Senna
| (SEN-ah) |
Agoral, Black-Draught, ex•lax, ex•lax chocolated, Fletcher Castoria, Senexon, Senna-Gen, Senokot, SenokotXTRA,  Glysennid, Mucinum Herbal |
| Class: Laxative |
Action Directly acts on intestinal mucosa by altering water and electrolyte secretion, inducing peristalsis and defecation.
Indications Short-term treatment of constipation; preoperative and preradiographic bowel evacuation for procedures involving GI tract.
Contraindications Nausea, vomiting or other symptoms of appendicitis; acute surgical abdomen; fecal impaction; intestinal obstruction; undiagnosed abdominal pain.
Route/DosageADULTS: PO 2 tablets, 1 tsp of granules or 10 to 15 ml of syrup, usually at bedtime. PR 1 suppository at bedtime; may repeat in 2 hr. CHILDREN: Generally, for children 6 to 12 yr or > 60 lb, give (at bedtime) 1 tablet or ½ tsp granules PO or ½ suppository PR. Liquid dose ranges from 1.25 to 15 ml depending on age and product formulation.
Interactions None well documented.
Lab Test Interferences None well documented.
Adverse ReactionsCV: Palpitations. CNS: Dizziness; fainting. GI: Excessive bowel activity (eg, griping, diarrhea, nausea, vomiting); perianal irritation; bloating; flatulence; abdominal cramping. OTHER: Sweating; weakness.
PrecautionsPregnancy: Category C. Lactation: Undetermined. Abuse/dependency: Long-term use may lead to laxative dependency, which may result in fluid and electrolyte imbalances, steatorrhea, osteomalacia and vitamin and mineral deficiencies. Cathartic colon, a poorly functioning colon, results from long-term abuse. Pathologic presentation may resemble ulcerative colitis. Discoloration of acidic urine: May result in yellow-brown urine. Discoloration of alkaline urine: May result in pink to red urine. Fluid and electrolyte imbalance: Excessive laxative use may lead to significant fluid and electrolyte imbalance. Melanosis Coli: Darkened pigmentation of colonic mucosa may occur after long-term use, usually resolving within 5 to 11 months of discontinuation. Rectal bleeding or failure to respond: May indicate serious condition requiring further attention.
| PATIENT CARE CONSIDERATIONS |
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Administration/Storage- Administer at bedtime on empty stomach.
- Shake liquid solution before administering.
- Dissolve granules before administering.
- For preoperative or prediagnostic bowel preparation, give between 2 to 4 PM on day before procedure.
- Limit patient’s diet to clear liquids until after procedure.
- Give oral dosages with full glass of water or juice.
- Administer suppository with patient lying on left side.
Assessment/Interventions- Obtain patient history, including drug history and any known allergies.
- Assess bowel function, including normal frequency, type, last bowel movement, bowel sounds, abdominal distention.
- Assess for presence of abdominal pain, nausea, vomiting.
- Assess for fluid and electrolyte imbalance associated with long-term laxative use.
- Identify factors potentially contributing to constipation (ie, opioid analgesics), inactivity.
- Monitor effectiveness of therapy.
- Implement measures to prevent constipation, ie, fluids, activity, dietary bulk.
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Patient/Family Education- Explain potential hazards (eg, dependence) associated with long-term laxative use.
- Advise that senna may result in discolored yellow-brown or reddish urine.
- Explain that bowel patterns are very individual.
- Identify measures to improve bowel function, ie, fluids, activity, dietary bulk.
- Caution against taking laxatives in presence of acute abdominal pain or in presence of nausea or vomiting.
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