Mindanao State University – Iligan Institute of Technology Student: _Dannah S.

Bullianday Group: ______

COLLEGE OF NURSING Inclusive Dates of Duty: December 7-9, 2020

Patient: Arturo L. Mendoza Room No.: ________
PHARMACOLOGY

DRUG STUDY
Brand Name: Cephulac, Chronulac Generic Name: Lactulose; Grilinctus Syrup Drug Classification: Gastrointestinal Agent; Hyperosmotic Laxative
Dosage, Route & Frequency Drug-Drug & Drug- Side Effects Adverse Reactions (By
Drug Action Indications Contraindications
Recommended Prescribed Food Interactions (By System) System)
Prevention and Treatment of Grilinctus 2 Reduces blood ammonia; Drug: Grilinctus Syrup (Ammonium Low galactose diet;  Dehydration GI: Flatulence, borborygmi,
Portal-Systemic Encephalopathy top PO BID appears to involve metabolism Chloride) Lactate Lotion, 12% pregnancy (category C).  Diarrhea belching, abdominal cramps,
Adult: PO 30–45 mL t.i.d. or q.i.d. of lactose to organic acids by Laxatives may incorrectly is indicated for the treatment of Safe use in lactation or  excessive pain, and distention (initial
adjusted to produce 2–3 soft stools/d resident intestinal bacteria. suggest therapeutic action dry, scaly skin (xerosis) and children is not established. bowel activity dose); diarrhea (excessive
Adolescent/Child: PO 40–90 mL/d of lactulose. ichthyosis vulgaris, and for the  high blood dose); nausea, vomiting, colon
in divided doses adjusted to produce temporary relief of itching Cautious Use sodium levels accumulation of hydrogen gas;
2–3 soft stools/d Absorption: Poorly associated with these  low blood hypernatremia.
Infant: PO 2.5–10 mL/d in 3–4 absorbed from GI tract. conditions. Diabetes mellitus; sodium levels
divided doses adjusted to produce concomitant use with  nausea
2–3 soft stools/d Metabolism: Metabolized Prevention and treatment of electrocautery procedures  vomiting
in gut by intestinal portal-systemic encephalopathy (proctoscopy,  abdominal
Management of Acute Portal- bacteria. (PSE), including stages of colonoscopy); older adult cramping
Systemic Encephalopathy hepatic precoma and coma, and and debilitated patients;  abdominal
Adult: PO 30–45 mL q1–2 h until by prescription for relief of pediatric use. distention
laxation is achieved, then adjusted chronic constipation.  burping
to produce 2–3 soft stools/d. Rectal (belching)
300 mL diluted with 700 mL water  gas
given via rectal balloon catheter, (flatulence)
and retained for 30–60 min, may
repeat in 4–6 h if necessary or until
patient can take PO

Chronic Constipation
Adult: PO 30–60 mL/d prn
Child: PO 7.5 mL/d after breakfast

Administration

Oral
Give with fruit juice, water, or milk
(if not contraindicated) to increase
palatability. Laxative effect is
enhanced by taking with ample
liquids. Avoid meal times.

Rectal
Administer as a retention enema via
a rectal balloon catheter. If solution
is evacuated too soon, instillation
may be promptly repeated.
Do not freeze. Avoid prolonged
exposure to temperatures above 30°
C (86° F) or to direct light. Normal
darkening does not affect action, but
discard solution that is very dark or
cloudy.

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)

Assessment & Drug Effects Patient & Family Education

 In children if the initial dose causes diarrhea, dosage is reduced immediately. Discontinue if  Laxative action is not instituted until drug reaches the colon; therefore, about 24–48 h is needed.

diarrhea persists.  Do not self-medicate with another laxative due to slow onset of drug action.

 Promote fluid intake (1500–2000 mL/d) during drug therapy for constipation; older adults often  Notify physician if diarrhea (i.e., more than 2 or 3 soft stools/d) persists more than 24–48 h.

self-limit liquids. Lactulose-induced osmotic changes in the bowel support intestinal water loss and Diarrhea is a sign of overdosage. Dose adjustment may be indicated.

potential hypernatremia. Discuss strategy with physician.  Do not breast feed while taking this drug without consulting physician.