Mitrolan

[mi-trol´an] trademark for a preparation of calcium polycarbophil, a bulk laxative.

polycarbophil

(pol-i-kar-boe-fil) polycarbophil,

Bulk Forming Fiber Laxative

(trade name),

Equalactin

(trade name),

FiberCon

(trade name),

Fiber-Lax

(trade name),

Konsyl Fiber

(trade name),

Mitrolan

(trade name)

Classification

Therapeutic: antidiarrheals
Pharmacologic: bulk forming agents
Pregnancy Category: UK

Indications

Treatment of constipation or diarrhea that may be associated with diverticulosis or irritable bowel syndrome.

Action

Acts as a bulk laxative by keeping water within the bowel lumen.Acts as an antidiarrheal by taking on water within the bowel lumen to create a formed stool.

Therapeutic effects

Normalization of bowel water content while adding bulk, treating both diarrhea and constipation.

Pharmacokinetics

Absorption: Minimal systemic absorption.Distribution: Unknown.Metabolism and Excretion: Complex plus absorbed water are excreted in the feces.Half-life: Unknown.

Time/action profile (effect on bowel function)

ROUTE	ONSET	PEAK	DURATION
PO	12–24 hr†	unknown	unknown

†May take as long as 72 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Abdominal pain; Nausea or vomiting (especially when associated with fever or other signs of acute abdomen); Serious intra-abdominal adhesions; Dysphagia.Use Cautiously in: Pregnancy or lactation (has been used safely).

Adverse Reactions/Side Effects

Gastrointestinal

abdominal fullness

Interactions

Drug-Drug interaction

May decrease the absorption of concurrently administered tetracycline.

Route/Dosage

Oral (Adults) 1 g 1–4 times daily or as needed (not to exceed 6 g/24 hr); for severe diarrhea, may repeat q 30 min.Oral (Children 6–12 yr) 500 mg 1–3 times daily or as needed (not to exceed 3 g/24 hr); for severe diarrhea, may repeat q 30 min.Oral (Children 2–6 yr) 500 mg 1–2 times daily or as needed (not to exceed 1.5 g/24 hr); for severe diarrhea, may repeat q 30 min.

Availability (generic available)

Tablets: 500 mg^OTCChewable tabletsEqualactin—citrus flavor; Mitrolan—citrus-vanilla flavor: 500 mg^OTC, 1000 mgOTC

Nursing implications

Nursing assessment

Assess for fever, nausea, vomiting, abdominal distention, and pain. Notify health care professional if present. Auscultate bowel sounds. Inquire about patient’s usual diet, fluid intake, activity level, and bowel function.
- Monitor for color, consistency, and amount of stool produced.
Diarrhea: Monitor for signs of dehydration (decreased skin turgor, dry mucous membranes, weight loss, decreased urine output, tachycardia, and hypotension).

Potential Nursing Diagnoses

Constipation (Indications)
Diarrhea (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

Administer 1 hr before or 2 hr after tetracycline.
Diarrhea: For treatment of severe diarrhea, dose may be repeated every 30 min. Do not exceed total daily prescribed dose.
- Chewable tablets consume up to 60 times their weight in water.
Constipation: For treatment of constipation, administer with 8 oz water or juice.

Patient/Family Teaching

Encourage patients with constipation to use other forms of bowel regulation, such as increasing bulk in diet, fluid intake, and mobility. Normal bowel habits are individualized and may vary from 3 times/day to 3 times/wk.
Instruct patients with sudden onset of constipation to notify health care professional; medical evaluation may be necessary.
Instruct patients with diarrhea to notify health care professional if fever or bloody stools occur or if diarrhea persists or worsens. Discuss need for fluids and diet modifications during episodes of diarrhea.

Evaluation/Desired Outcomes

Soft, formed bowel movement. May require 3 days for therapeutic effect to occur.