Therapeutic Classification: laxatives

Pharmacologic Classification: lubricant laxatives

• Used to soften impacted feces in the management of constipation.

• Coats surface of stool and intestine with lubricant film to allow passage of stool through intestine.
• Improves water retention of stool.

• Softening of fecal mass and subsequent passage.

Absorption: Minimally absorbed following oral administration.

Distribution: Distributes locally into the intestinal mucosa.

Metabolism/Excretion: Action is primarily local; unabsorbed mineral oil is passed with fecal mass.

Half-life: Not applicable.

(laxation)

Contraindicated in:

• Hypersensitivity
• Children <6 yr (oral)
• Children <2 yr (rect).

Use Cautiously in:

• Children or debilitated patients (increased risk of lipid pneumonia)
• OB: Chronic use during pregnancy decreases absorption of fat-soluble vitamins and may cause hypoprothrombinemia in newborn
• Geri: Appears on Beers list. ↑ risk of aspiration in older adults. Avoid use in older adults.

GI: diarrhea, anal irritation, rectal seepage of mineral oil.

Resp: lipid pneumonia.

Drug-Drug:

• ↓absorption of fat-soluble vitamins (A, D, E, and K).
• Concurrent use with stool softeners may increase absorption of mineral oil or produce more diarrhea.

Drug-Food:

• ↓absorption of fat-soluble vitamins (A, D, E, and K).

• PO (Adults and Children >12 yr): 5–45 mL as a single dose.
• PO (Children 6–12 yr): 5–15 mL as a single dose.
• Rect (Adults and Children >12 yr): 60–150 mL as a single dose.
• Rect (Children 2–11 yr): 30–60 mL as a single dose.

(Generic available)

• Liquid: 30-mL, 180-mL, pint, and gallon containers^OTC;
• Rectal enema: 480-mL containers^OTC;

• Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
• Assess color, consistency, and amount of stool produced.

• This medication does not stimulate intestinal peristalsis.
  • Administer carefully to bedridden patients or children to prevent lipid pneumonia from aspiration of mineral oil. Do not administer to patients in a reclining position.
• PO: Usually administered at bedtime. Do not administer within 2 hr of meals; may interfere with absorption of nutrients and vitamins.
  • Do not administer within 2 hr of stool softeners; may cause increased absorption of mineral oil.

• Advise patients that laxatives should be used only for short-term therapy. Long-term therapy may interfere with absorption of nutrients and vitamins A, D, E, and K.
• Advise patients not to take this medication within 2 hr of food or other medications.
• Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake, and increasing mobility. Normal bowel habits are variable and may vary from 3 times/day to 3 times/wk.
• Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver).
• Advise patients that large doses of mineral oil may cause leakage of mineral oil from the rectum; protection of clothing may be necessary. This may be prevented by reducing or dividing the dose or by administering in emulsified form.
• Advise patients not to use laxatives when abdominal pain, nausea, vomiting, or fever is present.

• Soft, formed bowel movement, usually within 6–8 hr of an oral dose.
  • Results are usually obtained from rectal doses in 2–15 min.

Fleet Oil, Milkinol

• Constipation (Indications).
• Deficient knowledge, Relate med (Patient/Family Teaching).