Hey all, welcome back to the Real Life Pharmacology podcast. I'm your host, pharmacist, Derek Christensen.

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pharmacology.com. All right, the drug of the day today is lactulose. Brand name is Enelos.

Jenerlack is another brand name I've heard utilized here.

So this is technically classified as an osmotic laxative.

So recall osmotic laxative.

They draw water into the gut or GI tract, basically.

And that extra water is going to stimulate peristolsus

and ultimately help with constipation management.

Now, in clinical practice, I rarely see it used for constipation.

We've got a lot of other meds that we utilize,

polyethylene glycol, stimulant laxatives,

you know, fiber supplements, and so on and so forth.

So with that, where you are most likely,

or where I most likely see this medication used,

is in people with hepatic failure, cirrhosis, things like that,

where ammonia levels or hepatic encephalopathy is present. So lactulose actually reduces ammonia levels.

This is kind of a toxic buildup in the blood that can cause

some CNS changes like confusion and stuff like that. So lactulose can be an important therapy in

reducing ammonia levels. Now, how does it do that in hepatic encephalopathy? So basically, lactulose is broken down by

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