laxative



References: Laxative






Br J Clin Pharmacol. 2004 Apr;57(4):522-524.
Overanticoagulation associated with combined use of lactulose and coumarin anticoagulants.

Visser LE, Penning-Van Beest FJ, Wilson JH, Vulto AG, Kasbergen AA, De Smet PA, Hofman A, Stricker BH.

Pharmaco-epidemiology Unit, Departments of Internal Medicine and Epidemiology & Biostatistics, Erasmus MC, Rotterdam, The Netherlands.

Some medical textbooks on drug interactions take note of the potential interaction between laxatives and coumarin anticoagulants, but epidemiological evidence that this interaction is of practical importance is lacking. We conducted a follow-up study in a large population-based cohort to investigate which laxatives are associated with overanticoagulation during therapy with coumarins. Of the 1124 patients in the cohort, 351 developed an International Normalized Ratio >/= 6.0. The only laxative with a moderate but significantly increased relative risk of overanticoagulation was lactulose (relative risk 3.4, 95% confidence interval 2.2, 5.3). In view of the widespread use of lactulose, especially among the elderly, awareness of this potential drug interaction is required.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15025752&dopt=Abstract constipation laxative [PubMed - as supplied by publisher]



Bull Schweiz Akad Med Wiss. 1976 Dec;32(4-6):233-50.
[Biologic membrane functions in health and disease. Effects of bile acids and laxatives on the mucosal transfer]

[Article in German]

Rummel W.

The morphologica and biochemical asymmetry of the intestinal epithelium is the precondition for the net transfer of sodium and water from the lumen to the bloodstream. Dihydroxy bile acids and diphenol laxatives belong to the group of drugs which are capable of inhibiting or reversing this net transfer in rats and humans. This property is characterized as antiabsorptive and hydragogue. In addition to their pharmacologic action, pathophysiologic (cholagenic diarrhea) and toxic symptoms (hypokalemia and secondary aldosteronism) can be ascribed to this property. Dihydroxy bile acids and diphenal laxatives render the junctions more permeable. Their mechanism of action can therefore be explained by stating that, due to increased intercellular permeability, the asymmetry of the system is lost and absorption thus comes to a standstill. Since slight hydrostatic pressure on the subepithelial side suffices to reverse the net transfer, it is assumed that in vivo the filtration pressure of the capillaries is the motive force for net transfer into the lumen.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1009264&dopt=Abstract constipation laxative



Schweiz Med Wochenschr. 1976 Oct 23;106(43):1459-65.
[Long-term course of anorexia nervosa]

[Article in German]

Willi J, Hagemann R.

A follow-up study has been recently conducted in 20 female patients with severe anorexia nervosa who had undergone stationary psychotherapeutic treatment at our clinic 8-16 years ago. Whilst according to our findings the prognosis for anorexia nervosa still remains poor, it does not seem quite so hopeless as is frequently presumed. Out of the 20 patients followed up, 5 now have chronic anorexia nervosa and in 2 cases transition to an endogenous psychosis has occurred (schizophrenia simplex with chronified anorexia in one, and endogenous depression after improvement of anorexia in the other case). 1 patient died in the interval between observations as a result of her anorexia. The general results of our investigation roughly confirm the rule-of-thumb predictions for many psychotherapeutic treatments of neurotic diseases, i.e. 1/3 unimproved, 1/3 improved, 1/3 cured. Although free from illness, the majority of the patients must be described as conspicuous within the norm. The typical personal characteristics of the anorectic are maintained, their weight remains below normal level, and they suffer from eating problems. According to our investigation a positive prognosis correlates with onset of the illness before the age of 18, absence of laxative abuse, and subsequent marriage, whereas premature interruption of the treatment with return to the parental home proves to have a negative effect. In apparent contradiction to the persistence of the characteristic anorectic features is the evidence that out of the 20 patients in question 12 married and 8 had children. On the other hand, the fact that during the interval between observations 4 patients relapsed into severe anorexia in connexion with engagement or pregnancy indicates that acceptance of a mature female or maternal role often remains a problem. Of gynecologic interest is the fact that long-lasting secondary amenorrhea (



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