumulation of hydrogen gas; hypernatremia.
CONTRAINDICATION Low galactose diet.
NURSING CONSIDERATION >In children if the initial dose causes diarrhea, dosage is reduced immediately. Discontinue if diarrhea persists. >Promote fluid intake during drug therapy for constipation; older adults often self-limit liquids. Lactuloseinduced osmotic changes in the bowel support intestinal water loss and potential hypernatremia. Discuss strategy with physician.