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Stimulant Laxative
Aka: Stimulant Laxative, Stimulant Cathartic, Irritant Laxative, Anthraquinone Laxative, Diphenylmethane Laxative, Phenolphthalein, Castor oil, Bisacodyl, Senna, Senokot, Cascara, Casanthranol, Peri-Colace, Melanosis coli, Ex-Lax, Correctol- See Also
- Precautions
- Avoid chronic use of these agents
- Preparations: Anthraquinone Laxative
- Cascara (Casanthranol) Extract
- Onset of activity within 6-12 hours
- Dose: 325 mg PO qhs
- Senna Extract (Senokot)
- Onset of activity within 6-12 hours
- Adult: 10-15 ml PO qhs or 2-4 tablets PO bid
- Child: Senna Syrup (8.8 grams per 5 ml)
- Age 2-6 years: 2.5 to 7.5 ml per day divided bid
- Age 6-12 years: 5 to 15 ml per day divided bid
- Combinations with senna and Docusate
- Senekot-S
- Peri-Colace (previously contained Cascara)
- Cascara (Casanthranol) Extract
- Preparations: Diphenylmethane Laxative
- Bisacodyl (Dulcolax)
- Onset of activity
- Oral: 6-12 hours
- Rectal: 60 minutes
- Dose
- Adult: 10 mg PO/PR per day (PO may be repeated)
- Child (6-12 years old): 5 mg PO/PR
- Protocol
- Start at 1 tablet once daily orally after breakfast
- Advance up to 3 tablets orally twice daily
- Cost: <50 cents per day
- Onset of activity
- Phenolphthalein (OTC Preparations: Correctol, Ex-Lax)
- As an OTC medication, high risk of overuse
- Dose: 100 mg tablets, 1-2 PO q8 hours
- Associated with Stevens-Johnson Syndrome
- Bisacodyl (Dulcolax)
- Adverse Effects: Long-term use (Laxative abuse)
- Colonic denervation and atony (Cathartic colon)
- Decreased motility of right colon
- Associated with Anthraquinone Laxatives
- Results from myenteric plexus injury
- Constipation
- Electrolyte and nutritional disturbance
- Hypokalemia
- Sodium overload
- Protein-losing Enteropathy
- Melanosis coli
- Benign darkening of colonic mucosa
- Macrophage deposition in lamina propria
- Colonic denervation and atony (Cathartic colon)
Bisacodyl (C0005632) |
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|---|---|
| Definition (MSH) | A diphenylmethane stimulant laxative used for the treatment of constipation and for bowel evacuation. (From Martindale, The Extra Pharmacopoeia, 30th ed, p871) |
| Definition (NCI) | A synthetic pyridinylmethylene-diacetate ester derivative stimulant laxative, Bisacodyl acts with a parasympathetic effect directly on mucosal sensory nerves, increasing peristaltic contractions. It is used for occasional constipation, in pre- and postoperative treatment, and in conditions that require facilitation of defecation. (NCI04) |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D001726 |
| SnomedCT | 391851004, 13565005, 387075009 |
| English | Bisacodyl, Phenol, 4,4'-(2-pyridinylmethylene)bis-, diacetate (ester), Bisacodyl, NOS, Bisacodyl - chemical (substance), bisacodyl (medication), bisacodyl, Bisacodyl [Chemical/Ingredient], BISACODYL, Bisacodyl (product), Bisacodyl (substance), Bisacodyl - chemical |
| Swedish | Bisakodyl |
| Czech | bisakodyl |
| Spanish | Bisacodyl - chemical, bisacodilo (producto), bisacodilo (sustancia), bisacodilo, Bisacodilo |
| Finnish | Bisakodyyli |
| Russian | BISAKODIL, БИСАКОДИЛ |
| Japanese | ビサコジル |
| Polish | Bisakodyl |
| French | Bisacodyl |
| German | Bisacodyl |
| Italian | Bisacodil |
| Portuguese | Bisacodil |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Cascara sagrada (C0205704) |
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|---|---|
| Definition (MSH) | Dried aged bark of a buckthorn, Frangula purshiana (FRANGULA), that contains the anthraquinone EMODIN and cascarosides. It is used as a laxative (CATHARTICS). |
| Definition (NCI) | Used as a laxative in constipation and various medical conditions, Cascara (cascara sagrada) is dried bark of Picramnia sp. (Simarubaceae) or Rhamnus purshiana (Rhamnaceae) containing stimulant laxative anthranol glycosides that act on the intestinal wall to increase muscle contractions and encourage bowel movements. (NCI04) |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D002362 |
| SnomedCT | 23888001, 387128007 |
| English | Cascara, Cascara sagrada, Sacred Bark, cascara sagrada, laxatives cascara sagrada, cascara sagrada (medication), Cascara Sagrada Fluid Extract, cascara sagrada fluid extract, Cascara Sagrada, CASCARA SAGRADA FLUID EXTRACT, CASCARA SAGRADA @ @ FLUID EXTRACT, CASCARA, Cascara [Chemical/Ingredient], cascara, Cascara (product), Cascara (substance), CASCARA SAGRADA ORAL FLUID EXTRACT, CASCARA SAGRADA@@ORAL@FLUID EXTRACT, CASCARA SAGRADA, CASCARA SAGRADA EXTRACT |
| Portuguese | Cáscara |
| Swedish | Sagrada |
| Czech | kaskara |
| Finnish | Sagradankuori |
| Italian | Cascara sagrada, Cascara |
| Russian | KAZANTRANOL, KASKARA, CASANTHRANOL, КАЗАНТРАНОЛ, КАСКАРА |
| Japanese | カスカラ, カスカラサグラダ, カサントラノール |
| French | Écorce sacrée, Cascara |
| Polish | Kaskara |
| Spanish | cáscara (producto), cáscara (sustancia), cáscara sagrada, cáscara, Cascara, Cáscara |
| German | Cascara |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Phenolphthalein (C0600489) |
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|---|---|
| Definition (MSH) | An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. |
| Definition (NCI) | An organic compound used as a laboratory reagent and pH indicator. Phenolphthalein exerts laxative effects by stimulating the intestinal mucosa and constricting smooth muscles. However, phenolphthalein is no longer used as a laxative due to the suspected carcinogenicity of this compound. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) , Indicator, Reagent, or Diagnostic Aid (T130) |
| MSH | D020113 |
| SnomedCT | 255671009, 19595005, 398955002 |
| English | phenolphthalein, Phenolphthalein, 1(3H)-Isobenzofuranone, 3,3-bis(4-hydroxyphenyl)-, phenolphthalein (medication), laxatives phenolphthalein, 3,3-Bis(4-hydroxyphenyl)-1(3H)-isobenzofuranone, 3,3-Bis(p-hydroxyphenyl)phthalide, Phenolphthalein [Chemical/Ingredient], Phenolphthalein (product), Phenolphthalein (substance), PHENOLPHTHALEIN, PHENOLPHTHALEIN,WHITE, PHENPOLPHTHALEIN |
| Swedish | Fenolftalein |
| Czech | fenolftalein |
| Spanish | Phenolphthalein, fenolftaleína (producto), fenolftaleína (sustancia), fenolftaleína, Fenolftaleina, Fenolftaleína |
| Finnish | Fenolftaleiini |
| Russian | FENOLFTALEIN, ФЕНОЛФТАЛЕИН |
| Japanese | フェノールフタレイン |
| Polish | Fenoloftaleina |
| French | Phénolphtaléine |
| German | Phenolphthalein |
| Italian | Fenolftaleina |
| Portuguese | Fenolftaleína |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Casanthranol (C0205705) |
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|---|---|
| Definition (MSH) | A concentrated mixture of anthranol glycosides derived from cascara sagrada. |
| Definition (NCI) | A concentrated mixture of anthranol glycosides from cascara sagrada (dried bark of Rhamnus p.) and used as a laxative in constipation and various medical conditions, stimulant laxative Casanthranol encourages bowel movements by acting on the intestinal wall to increase muscle contractions. (NCI04) |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D002362 |
| SnomedCT | 116530002, 400300006 |
| English | casanthranol, casanthranol (medication), laxatives casanthranol, Casanthranol [Chemical/Ingredient], Casanthranol (product), Casanthranol (substance), Casanthranol, CASANTHRANOL |
| Portuguese | Casantranol |
| Spanish | Casantranol, casantranol (producto), casantranol (sustancia), casantranol |
| German | Casanthranol |
| French | Casanthranol |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Senna Extract (C0036656) |
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| Definition (NCI) | An extract made from the dried leaflets on the pods of Cassia angustifolia or Cassia acutifolia with cathartic activity. Dimeric glycosides in dried senna extract are converted to the active monoanthrones by bacterial action in the colon. Through direct effects on enterocytes, enteric neurons, and muscle, monoanthrones produce giant migrating colonic contractions in addition to water and electrolyte secretion. As do other stimulant laxatives, monoanthrones may induce a limited low-grade inflammation in the colon through activation of prostaglandin/cyclic AMP and nitric oxide/cyclic GMP pathways and perhaps inhibition of Na+, K+-ATPase. |
| Definition (MSH) | Preparations of Cassia senna and C. angustifolia (see SENNA PLANT). They contain sennosides, which are anthraquinone type CATHARTICS and are used in many different preparations as laxatives. |
| Definition (PDQ) | An extract made from the dried leaflets on the pods of Cassia angustifolia or Cassia acutifolia with laxative properties. Dimeric glycosides in dried senna extract are converted to the active monoanthrones by bacterial action in the colon. Through direct effects on enterocytes, enteric neurons, and muscle, monoanthrones produce giant migrating colonic contractions in addition to water and electrolyte secretion. As do other stimulant laxatives, monoanthrones may induce a limited low-grade inflammation in the colon through activation of prostaglandin/cyclic AMP and nitric oxide/cyclic GMP pathways and perhaps inhibition of Na+, K+-ATPase. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=480408&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=480408&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C61324" NCI Thesaurus) |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D012676 |
| Swedish | Sennaextrakt |
| English | senna extract, Senna Extract [Chemical/Ingredient], Senna Extract, Extract, Senna, SENNA EXTRACT |
| Czech | senna - extrakt |
| Finnish | Sennauute |
