IBD drug therapy Flashcards
What does LORES stand for when considering a pt w/ IBD diet?
Limited fat 0 (zero) milk Red fresh fish/ground meat Eggs boiled Strained foods
If a pt. has severe s/s what should their nutritional therapy be?
NPO to promote bowel rest
If a pt is severely ill/malnourished or if needs to be NPO for >7days or is unable to eat what should be there nutritional therapy be?
TPN
If a pt has less severe s/s what should their nutritional therapy be?
Elemental formulas like Boost, absorbed in s.bowel and reduce bowel stimulation
If a pt has even less severe s/s but are still significant what should their nutritional therapy be?
Low residue diet {low fiber} (trial of removing lactose from diet bc often poorly tolerated)
What is the typical rate for TPN?
83.3
What are some important s/s of life-threatening fluid shifts that are essential to look out for in a pt on TPN?
Edema, crackles/rales
If TPN is temporarily not available what should you give until it is?
10% dextrose/water or 20% D/W
What is used to treat mild-to-moderate IBD?
Locally acting and systemic anti-inflammatory drugs
What is used to treat severe IBD?
Immunosuppressant drugs
What are the 2 used aminosalicylates?
Sulfonamides and/or nonsulfonamides
What are some commonly used sulfonamides?
Sulfasalazine or Olsalazine
What are some commonly used nonsulfonamides?
Asacol, Pentasa, Rowasa
What are some important nursing considerations when a pt is taking a aminosalicylates?
Give w/ food, adequate fluid intake, inform about possible changes in urine color and to notify doc, photosensitivity, monitor labs
Aminosalicylates are what that can cause the pt to have dark or orange urine, jaundice, tired, anorexia, light colored stools and labs can increase?
Hepatoxicity
What are the common corticosteroids used in IBD?
Prednisone or Methylprednisolone
What is the major concern w/ corticosteroids?
Osteoporosis
What are some important nursing considerations when a pt is taking corticosteroids?
Don’t stop abruptly, don’t take on empty stomach, monitor wts/glucose/electrolytes, warn about bruising easily and can mask/worsen infections, may need vitamin/calcium supplements
What do biologics/immunomodulators/immunosuppressents do?
Alter bodies immune response/allow for w/draw from corticosteroids
What are some common biologics drugs?
Mercaptopurine (6-MP), