Page 70 - Community pharmcy practice E-book 2025
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02/11/2025, 00:10 Otic & Ophthalmic Disorders | Dermatological Disorders
Product Selection Guidelines
To treat uncomplicated constipation, the use of bulking agents often is recommended as the initial
treatment choice for self-care for acute constipation. However, bulk-forming laxatives may take up to
72 hours or longer for onset of effect.
If faster onset is desired, or if a bulk-forming agent is ineffective or inappropriate, the hyperosmotic PEG
3350 also is considered a first-line agent, in view of its effectiveness and favorable adverse effect
profile.
If PEG 3350 is unable to produce a satisfactory response, addition of a stimulant (e.g., bisacodyl)
should be considered.
In each case, the lowest effective dose should be used, and the dose should be reduced once
symptoms subside.
Patients who fail to achieve a therapeutic response after 7 days of self-treatment require medical referral.
Patient Counseling Summary
Lifestyle Changes
Drink more water
Eat more fiber-containing food
Decrease the intake of bulky food
Increase the intake of bran (eat diet bread) Decrease the
intake of caffeine (coffee)
Medication Considerations
Bulking agents and stimulant laxatives should not be used if patients have an intestinal obstruction
Rectal burning may occur with glycerin supp
Special Population Considerations
Patients with hypertension or congestive heart failure should not receive saline laxatives on a prolonged
basis due to fluid retention from sodium absorption
Patients with severe kidney disease should not use products containing magnesium
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