| Russian | SENNY EKSTRAKT, СЕННЫ ЭКСТРАКТ |
| Japanese | セノコット, ヨーデルS, ヨーヤクール, アジャストA, センナエキス |
| Polish | Wyciąg z senesu |
| French | Extrait de séné |
| German | Senna-Extrakt |
| Italian | Estratto di Senna |
| Portuguese | Extrato de Cássia, Extrato de Cene, Extrato de Sena, Extrato de Sene |
| Spanish | Extracto de Senna |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Diphenylmethane laxative (C0304558) |
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| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| SnomedCT | 61939007, 387345006 |
| English | Diphenylmethane laxative, NOS, Diphenylmethane laxative (product), Diphenylmethane laxative (substance), Diphenylmethane laxative |
| Spanish | laxante de difenilmetano (producto), laxante de difenilmetano (sustancia), laxante de difenilmetano |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Ex-Lax (C0720319) |
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| Definition (NCI) | A commercial preparation, by Novartis, with laxative activity. Ex-Lax contains anthraquinone glycosides sennosides, extracted from senna leaves. Sennosides irritate the lining of the intestine wall, thereby causing increased intestinal muscle contractions that lead to vigorous bowel movement and relief constipation. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D020113 |
| English | ex-lax, ex lax, Ex-Lax, Manesco Brand of Phenolphthalein, Novartis Brand of Phenolphthalein |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Stimulant laxative (C0304553) |
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|---|---|
| Concepts | Pharmacologic Substance (T121) |
| SnomedCT | 317511006, 56762002 |
| English | Stimulant laxative, NOS, Stimulant laxative, STIMULANT LAXATIVES, Stimulant Laxative, Stimulant Laxative [EPC], [GA204] STIMULANT LAXATIVES, stimulant laxatives, laxatives stimulant, laxative stimulants, laxative stimulant, stimulant laxative, Stimulant laxatives, Stimulant laxative (substance), Stimulant laxatives (product), Stimulant laxatives (substance) |
| Spanish | laxante estimulante (sustancia), laxante estimulante, laxantes estimulantes (producto), laxantes estimulantes |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Anthraquinone laxative (C0360063) |
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|---|---|
| Concepts | Pharmacologic Substance (T121) |
| SnomedCT | 74780007, 387424000 |
| English | Anthraquinone laxative, NOS, Anthraquinone laxatives, Anthraquinone laxative (product), Anthraquinone laxative (substance), Anthraquinone laxative |
| Spanish | laxante de antraquinona (producto), laxante de antraquinona (sustancia), laxante de antraquinona |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Peri-Colace (C0307257) |
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|---|---|
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| English | Peri-Colace, peri colace, peri-colace, Peri-Colace (obsolete) |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Correctol laxative (C0618983) |
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| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | C038509 |
| English | Correctol laxative, Correctol (obsolete), Correctol Capl (obsolete) |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Senokot (C0699932) |
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|---|---|
| Definition (NCI) | A standardized, concentrated preparation, by Purdue, containing the anthraquinone glycosides sennosides extracted from senna leaves with laxative activity. Sennosides act on and irritate the lining of the intestine wall, thereby causing increased intestinal muscle contractions leading to vigorous bowel movement. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D012676 |
| German | Senokot |
| English | senokot, senokots, Senokot |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Melanosis coli (C0221391) |
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| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 11256005 |
| English | Melanosis, MELANOSIS COLI, Melanosis coli, melanosis coli (diagnosis), melanosis coli, colon melanosis, melanosis of colon, melanosis, coli melanosis, melanosi coli, Colonic melanosis, Colonic pseudomelanosis, Melanosis of colon, Melanosis coli (disorder), colon; melanosis, melanosis; colon |
| Italian | Melanosi del colon, Melanosi colon |
| Japanese | 結腸メラノーシス, ｹｯﾁｮｳﾒﾗﾉｰｼｽ |
| Czech | Střevní melanóza |
| Hungarian | Melanosis coli |
| French | Melanose, Melanose colique, Mélanose colique |
| Dutch | colon; melanose, melanose; colon, melanosis coli |
| Spanish | melanosis coli (trastorno), melanosis coli, melanosis del colon, seudomelanosis colónica, Melanosis del colon |
| Portuguese | Melanose do cólon |
| German | Melanosis coli |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |