Gastroenterology Book

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Emollient LaxativeAka: Stool Softener, Docusate, Colace, Mineral Oil, Glycerin

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  1. See Also
    1. Laxative
    2. Constipation
    3. Functional Constipation
    4. Pediatric Constipation
    5. Neonatal Constipation
  2. Mechanism
    1. Theoretically softens stool
      1. Allow water and fat to penetrate the fecal mass
    2. Effect probably due to induced Secretory Diarrhea
    3. Slow onset of action (24 to 48 hours)
  3. Precautions
    1. Do not use longterm
    2. Docusate enhances intestinal mineral oil absorption
      1. Do not use docusate with mineral oil preparations
    3. May also increase absorption of other medications
    4. Risk of hepatotoxicity
  4. Efficacy
    1. Some studies suggest no greater effect than Placebo
  5. Preparations
    1. Docusate Sodium or Dioctyl sulfosuccinate (Colace)
      1. Onset of action within 24-72 hours
      2. Adult
        1. Twice daily: 100 mg PO bid
        2. Once daily: 200 mg PO qhs
        3. Maximum daily total dose: 400 mg
      3. Pediatric
        1. Age <3 years: 10-40 mg per dose
        2. Age 3-6 years: 20-60 mg per dose
    2. Docusate Calcium (Surfak)
      1. Adult: 240 mg PO qd
      2. Child: 50-150 mg qd
    3. Mineral oil (use caution due to aspiration risk)
      1. Contraindications
        1. Risk of Aspiration Pneumonia (lipoid Pneumonia)
        2. Risk of malabsorption
      2. General dosing
        1. Give chilled in juice to maximize tolerability
        2. Coadminister multivitamin daily if used chronically
      3. Child Dose (over 18 months of age)
        1. Low: 1-3 cc/kg/day divided daily to twice daily
          1. Used in maintenance of bowel regimen
        2. High dose: 15-30 ml per age in years up to 240 ml
          1. Used in acute disimpaction
          2. May repeat daily for 3-4 days
      4. Adult Dose: 5-45 ml PO qhs
    4. Glycerin Suppository
      1. One Suppository (Adult or Pediatric) PR prn
      2. Indicated in Constipation in Infants

Glycerol (C0017861)

Definition (MSH)A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent.
Definition (CSP)1,2,3-trihydroxypropane, a key intermediate in glucose metabolism; also serves as the bridge between hydrophobic "tails" and hydrophilic "heads" of many membrane lipids; reagent is used as a water-soluble solvent and lubricant.
Definition (NCI)A trihydroxyalcohol with localized osmotic diuretic and laxative effects. Glycerin elevates the blood plasma osmolality thereby extracting water from tissues into interstitial fluid and plasma. This agent also prevents water reabsorption in the proximal tubule in the kidney leading to an increase in water and sodium excretion and a reduction in blood volume. Administered rectally, glycerin exerts a hyperosmotic laxative effect by attracting water into the rectum, thereby relieving constipation. In addition, glycerin is used as a solvent, humectant and vehicle in various pharmaceutical preparations.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121) , Biologically Active Substance (T123)
EnglishGlycerin, GLYCERIN PREPARATION, Glycerine, Glycerol, Glycerol analyte, Glycerol product
Spanishanálito de glicerol, analito de glicerol, glicerina, glicerol, preparado de glicerina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Mineral Oil (C0026156)

Definition (MSH)A mixture of liquid hydrocarbons obtained from petroleum. It is used as laxative, lubricant, ointment base, and emollient.
Definition (NCI)A mixture of liquid paraffinic, naphthenic and polycyclic aromatic hydrocarbons obtained from petroleum in which the amount and types of aromatic hydrocarbons is dependent on the treatment process. Untreated and mildly treated mineral oils contain the highest amount of aromatic and unsaturated compounds and are primarily used as a lubricant base oil to produce further refined oil products. Exposure to these types of mineral oils can cause rapid respiration, cyanosis, tachycardia and low-grade fever. Untreated and mildly treated mineral oils are strongly associated with an increased risk of scrotal and skin cancer but can also cause gastrointestinal, rectal, bladder and certain respiratory-tract cancers. (NCI05)
ConceptsLipid (T119) , Pharmacologic Substance (T121)
EnglishHydrocarbon oils, Liquid paraffin, Liquid paraffin product, Liquid petrolatum, MINERAL, Mineral Oil, MINERAL OIL @ @ OIL, MINERAL OIL MISC. OIL, MINERAL OIL OIL, MINERAL OIL PREPARATION, Mineral oils, Paraffin liquid, White mineral oil
Spanishaceite mineral, aceite mineral blanco, parafina líquida, parafina liquida, petrolato líquido, petrolato liquido
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Colace (C0282139)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishColace
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Docusate (C1692318)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishDioctyl Sulfosuccinate, Dioctyl sulphosuccinate, Dioctylsulfosuccinate, Docusate, DOCUSATE PREPARATION, DOSS
Spanishdocusato
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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