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This page was prepared by Lynn Kash, RN, Internet Nursing Guide
Pennsylvania Nurses,Emergency Department
http://www.nursefriendly.com/kash/

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Lactulose, Fruit-eze.com:"Lactulose, a disaccharide, is a sugar like Hyperosmotic Laxative. Lactulose produces an osmotic effect in the colon as bacterial flora breaks down the lactose into lactic, formic and acetic acids. Fluids that accumulate distend the abdomen, promoting peristalsis and bowel evacuation. Lactulose produces results much more slowly than the saline type of hyperosmotic and has been used for long-term treatment of chronic constipation. Evacuation is watery. Results usually occur in 24-48 hours lasting no longer than 24 hours."
http://www.fruit-eze.com/ingredients/lactulose.html

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Cronulac Syrup, Why is this drug prescribed, Health Square:"Chronulac treats constipation. In people who are chronically constipated, Chronulac increases the number and frequency of bowel movements."
http://www.healthsquare.com/newrx/chr1081.htm

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Lactulose, Description, Medizine:"This is an effective laxative that softens stools by increasing the amount of water in the large intestine. It is useful for the relief of constipation and faecal impaction, especially in the elderly and is less likely to disrupt normal bowel action than some other types of laxatives. Lactulose can also prevent and treat the brain disturbance associated with liver failure known as hepatic encephalopathy. Because the drug acts locally in the large intestine and is not absorbed into the body it is safer than many other laxatives. However, it can cause stomach cramps and flatulence at the start of treatment."
http://www.cix.co.uk/~cyberville/medizine/lactulos.htm

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Lactulose, Why is this medication prescribed, MEDLINEplusLactulose is a synthetic sugar used to treat constipation. It is broken down in the colon into products that pull water out from the body and into the colon. This water softens stools. Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body."
:"http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682338.html

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Lactulose, Action/kinetics, NursesPDR:"A disaccharide containing both lactose and galactose; causes a decrease in the blood concentration of ammonia in clients suffering from portal-systemic encephalopathy. Due to bacteria-induced degradation of lactulose in the colon, resulting in an acid medium. Ammonia will then migrate from the blood to the colon to form ammonium ion, which is trapped and cannot be absorbed. A laxative action due to increased osmotic pressure from lactic, formic, and acetic acids then expels the trapped ammonium. The decrease in blood ammonia concentration improves the mental state, EEG tracing, and diet protein tolerance of clients. The increased osmotic pressure also results in a laxative effect, which may take up to 24 hr. Partly absorbed from the GI tract."
http://www.nursespdr.com/members/database/ndrhtml/lactulose.html

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Lactulose, Clinical Pharmacology, RXlist:"KRISTALOSE™ (Lactulose) is poorly absorbed from the gastrointestinal tract and no enzyme capable of hydrolysis of this disaccharide is present in human gastrointestinal tissue. As a result, oral doses of lactulose reach the colon virtually unchanged. In the colon, lactulose is broken down primarily to lactic acid, and also to small amounts of formic and acetic acids, by the action of colonic bacteria, which results in an increase in osmotic pressure and slight acidification of the colonic contents. This in turn causes an increase in stool water content and softens the stool."
http://www.rxlist.com/cgi/generic2/lactulose_cp.htm

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Lactulose, What is lactulose, West Shore Endoscopy Center:"Lactulose is a sugar which is not metabolized and absorbed by the body. Rather, the bacteria in the colon or large bowel break this sugar down into acids. These acids, in turn, pull water into the colon and soften the stool. Another thing that happens is that ammonia then moves from the blood into the colon. In patients with cirrhosis of the liver, it lowers ammonia in the blood and thereby reduces the mental changes of sluggishness, confusion and mental wandering."
http://www.endowsec.com/pated/lactulose.htm

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Lactulose, Range and Frequency, Whole Health Md:"For constipation: 15 to 30 ml once a day. The dose may be increased to 60 ml once a day, if needed. For severe liver disease: 30 to 45 ml, 3 or 4 times a day until 2 or 3 soft stools are produced daily."
http://www.wholehealthmd.com/refshelf/drugs_view/1,1524,352,00.html

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