Colace Nursing Considerations

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Colace is used to treat constipation. It increases the amount of water and fat absorbed by the feces, softening the stool and making it easier to pass.


Colace is the brand name for docusate sodium and is available as liquid, capsules and suppositories, on prescription and over the counter. It is made by Purdue Products L.P.

Misconceptions

  • Contrary to popular opinion, it is not necessary to have a bowel movement every day. Everyone has their own pattern and constipation is diagnosed when bowel movements are fewer than three times weekly. Constipated stools are small in size, hard, dry and difficult or painful to pass.

    Constipation is a very common complaint in the U.S. accounting for 2.5 million visits to a physician and $725 million spent on laxative products every year. It is most prevalent in people over 60 and in women, particularly when pregnant .

Warning

  • Colace should not be given if there is a suspicion of intestinal obstruction.

    It may interfere with the efficacy of aspirin, potassium supplements, potassium-sparing diuretics and mineral oil (liquid paraffin).

    It increases the absorption of anthraquinones such as found in laxatives, antimalarial drugs and some cancer drugs.

    Other contraindications include: inflammatory bowel disease such as Crone's and ulcerative colitis; coloproctitis; abdominal pain and nausea. Rectal preparations should be avoided in the case of hemorrhoids, anal fissure and bleeding from the anus.

Use With Caution

  • Briggs' "Drugs in Pregnancy and Lactation" states that no congenital defects have been noted as a result of taking Colace, even during the first trimester.

    No undue effects have been reported in breastfeeding babies and it is not known whether it passes into breast milk.

    Colace should be given as a short-term remedy only and dietary advice given. The Food Standards Agency recommends a diet which includes adequate fluids and dietary fiber.

Side Effects

  • Side effects include stomach ache, abdominal cramps, nausea and loss of appetite.

    Oral preparations can cause throat irritation which can be avoided by mixing the solution in fruit juice.

    Rectal preparations can also cause local irritation.

    Allergy to ingredients can cause skin rash; the medication should be stopped immediately and a doctor consulted.

    Hypocalcaemia (low calcium) may occur, leading to muscle cramps, muscle weakness and dizziness.

Considerations

  • Prior to administering Colace, the nurse should make a full assessment of the patient to identify possible causes of constipation.

    WD.com recommends enquiry into: diet and lifestyle; duration of constipation and whether it is acute or chronic; all medications taken, whether prescribed over the counter or recreational; associated symptoms such as bleeding from the rectum, abdominal pain, vomiting.

    Physical exam should include examination of the abdomen and the rectum. An empty rectum may be a sign of bowel obstruction rather than simple constipation.

Administering Colace

  • Oral preparations of Colace should be administered on an empty stomach at least one hour apart from other medications, meals, milk and antacids. It may be given in juice to prevent possible throat irritation.

    Six to eight ounces or 180-240 ml of water should be taken with oral preparations. When administering rectal preparations, beware of forcing past impacted feces.

    Discontinue the medication at the first sign of nausea and vomiting, abdominal cramps or rectal bleeding.

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References

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