Senna glycoside

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Senna glycoside
Sennoside.png
Clinical data
Trade names Ex-Lax, Senokot, others [1]
AHFS/Drugs.com Monograph
MedlinePlus a601112
License data
Pregnancy
category
Routes of
administration 		By mouth, rectal
ATC code
Legal status
Legal status
Pharmacokinetic data
Onset of action Minutes (by rectum), 6 to 12 hours (by mouth) [3]
Identifiers
  • 9-[2-carboxy-4-hydroxy-10-oxo-5-[3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-9H-anthracen-9-yl]-4-hydroxy-10-oxo-5-[3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-9H-anthracene-2-carboxylic acid
CAS Number
PubChem CID
DrugBank
ChemSpider
KEGG
Chemical and physical data
Formula C42H38O20 [4]
Molar mass 862.746 g·mol−1
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Senna glycoside, also known as sennoside or senna, is a medication used to treat constipation and empty the large intestine before surgery. [1] [5] The medication is taken by mouth or via the rectum. [1] [6] It typically begins working in around 30 minutes when given by rectum and within twelve hours when given by mouth. [3] It is a weaker laxative than bisacodyl and castor oil. [1]

Contents

Common side effects of senna glycoside include abdominal cramps. [3] It is not recommended for long-term use, as it may result in poor bowel function or electrolyte problems. [1] While no harm has been found to result from use while breastfeeding, such use is not typically recommended. [1] It is not typically recommended in children. [1] Senna may change urine to a somewhat reddish color. [1] Senna derivatives are a type of stimulant laxative and are of the anthraquinone type. [1] While its mechanism of action is not entirely clear, senna is thought to act by increasing fluid secretion within and contraction of the large intestine. [1]

Sennosides come from the group of plants Senna . [3] In plant form, it has been used at least since the 700s AD. [7] It is on the World Health Organization's List of Essential Medicines. [8] It is available as a generic medication. [1] [6] In 2021, it was the 270th most commonly prescribed medication in the United States, with more than 1 million prescriptions. [9] [10] In 2021, the combination with docusate was the 275th most commonly prescribed medication in the United States, with more than 800,000 prescriptions. [9] [11] It is sold under a number of brand names including Ex-Lax and Senokot. [1]

Medical uses

Senna is used for episodic and chronic constipation though there is a lack of high-quality evidence to support its use for these purposes. [5] It may also be used to aid in the evacuation of the bowel prior to surgery or invasive rectal or colonic examinations. [12] [13]

Administration

Oral senna products typically produce a bowel movement in 6 to 12 hours. Rectal suppositories can act within minutes or take up to two hours. [14]

Contraindications

According to Commission E, senna is contraindicated in cases of intestinal obstruction, acute intestinal inflammation (e.g., Crohn's disease), ulcerative colitis, appendicitis, and abdominal pain of unknown origin. [12]

Senna is considered contraindicated in people with a documented allergy to anthraquinones. Such allergies are rare and typically limited to dermatological reactions of redness and itching. [12]

Adverse effects

Adverse effects are typically limited to gastrointestinal reactions and include abdominal pain or cramps, diarrhea, nausea, and vomiting. [12]

Regular use of senna products can lead to a characteristic brown pigmentation of the internal colonic wall seen on colonoscopy. This abnormal pigmentation is known as melanosis coli. [14]

Interactions

Senna glycosides can increase digoxin toxicity in patients taking digoxin by reducing serum potassium levels, thereby enhancing the effects of digoxin. [15]

Mechanism of action

The breakdown products of senna act directly as irritants on the colonic wall to induce fluid secretion and colonic motility. [16]

Pharmacology

They are anthraquinones derivatives and dimeric glycosides. [17]

Society and culture

Formulations

Senna is an over-the-counter drug available in multiple formulations, including oral formations (liquid, tablet, granular) and rectal suppositories. Senna products are manufactured by multiple generic drug makers and sold under various brand names. [13]

Brand names

Ex-Lax, Geri-kot, Perdiem Overnight Relief, Senexon, Pursennid, Senna Smooth, Senna-Gen, Senna-GRX, Senna-Lax, Senna-Tabs, Senna-Time, SennaCon, Senno, Senokot. [12]

Related Research Articles

<span class="mw-page-title-main">Constipation</span> Bowel dysfunction

Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.

<span class="mw-page-title-main">Laxative</span> Agents that relax and loosen the bowels and stools

Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.

