PSYLLIUM HYDROPHILIC MUCILLOID

(sill'i-um)

Hydrocil, Instant, Karasil

, Konsyl, Metamucil, Modane Bulk, Perdiem Plain, Reguloid, Serutan, Siblin, Syllact, V-Lax
Classifications: bulk laxative;
Therapeutic: bulk laxative
Pregnancy Category: C

Availability

3.4 g/dose powder; 2.5 g, 3.4 g, 4.03 g/teaspoon granules

Action

Bulk-producing laxative that promotes peristalsis and natural elimination. Highly refined colloid of psyllium seed. Absorbs liquid in the GI tract, resulting in an alteration in facilitating peristalsis and bowel motility.

Therapeutic Effect

Bulk-producing laxative that promotes peristalsis and natural elimination.

Uses

Chronic atonic or spastic constipation and constipation associated with rectal disorders or anorectal surgery.

Contraindications

Esophageal and intestinal obstruction, dysphagia; nausea, vomiting, fecal impaction, acute abdomen; undiagnosed abdominal pain, appendicitis; pregnancy (category C), children <6 y.

Cautious Use

Diabetics; pregnancy (category C), lactation.

Route & Dosage

Constipation or Diarrhea
Adult: PO 1–2 rounded tsp or 1 packet 1–3 times/d prn
Child (<6 y): PO 1 tsp in water h.s.

Administration

Oral

Fill an 8-oz (240-mL) water glass with cool water, milk, fruit juice, or other liquid; sprinkle powder into liquid; stir briskly; and give immediately (if effervescent form is used, add liquid to powder). Granules should not be chewed.
Follow each dose with an additional glass of liquid to obtain best results.
Exercise caution with older adult patient who may aspirate the drug.

Adverse Effects (≥1%)

Hematologic: Eosinophilia. GI: Nausea and vomiting, diarrhea (with excessive use); GI tract strictures when drug used in dry form, abdominal cramps.

Interactions

Drug: Psyllium may decrease absorption and clinical effects of antibiotics, warfarin, digoxin, nitrofurantoin, salicylates.

Pharmacokinetics

Absorption: Not absorbed from GI tract. Onset: 12–24 h. Peak: 1–3 d.

Nursing Implications

Assessment & Drug Effects

Report promptly to physician if patient complains of retrosternal pain after taking the drug. Drug may be lodged as a gelatinous mass (because of poor mixing) in the esophagus.
Monitor therapeutic effectiveness. When psyllium is used as either a bulk laxative or to treat diarrhea, the expected effect is formed stools. Laxative effect usually occurs within 12–24 h. Administration for 2 or 3 d may be needed to establish regularity.
Assess for complaints of abdominal fullness. Smaller, more frequent doses spaced throughout the day may be indicated to relieve discomfort of abdominal fullness.
Monitor warfarin and digoxin levels closely if either is given concurrently.

Patient & Family Education

Note sugar and sodium content of preparation if on low-sodium or low-calorie diet. Some preparations contain natural sugars, whereas others contain artificial sweeteners.
Understand that drug works to relieve both diarrhea and constipation by restoring a more normal moisture level to stool.
Be aware that drug may reduce appetite if it is taken before meals.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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