Laxative cascara sagrada

Cascara sagrada is used as a cathartic. It is most useful when prepared as a fluid extract, and tends to be a mild laxative causing Htfle discomfort. However, on prolonged use it may result in characteristic melanotic pigmentation of the rectal mucosa. The bitter taste can be lessened, owing to neutralization of the acid constituents, if the ground substance is moistened and mixed with magnesium or calcium hydroxide. This treatment may lessen the potency of the preparation. 

Irritant or stimulant laxatives increase peristalsis by direct action on the intestine. An example of an irritant laxative is cascara sagrada and senna (Senokot). 

The answer is c. (Hardman, p 924.) Dioctyl sodium sulfosuccinate (docusate) is a detergent that, when given orally, softens the stool and prevents straining. Mineral oil also softens the stool, but it tends to inhibit the absorption of fat-soluble vitamins and other nutrients. Castor oil, phenol-phthalein, and cascara sagrada are strong laxatives and cause watery stools... 

Cascara Sagrada [Rhamnus purshiana) Uses Laxative Action Stimulates large intestine, T bowel motility propulsion Available forms Liq extract 1-5 mL PO OD Contra w/ PRG, lactation IBD Notes/SE N/V, abd cramps, urine discoloration, osteomalacia Interactions t Effects OF antiarrhyth-mics, cardiac glycosides T loss W/ diuretics, corticosteroids, cardiac glycosides effects W/ antacids, milk EMS Short-term use monitor ECG for hypokalemia (flattened T waves) d/t D caution w/ diuretics... 

Anthraquinone derivatives (e.g., cascara, aloe, senna, and rhubarb) are among the oldest laxatives known. They act on the colon rather than on the ileum and produce evacuation 8 to 10 hours after administration. This makes them particularly suitable for dosage overnight. Cascara sagrada is one of the mildest of the anthraquinone-containing laxatives. 

Long-term use of stimulant laxatives bisacodyl (Dulcolax), cascara sagrada, and Neoloid except in the presence of opiate analgesic use May exacerbate bowel dysfunction. High... 

Cascara sagrada was used as a laxative in the past and continues to be used for the same purpose today. 

Aloe-emodin, found in cascara sagrada, is being researched as a possible treatment for leukemia. This herb, which has had a place in the U.S. Pharmacopoeia since 1890, is one of the most popular herbal medicines in the world. It is included in many over-the-counter laxatives and is prescribed more than 2.5 million times a year. The bark must be dried for up to 1 year before it can be used officially as a laxative. 

Irritant agents used in the treatment of constipation include cascara sagrada, castor oil, senna, rhubarb, phenolphthalein, and acetphenolisatin. Phenolphthalein is a constituent of many over-the-counter preparations, including Corrected , Ex-Lax , and Feen-A-Mint . Most of these agents, with the exception of castor oil, are slow in their onset of action (24 h). 

LAXATIVES Gently loosen the bowels.—Cascara Sagrada, Dandelion, Feverfew, Golden Seal, Mountain Flax, Psyllium, Senna, Turkey Rhubarb. 

Cascara sagrada Laxative Rhamnus purshiana Cascara sagrada... 

The Food and Drug Administration (FDA) has mled that the stimulant laxatives aloe (including aloe extract and aloe flower extract) and cascara sagrada (including casanthranol, cascara fluidextract aromatic, cascara sagrada bark, cascara sagrada extract, and cascara sagrada fluid extract) in over-the-counter formulations are not safe and effective or are misbranded (9). 

The bark of Rhamnus purshiana (cascara sagrada) contains laxative anthranoid derivatives, which occur primarily in various laxative herbs (such as aloe, cascara sagrada. 

C Calcium and iron supplementation are common causes of constipation. Polycarbophil, a bulk-forming laxative, exerts its therapeutic effect by increasing the mass and water content of stool and by speeding transit time in the colon. Cascara sagrada and sennosides are cathartics, which speed colonic transit time and alter water and electrolyte transport across the colonic mucosa. Sodium biphosphonate is a saline cathartic, which increases intestinal peristalsis by osmotic properties. Docusate sodium is a stool... 

Cassia acutfolia (Senna) and Rhamnus purshiana (cascara sagrada), which are used as laxatives ... 

CASCARA, Rhamni purshiani cortex Cascara bark is more widely used than Frangula as a laxative in the USA since the trees of Rhamnus purshianus DC, family Rhamnaceae, are cultivated in Northwestern USA and Canada. Cascara has also been known as Cascara Sagrada from the Spanish name for sacred bark. Like the closely related Frangula bark, fresh Cascara bark contains reduced emodin-based glycosides. In order to convert these to milder oxidised forms the bark must either be stored for 1 year or heat treated. 

Cascara sagrada, the dried bark of Rhamnus purshiana, was first used in conventional American medicine in 1877, after being introduced as a laxative by Mexican and Spanish priests in California. A European counterpart (European buckthorn R frangula) was described by the Anglo-Saxons, and the berries were included in the 1650 London Pharmacopoeia (Anonymous, 1996). 

Cascara sagrada is a nonprescription laxative. Since the removal of phenolphthalein from the US market in 1998, it has replaced phenolphthalein in several laxative products. 

Ex-Lax, Feen-A-Mint, Correctol), bisacodyl (Dulcolax), cascara sagrada, senna (Senokot), and castor oil (purgative). Bisacodyl and phenolphthalein are two of the most frequently used and abused laxatives because they can be purchased over-the-counter. 

Concomitant internal use of cascara sagrada is cautioned with thiazide diuretics, corticosteroids, and licorice, and long-term use of cascara sagrada as a laxative may increase the potassium loss induced by these drugs and botanicals (Drinker 2001 ESCOP 2003 Mills and Bone 2005). 

Use of stimulant laxatives, such as cascara sagrada, may reduce the gastrointestinal transit time and thus reduce the absorption of orally administered drugs (Drinker 2001 Mills and Bone 2005). 

Anthraquinone glycosides have long been used medicinally as cathartics and laxatives. Plant-derived drugs of this type include aloes Aloe species), cascara sagrada (Rhamnus purshiams), frangula (Rhamnus frangula), rhubarb (Rheum officinale), rumex or yellow dock (Rumex crispus) and senna (Cassia spp.). Many of the commercial preparations (patent medicines) based on these plants are readily available. 

Regulatory Status. Allowed as a natural flavoring substance at subtherapeutic levels ( 172.510). In 2002, the U.S. FDA. ruled that in over-the-counter products cascara sagrada is not GRAS and effective. Bark subject of a German therapeutic monograph allowed for short-term use in laxative formulations only sold in pharmacies (blumenthal 1 wichtl). 

---