laxative



References: Laxative






J R Soc Med. 1996 Feb;89(2):79-84.
Characteristics of referrals to an inpatient hospice and a survey of general practitioner perceptions of palliative care.

Seamark DA, Lawrence C, Gilbert J.

Postgraduate Medical School, University of Exeter, England.

In order to determine symptoms, drug prescribing and physical problems of patients referred to an inpatient hospice, case notes from 130 consecutive first admissions (95 general practitioner (GP) referrals, 35 consultant referrals) were analysed. GP referrals were more likely to be constipated, require care and be discharged to home. Consultant referrals were more gravely ill, dependent and more likely to die in the hospice. On admission 76 (58%) patients were receiving opiates with co-prescription of opiate and laxative occurring in 41% (31/76) of the cases. The prescription of laxatives with the symptoms of constipation occurred in 62% (26/42) of the cases on admission. A telephone survey of 79 referring GPs revealed that 37% had attended neither a course nor a lecture relevant to palliative care in the past 3 years. GPs experienced difficulties frequently or always in: (a) managing pain (8/79); (b) managing other symptoms (25/79); (c) helping patients and relatives cope with their emotional distress (18/79); and (d) coping with their own emotional responses to death and dying (5/79). In conclusion, the differences demonstrated between the GP and consultant referrals have implications for purchasers. The high incidence of possible opiate-induced side-effects and the difficulties with symptom control expressed by some GPs indicate a continuing need for effective educational input.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8683506&dopt=Abstract constipation laxative



Eur J Pharmacol. 1996 Apr 22;301(1-3):137-42.
NG-nitro-L-arginine methyl ester reduces senna- and cascara-induced diarrhoea and fluid secretion in the rat.

Izzo AA, Gaginella TS, Mascolo N, Borrelli F, Capasso F.

Department of Experimental Pharmacology, University of Naples Federico II, Italy.

Senna (60 mg/kg orally) and cascara (800 mg/kg orally)-induced diarrhoea and net fluid secretion were studied in rats for a time period of 1-8 h. NG-Nitro-L-arginine methyl ester (L-NAME) (2.5-25 mg/kg i.p. twice, 15 min before and 4 h after laxative administration), an inhibitor of nitric oxide synthase, reduced the diarrhoeal response. This effect was counteracted by L-arginine (600 and 1500 mg/kg i.p. 15 min before laxative administration), the precursor of nitric oxide (NO). The senna- and cascara-stimulated fluid secretion was reduced by NG-nitro-L-arginine methyl ester 25 mg/kg i.p. (twice, 15 min before and 4 h after laxative administration), while the stereoisomer NG-nitro-D-arginine methyl ester (D-NAME) 25 mg/kg i.p. was without effect. These results suggest a possible involvement of NO in senna- and cascara-induced diarrhoea and fluid secretion.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8773457&dopt=Abstract constipation laxative



Biol Pharm Bull. 1995 Dec;18(12):1671-5.
Effects of KW-5092, a novel gastroprokinetic agent, on intestinal water and electrolyte transport in rats.

Kishibayashi N, Karasawa A.

Department of Pharmacology, Pharmaceutical Research Laboratories, Kyowa, Shizuoka, Japan.

KW-5092 ([1-[2-[[[5-(piperidinomethyl)- 2-furanyl]methyl]amino]ethyl]-2-imidazolidinylidene]propanedini trile fumarate) enhances acetylcholine release from enteric neurons and inhibits acetylcholinesterase (AChE), resulting in the enhancement of a wide range of gastrointestinal motilities. The present study examined the effects of KW-5092 on intestinal water and electrolyte transport in rats. In the jejunum, oral or intrajejunal administration of the laxative bisacodyl (30 mg/kg) significantly inhibited absorption of water, Na+ and Cl-, and significantly enhanced K+ secretion. In contrast, neither KW-5092 (1-30 mg/kg) nor the AChE inhibitor neostigmine (0.3-10 mg/kg), orally or intrajejunally administered, affected water or electrolyte transport in the jejunum. Similar results were obtained in the colon when the drugs were applied orally or intracolonically. Moreover, neither KW-5092 (1-30 mg/kg, p.o.) nor neostigmine (0.3-10 mg/kg, p.o.) induced diarrhea, while bisacodyl (30 mg/kg, p.o.) induced diarrhea in all the rats examined. These results demonstrate that KW-5092 or neostigmine at the gastroprokinetic doses does not affect intestinal water or electrolyte transport in rats, suggesting that cholinergic activation enhances gastrointestinal motility rather than intestinal secretion of water and electrolytes.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8787786&dopt=Abstract constipation laxative



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