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Chapter: Clinical Pharmacology: Gastrointestinal drugs

Lubricant laxatives

Mineral oil is the main lubricant laxative currently in clinical use.

Lubricant laxatives

 

Mineral oil is the main lubricant laxative currently in clinical use.

Pharmacokinetics

 

In its nonemulsified form, mineral oil is minimally absorbed; the emulsified form is about half absorbed. Absorbed mineral oil is distributed to the mesenteric lymph nodes, intestinal mucosa, liv-er, and spleen.

Metabolism and excretion

Mineral oil is metabolized by the liver and excreted in stool.

Pharmacodynamics

Mineral oil lubricates stool and the intestinal mucosa and prevents water reabsorption from the bowel lumen. The increased fluid content of stool increases peristalsis. Administration by enema also produces distention.

Pharmacotherapeutics

 

Mineral oil is used to treat constipation and maintain soft stool when straining is contraindicated, such as after a recent MI (to avoid Valsalva’s maneuver), eye surgery (to prevent increased pressure in the eye), or cerebral aneurysm repair (to avoid in-creased ICP).

Impacting impaction

 

Administered orally or by enema, this lubricant laxative is also used to treat the patient with fecal impaction.

Drug interactions

 

Mineral oil can interact with other drugs.

 

·                 Mineral oil may impair the absorption of many oral drugs, in-cluding fat-soluble vitamins, hormonal contraceptives, and anti-coagulants.

 

·                 Mineral oil may interfere with the antibacterial activity of non-absorbable sulfonamides. To minimize drug interactions, adminis-ter mineral oil at least 2 hours before these medications. (See Ad-verse reactions to mineral oil.)

 

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Clinical Pharmacology: Gastrointestinal drugs : Lubricant laxatives |


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