<span class="mw-page-title-main">Loperamide</span> Medicine used to reduce diarrhea

Loperamide, sold under the brand name Imodium, among others, is a medication of the opioid receptor agonist class used to decrease the frequency of diarrhea. It is often used for this purpose in irritable bowel syndrome, inflammatory bowel disease, short bowel syndrome Crohn's disease and ulcerative colitis. It is not recommended for those with blood in the stool, mucus in the stool, or fevers. The medication is taken by mouth.

Functional constipation, also known as chronic idiopathic constipation (CIC), is defined by less than three bowel movements per week, hard stools, severe straining, the sensation of anorectal blockage, the feeling of incomplete evacuation, and the need for manual maneuvers during feces, without organic abnormalities. Many illnesses, including endocrine, metabolic, neurological, mental, and gastrointestinal obstructions, can cause constipation as a secondary symptom. When there is no such cause, functional constipation is diagnosed.

<span class="mw-page-title-main">Mesalazine</span> Anti-inflammatory medication

Mesalazine, also known as mesalamine or 5-aminosalicylic acid (5-ASA), is a medication used to treat inflammatory bowel disease, including ulcerative colitis and Crohn's disease. It is generally used for mildly to moderately severe disease. It is taken by mouth or rectally. The formulations which are taken by mouth appear to be similarly-effective.

<span class="mw-page-title-main">Sulfasalazine</span> Chemical compound

Sulfasalazine, sold under the brand name Azulfidine among others, is a medication used to treat rheumatoid arthritis, ulcerative colitis, and Crohn's disease. It is considered by some to be a first-line treatment in rheumatoid arthritis. It is taken by mouth or can be administered rectally.

<span class="mw-page-title-main">Phytochemistry</span> Study of phytochemicals, which are chemicals derived from plants

Phytochemistry is the study of phytochemicals, which are chemicals derived from plants. Phytochemists strive to describe the structures of the large number of secondary metabolites found in plants, the functions of these compounds in human and plant biology, and the biosynthesis of these compounds. Plants synthesize phytochemicals for many reasons, including to protect themselves against insect attacks and plant diseases. The compounds found in plants are of many kinds, but most can be grouped into four major biosynthetic classes: alkaloids, phenylpropanoids, polyketides, and terpenoids.

<span class="mw-page-title-main">Lactulose</span> Treatment for constipation and hepatic encephalopathy

Lactulose is a non-absorbable sugar used in the treatment of constipation and hepatic encephalopathy. It is administered orally for constipation, and either orally or rectally for hepatic encephalopathy. It generally begins working after 8–12 hours, but may take up to 2 days to improve constipation.

Diphenoxylate/atropine, also known as co-phenotrope, is a combination of the medications diphenoxylate and atropine, used to treat diarrhea. It should not be used in those in whom Clostridioides difficile infection is a concern. It is taken by mouth. Onset is typically within an hour.

<span class="mw-page-title-main">Fecal impaction</span> Medical condition

A fecal impaction or an impacted bowel is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation. Fecal impaction is a common result of neurogenic bowel dysfunction and causes immense discomfort and pain. Its treatment includes laxatives, enemas, and pulsed irrigation evacuation (PIE) as well as digital removal. It is not a condition that resolves without direct treatment.

Proctitis or anusitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum.

The Bristol stool scale is a diagnostic medical tool designed to classify the form of human faeces into seven categories. It is used in both clinical and experimental fields.

<span class="mw-page-title-main">Bisacodyl</span> Laxative

Bisacodyl (INN) is an organic compound that is used as a stimulant laxative drug. It works directly on the colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic constipation and for the management of neurogenic bowel dysfunction, as well as part of bowel preparation before medical examinations, such as for a colonoscopy.

<span class="mw-page-title-main">Macrogol</span> Medication for constipation, classified as an osmotic laxative

Macrogol, also known as polyethylene glycol (PEG), is used as a medication to treat constipation in children and adults. It is taken by mouth. Benefits usually occur within three days. Generally it is only recommended for up to two weeks. It is also used as an excipient. It is also used to clear the bowels before a colonoscopy, when the onset of the laxative effect is more rapid, typically within an hour.

<span class="mw-page-title-main">Docusate</span> Laxatives/stool softeners

Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS).

<span class="mw-page-title-main">Prucalopride</span> Drug used to treat chronic constipation

Prucalopride, sold under brand names Resolor and Motegrity among others, is a medication acting as a selective, high affinity 5-HT4 receptor agonist which targets the impaired motility associated with chronic constipation, thus normalizing bowel movements. Prucalopride was approved for medical use in the European Union in 2009, in Canada in 2011, in Israel in 2014, and in the United States in December 2018. The drug has also been tested for the treatment of chronic intestinal pseudo-obstruction.

