Actions of Concure in details
Laxative.
Pharmacology: Mechanism of Action: Two mechanisms are believed to be involved in the laxative action of Concure: First, metabolism of Concure by bacteria results in reduced colonic pH which stimulates peristalsis and decreases stool transit time. In turn, decreased water reabsorption from the feces further facilitates the passage of soft well-formed stools. Second, increased osmotic pressure of fecal material secondary to an increase in colonic organic acids results in accumulation of fluid from surrounding tissues, helping to soften stool mass.
The therapeutic action of Concure in ameliorating the symptoms of hepatic encephalopathy is considered to be a result of the following: Reduction of fecal pH leading to a reduced ammonia absorption via non-ionic diffusion and/or diffusion of ammonia from the blood into the gut. The trapped ammonia is then excreted in the stools; suppression of urase-producing organisms; induction of an osmotic type of diarrhea which diminishes fecal stasis with reduction of nitrogenous substances for ammonia production. Decreased absorption of ammonia from the gut also results from shortening intestinal transit time.
The actual mechanism may be a combination of these effects.
Pharmacokinetics: Absorption: Concure is poorly absorbed from the GIT and no enzyme capable of hydrolysis of this disaccharide is present in human GI tissue. As a result, oral doses of Concure reach the colon virtually unchanged.
Less than 2% of Concure is absorbed systematically. Absorption may be enhanced 4- to 6-fold by increasing the osmotic value of the intestinal contents.
Distribution: Concure given orally resulted in only small amounts reaching the blood.
Metabolism and Elimination: Following administration by mouth, Concure passes essentially unchanged into the large intestine where it is metabolized by saccharolytic bacteria with the formation of simple organic acids, mainly lactic acid and small amounts of acetic and formic acids. The small amount of absorbed Concure is subsequently excreted unchanged in the urine. Urinary excretion has been determined to be ≤3% and is essentially complete within 24 hrs.
How should I take Concure?
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.
Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
The liquid form of Concure may become slightly darker in color, but this is a harmless effect. However, do not use the medicine if it becomes very dark, or if it gets thicker or thinner in texture.
Concure (Concure) powder should be mixed with at least 4 ounces of water. You may also use fruit juice or milk to make the medication better.
It may take up to 48 hours before you have a bowel movement after taking this medicine.
If you use Concure over a long period of time, your doctor may want you to have occasional blood tests. Do not miss any scheduled appointments.
Store Concure at room temperature away from moisture and heat.
Concure administration
Oral solution: May mix with fruit juice, water or milk.
Crystals for oral solution: Dissolve contents of packet in 120 mL water.
Rectal: Dilute with 700 mL of water or NS; administer as retention enema using a rectal balloon catheter; retain for 30 to 60 minutes. May repeat enema immediately if inadvertently evacuated too promptly. Cleansing enemas containing soapsuds or other alkaline agents should not be used.
Concure pharmacology
Concure causes a decrease in blood ammonia concentration and reduces the degree of portal-systemic encephalopathy. These actions are considered to be results of the following:
- Bacterial degradation of Concure in the colon acidifies the colonic contents.
- This acidification of colonic contents results in the retention of ammonia in the colon as the ammonium ion. Since the colonic contents are then more acid than the blood, ammonia can be expected to migrate from the blood into the colon to form the ammonium ion.
- The acid colonic contents convert NH3 to the ammonium ion [NH4]+, trapping it and preventing its absorption.
- The laxative action of the metabolites of Concure then expels the trapped ammonium ion from the colon.
Experimental data indicate that Concure is poorly absorbed. Concure given orally to man and experimental animals resulted in only small amounts reaching the blood. Urinary excretion has been determined to be 3% or less and is essentially complete within 24 hours.
When incubated with extracts of human small intestinal mucosa, Concure was not hydrolyzed during a 24-hour period and did not inhibit the activity of these extracts on lactose. Concure reaches the colon essentially unchanged. There it is metabolized by bacteria with the formation of low molecular weight acids that acidify the colon contents.
References
- DailyMed. "LACTULOSE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- NCIt. "Lactulose: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
- EPA DSStox. "Lactulose: DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology.". https://comptox.epa.gov/dashboard/ds... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Concure are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Concure. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
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Information checked by Dr. Sachin Kumar, MD Pharmacology
