Page 103 - COMMUNITY PHARMACY PRACTICE

02/04/2024

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Recommended stepwise treatment of
constipation in pregnancy:

Step 1: Non-pharmacological management
• Increased fiber
• Increased fluids
• Increased exercise

Step 2: Pharmacological management
• Bulk-forming laxatives (Safe OTC medication for ttt of chronic

constipation in pregnant)✓
• Lactulose : Pregnancy Category: B (POM)

• Glycerin suppositories (OTC) ✓
• Bisacodyl : pregnancy category B (OTC)
• Senna (OTC) ( contraindicated in third trimester )
• Docusate sodium – low doses (OTC)..cat C ✓

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Saline and osmotic laxatives

Mechanism of onset of action: Examples &
action marketed products
• Rectal
• create an osmotic formulations (e.g. • Epsom salt
gradient to pull water enemas and (Magnesium sulfate)
into the small and large suppositories)
intestines. have an onset of • Glycerin (Glycerin®
suppositories)…
• This increased volume 5-30 min. hyperOsmotic
results in distention of
the intestinal lumen, • oral preparations • Lactulose
work within 3-6 hr. (lactulose® ,
• peristalsis and bowel Duphalac syrup )
motility • Glycerin supp (15-
60min • . Poly ethylene
• activity of glycol 3350
cholycystokinin- • Lactulose (from 1- (Miralax ®)
pancreozymin, 3 days to act ) ..osmotic
POM
• the secretion of fluids
into the GIT.

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