Chapter 41 - Bowel Disorders Med Cards

Question 1

Psyllium Mucilloid - Bulk-type Laxative

Answer 1

Action - swell and increase the size of the fecal mass, promoting the passage of stool

Uses - promote the passage of stool

Contraindications - undiagnosed abdominal pain, intestinal obstruction, fecal impaction

Adverse Effects - if taken with insufficient mount of water, psyllium may swell in the esophagus and cause an obstruction

Patient Teaching - Maintain adequate fluid consumption (16 oz at time of administration

• normal bowel movements doesn’t always occur daily
• do not use in the presence of abdominal pain, nausea, vomiting
• notify prescriber if constipation is unrelieved or if symptoms of electrolyte imbalance occur; muscle cramps, pain, weakness, dizziness, excessive thirst

*safest laxative used

Question 2

Diphenoxylate with Atropine - Antidiarrheal, Opioids

Answer 2

Action - slow peristalsis, allowing time for additional water reabsorption from the colon and more solid stools

Use - moderate to severe diarrhea

Contraindications - children under 2, allergy, pseudomembranous colitis, severe electrolyte imbalance, diarrhea associated with organisms that penetrate intestinal mucosa

Adverse Effects - dizziness, drowsiness, light headedness, headache, nausea, vomiting, dry mouth, epigastric distress

Patient Teaching - Avoid OTC products unless directed by prescriber

• Do not use alcohol or CNS depressants
• Do not exceed recommended dose
• Do not engage in hazardous activities due to drowsiness that may occur
• Product can be habit forming
• -constipation
• • combined with atropine (less desirable for opioid users/abusers)

Question 3

Sulfasalazine - GI Anti-inflammatory, Antirheumatic

Answer 3

Action - inhibit mediators of inflammation in the colon, such as prostaglandins and leukotrienes, making it an anti-inflammatory drug

Use - Treat IBD, Crohn’s disease, and RA

Contraindications - pregnancy at term, children under 2, allergy to sulfonamides and salicylates, intestinal or urinary obstruction, porphyria (disorder resulting from buildup of certain chemicals related to red blood cell proteins)

Adverse Effects - Nausea, vomiting, abdominal pain, Stevens-Johnsons syndrome, renal failure, allergic myocarditis, hepatitis, hepatotoxic, nephrotoxic

Patient teaching - Take each oral dose with full class of water to avoid crystalluria

• contact lenses, urine, skin may be yellow-orange
• avoid sunlight or use sunscreen to prevent burns
• Notify prescriber of skin rash, sore, unusual bruising or bleeding

Question 4

Prochlorperazine - Antiemetic, Antipsychotic

Answer 4

Action - block dopamine receptors in the brain, which inhibits signals to the vomiting center in the medulla

Use - Psychoses, but it is also the most frequently prescribed antiemetic for severe nausea and vomiting

Contraindications - Allergy to phenothiazines, coma, infants, neonates, children under 2 or under 20lbs., surgery

Adverse Effects - Dry mouth, Sedation (#1 Side Effect), constipation, orthostatic hypotension, and rebound tachycardia

Patient teaching - Avoid alcohol

• avoid hazardous activities due to drowsiness
• report dark urine, clay-colored stool, bleeding, bruising, rash, blurred vision
• avoid sun or wear sunscreen or protective clothing
• • CNS depressant
• avoid other CNS depressants
• can cause severe anxiety
• take 30 to 60 mins before anxiety events (surgery)

Question 5

Pancrelipase - Pancreatic enzyme, Digestant

Answer 5

Action - Pancreatic enzyme needed for the breakdown of substances released from the pancreas

Use - Replacement therapy for clients with sufficient pancreatic exocrine secretion, from pancreatitis and cystic fibrosis

Contraindications - allergy to pork

Adverse Effects - Nausea, vomiting, and/or diarrhea; very high doses can cause hyperuricosuria

Patient teaching - notify PCP of allergic reactions, abdominal pain, cramping or blood in urine

• always take with food or before meals; not to crush, chew del rel products, caps
• store in room temperature away from moisture