Docusate Sodium / Docusate Calcium
**Docusate** (available as sodium or calcium salts) is an emollient laxative and **surfactant stool softener**. * **Primary Use**: Administered to small animals to alleviate constipation, particularly when passing firm feces would be painful or detrimental (e.g., post-operative anorectal surgery, pelvic fractures). * **Equine Use**: Utilized alone or in combination with mineral oil to treat large colon fecal impactions in horses. * **Clinical Pearl**: Docusate does not significantly stimulate GI peristalsis; rather, it facilitates the softening of the fecal mass, making it easier to pass without straining.
Mecanismo: Docusate acts primarily as an **anionic surfactant** (detergent). * **Surface Tension Reduction**: It lowers the surface tension of the stool → allows water and dietary fats to penetrate the ingesta and formed feces → softens the fecal mass. * **Secretory Effect**: In vivo studies show docusate increases **cAMP** concentrations in colonic mucosal cells → stimulates **ion secretion** (such as chloride) and increases fluid permeability from these cells into the colon lumen → further hydrates the stool.
Dosificación por especie
- Constipation · 50 mg · PO · per day · Docusate Sodium
- Constipation · 5-10 mL of Colace · Enema · as needed · Docusate Sodium
- Constipation · 50 mg · PO · as needed · Docusate Sodium
- Constipation · 1-2 pediatric suppositories · PR · as needed · Docusate Sodium
- Constipation · 50 mg · PO · q12-24h · Docusate Sodium
- Constipation · 50 mg · PO · once daily · Docusate Calcium
- Large colon impaction (to soften) · 6-12 g/500 kg diluted in 2-4 liters of water · Nasogastric tube · q12-24h
- Constipation · 50-100 mg (total dose) · PO · q12-24h · Docusate Sodium
- Constipation · 25 mg · PO · once to twice daily · Docusate Sodium; Small Dogs
- Constipation · 50 mg · PO · once to twice daily · Docusate Sodium; Medium/large Dogs
- Constipation · Two to three 50 mg capsules or one 240 mg capsule · PO · once daily · Docusate Calcium
Vías de administración
Contraindicaciones
- Pre-existing fluid or electrolyte abnormalities (use with caution)
Efectos adversos
- Cramping
- Diarrhea
- Intestinal mucosal damage (especially at high doses)
- Throat irritation (liquid preparations)
- Bitter taste (can cause hypersalivation/foaming in cats)
Interacciones farmacológicas
- Mineral Oil · Theoretically enhances absorption of mineral oil. Not a significant concern in large animals, but concurrent use in dogs/cats is not recommended. If both are necessary in small animals, separate doses by at least 2 hours. · major
Monitoreo
- Clinical efficacy (resolution of constipation/impaction)
- Hydration status
- Electrolyte status (if indicated or in high doses)
Sobredosis
In **horses**, single doses of 0.65-1 g/kg have caused dehydration, intestinal mucosal damage, and death. Maximum therapeutic dosages of up to 0.2 g/kg have been reported. * **Clinical Signs (Horses)**: Begin 1-2 hours after dosing. Initial signs include restlessness and increased intestinal sounds, followed by increased respiratory and cardiac rates. Abdominal pain, watery diarrhea, and dehydration can occur, deteriorating over hours to days to lateral recumbency and death. * **Treatment**: Supportive care. Because of the secretory effects of high doses, hydration and electrolyte status must be monitored and corrected. GI protectants, bicarbonate, corticosteroids, and antiendotoxemic agents (NSAIDs) have been suggested as potentially helpful.
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