DRUG

MECHANISM OF
ACTION

INDICATION

Generic Name:
lactulose

Breakdown of
lactulose to organic
acids by colonic
bacteria, acidifies
colonic contents,
thereby
subsequently
inhibiting diffusion of
ammonia back to
blood.

Prevention and
treatment of portalsystemic
encephalopathy,
including stages of
hepatic precoma
and coma, and by
prescription for
relief of chronic
constipation.

Brand Name:
Duphalac

CONTRAINDICATION

ADVERSE EFFECTS

Diabetes mellitus

flatulence

Concomitant use
with electrocautery
procedures
(proctoscopy,
colonoscopy)

borborygmi
belching

NURSING CONSIDERATION

Promote fluid intake

(>15002000 mL/d) during
drug therapy for
constipation; older adults
often self-limit liquids.

-lactulose-induced
osmotic changes
in the bowel
support intestinal
water loss and
potential
hypernatremia.

Do not take any laxative

medications while using
this drug.

- can cause a
severe loss of
body water

If with diabetes, monitor

blood glucose regularly.

-may affect blood

glucose levels,
anti-diabetic
medications or
diet may need to
be adjusted.

abdominal
cramps
distention
diarrhea
nausea
vomiting
hypernatremia

RATIONALE

Notify physician if diarrhea

(more than 2 or 3 soft
stools/day) persists more
than 2448 hours.

- diarrhea is a sign
of overdosage