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
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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 12 rounded tsp or 1 packet 13 times/d prn Child (<6 y): PO 1 tsp in water h.s.
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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: 1224 h.
Peak: 13 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 1224 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.