Rhubarb constipation

Calcium Acetate (PhosLo) [Calcium Supplement/ Anti arrhythmic/Mmeral/ Electrolyte] Uses ESRD-associated hyper-phos-phatemia Action Ca " supl w/o aluminum to X P04 absorption Dose 2-4 tabs PO w/ meals Caution [C, ] Contra t Ca Disp Gelcap SE Can t Ca, hypophosphatemia, constipation Interactions t Effects OF quinidine X effects W/ large intake of dietary fiber, spinach, rhubarb X effects OF atenolol, CCB, etidronate, tetracyclines, fluoroquinolones, phenytoin, Fe salts, thyroid hormones EMS Pts have reduced renal Fxn, monitor ECG for signs of electrolyte disturbances OD S/Sxs of hypercalcemia (confusion, weakness, GI upset, constipation, N, V, and cardiac arrhythmias) give IV fluid for diuresis symptomatic and supportive Calcium Carbonate (TumS/ Alka Mints) [Antacid/ Calcium Supplement/Mineral/ Electrolyte] [OTC] Uses Hyperacidity associated w/ peptic ulcer Dz, hiatal hernia, etc Action Neutralizes gastric acid Dose 500 mg—2 g PO PRN -1- in renal impair Caution [C, ] Disp Chew tabs, susp SE t -1- PO constipation Interactions X Effect OF tetracyclines, fluo-... 

Rhubarb is indicated in constipation, bowel movement relief with anal fissures, hemorrhoids, after recto-anal surgery and in preparation for diagnostic interventions of the gastrointestinal tract. 

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). 

In the late 18th century Britain made approaches to trade with China which were met with indifference it seems that the mandarins held the belief that the British feared death from constipation if deprived of rhubarb (Rheum palmatum), one of China s exports. 

Comment Once constipation has been relieved, the use of these pills should be stopped since it is not good to take Rhubarb habitually. 

If there is no constipation or there are loose stools, subtract Rhubarb. 

Chapman s Peziataltic Persuaders. Tako I drachm powdered rhubarb, 10 grains powdered ipecacuanha, and 10 drops oil of caraway. Make up with sufficient powdered acacia into 20 puls. Dose, 2 pills at bed-time, in obstmato constipation. 

Birch s Pills for Habitual Constipation. Take 4 drachm alcoholic extract of rhubarb, 24 gmns extract of taraxacum, and 2 grains sulphate of quinine. Mix together and make into 12 pills. One to bo t en either on rising in the moming or at dinner time, or even at both periods when the constipation is very obstinate. This is a very gentle stomachic and tonic evacuant, particularly useful for the delicate. 

S. A-G occur in the leaves and fruits of Cassia species (C. senna, C. angustifolia, Fabaceae) and in rhubarb roots, sometimes as oxalyl derivatives (senno-sides E, F). S. are mostly formed from the corresponding anthrone glycosides when the senna leaves are dried. Drugs containing S. are used in therapy for acute constipation (see table, p. 581). 

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