Lactulose
Chemical
Non-absorbable synthetic, non digestible dissacharide
OSMOTIC LAXITIVE
Presentation
Tablets, syrup
Dose
30ml bd → qid for Hepatic Encephalopathy
Route
Oral
MoA
A synthetic sugar of Fructose & Galactose
In colon broken down by colonic bacteria to monosaccharides
This ↑osmotic pressure = ↑water retention in stool
Also draws NH3 out of body (same way it draws out H20)
PD
GI: ↑ water retention of stool
PK
A
Not absorbed/no human enzyme can hydrolyse
D
N/A
M
Metabolised by gut bacteria
Metabolites have osmotic & peristaltic effect
Metabolised completely (no lactulose in faeces)
E
Fecal
T1/2 = 2hrs
Adverse Effects
Diarrhoea
Bloating
Gas