GeriPal has put together a taste test on "Liquid Bowel Medications" (see attached video) which was inspired from a great selection of comments from our previous posts on medications that should never be prescribed to hospice patients. We have a fine selection of medications including sorbitol, lactulose, and liquid (and crushed!) docusate.
The conclusions are pretty clear. First, one should never give liquid docusate (colace) by mouth. Second, one should never, never, never ever crush docusate and mix it with applesauce.
This really begs the question whether colace should be prescribed in the hospice setting or in frail elderly patients, as both groups are at risk for losing their ability to swallow large pills. There is also very little evidence that docusate works. In a 2008 nonrandomized cohort study done in hospitalized patients with cancer, a senna only protocol was more effective than a senna+colace protocol. Even though this study was small, with only 30 patients in each group, it should make us question the continued use of this medication.
* to view a higher quality video on youtube click here.
by: Eric Widera (@ewidera)
Comments
and thanks for getting this message out really loud and clear on FB too!
I enjoyed this(while I hated my colace testing on Palliative care in the last January!)
and thanks for getting this message out really loud and clear on FB too!
I enjoyed this(while I hated my colace testing on Palliative care in the last January!)
(PEG-3350 is not too bad, pretty neutral overall.)
Nelly
There is really no good reason to give a patient liquid colace. Just don't do it. Get this medicine off your hospital, hospice, and nursing home formularies.
Ummmm, chocolatey....