<span class="mw-page-title-main">Rectal administration</span> Delivery of medication via the rectum

Rectal administration uses the rectum as a route of administration for medication and other fluids, which are absorbed by the rectum's blood vessels, and flow into the body's circulatory system, which distributes the drug to the body's organs and bodily systems.

The Macy Catheter is a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route. The catheter was developed to make rectal access more practical and provide a way to deliver and retain liquid formulations in the distal rectum so that health practitioners can leverage the established benefits of rectal administration. Patients often need medication when the oral route is compromised, and the Macy Catheter provides an alternative for those medications that can be prescribed per rectum. The Macy Catheter is of particular relevance during the end of life, when it can help patients to remain comfortable in their home.

<span class="mw-page-title-main">Potassium chloride (medical use)</span> Electrolyte replenisher used to treat hypokalemia

Potassium chloride, also known as potassium salt, is used as a medication to treat and prevent low blood potassium. Low blood potassium may occur due to vomiting, diarrhea, or certain medications. The concentrated version should be diluted before use. It is given by slow injection into a vein or by mouth.

<span class="mw-page-title-main">Colonic ulcer</span> Medical condition

Colonic ulcer can occur at any age, in children however they are rare. Most common symptoms are abdominal pain and hematochezia.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 American Society of Health-System Pharmacists (1 January 2008). "Senna". Drugs.com. Archived from the original on 6 September 2015. Retrieved 11 August 2015.
  2. ↑ "Prescribing medicines in pregnancy database". Therapeutic Goods Administration (TGA). Australian Government, Department of Health and Aged Care.
  3. 1 2 3 4 Navti P (2010). Pharmacology for pharmacy and the health sciences : a patient-centred approach. Oxford: Oxford University Press. p. 337. ISBN   9780199559824. Archived from the original on 5 March 2016.
  4. ↑ "Senna(Powdered)". PubChem. U.S. National Library of Medicine.
  5. 1 2 Wald A (January 2016). "Constipation: Advances in Diagnosis and Treatment". JAMA (Review). 315 (2): 185–91. doi:10.1001/jama.2015.16994. PMID   26757467.
  6. 1 2 Hamilton RJ (2010). Tarascon pharmacopoeia (2010 ed.). Sudbury, Mass.: Jones and Bartlett. p. 181. ISBN   9780763777685. Archived from the original on 5 March 2016.
  7. ↑ Khare CP (2004). Indian Herbal Remedies Rational Western Therapy, Ayurvedic and Other Traditional Usage, Botany. Berlin, Heidelberg: Springer Berlin Heidelberg. p. 133. ISBN   9783642186592. Archived from the original on 5 March 2016.
  8. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl: 10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  9. 1 2 "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  10. ↑ "Sennosides - Drug Usage Statistics". ClinCalc. Archived from the original on 18 January 2024. Retrieved 14 January 2024.
  11. ↑ "Senna; Docusate - Drug Usage Statistics". ClinCalc. Archived from the original on 18 January 2024. Retrieved 14 January 2024.
  12. 1 2 3 4 5 Lexicomp Online, Lexi Drugs Online, Hudson, Ohio: Lexi-Comp, Inc.; 17 April 2014.
  13. 1 2 Drugs.com "Senna (Professional Patient Advice)". Archived from the original on 19 April 2014. Retrieved 17 April 2014.
  14. 1 2 McQuaid KR (2012). "Chapter 62. Drugs Used in the Treatment of Gastrointestinal Diseases.". In Katzung BG, Masters SB, Trevor AJ (eds.). Basic & Clinical Pharmacology (12th ed.). New York, NY: McGraw-Hill. Archived from the original on 19 April 2014. Retrieved 18 April 2014.
  15. ↑ "Senna: MedlinePlus Supplements". Archived from the original on 6 April 2015.
  16. ↑ Sharkey KA, Wallace JL (2011). "Chapter 46. Treatment of Disorders of Bowel Motility and Water Flux; Anti-Emetics; Agents Used in Biliary and Pancreatic Disease.". In Brunton LL, Chabner BA, Knollmann BC (eds.). Goodman & Gilman's The Pharmacological Basis of Therapeutics (12th ed.). New York, NY: McGraw-Hill. Archived from the original on 19 April 2014. Retrieved 18 April 2014.
  17. ↑ Franz G (October 1993). "The senna drug and its chemistry". Pharmacology. 47 (Suppl. 1): 2–6. doi:10.1159/000139654. PMID   8234429.
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