Senna

A to Z Drug Facts

(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/Dosage

ADULTS: 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 Reactions

CV: Palpitations. CNS: Dizziness; fainting. GI: Excessive bowel activity (eg, griping, diarrhea, nausea, vomiting); perianal irritation; bloating; flatulence; abdominal cramping. OTHER: Sweating; weakness.

 Precautions

Pregnancy: 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.

 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.

 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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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts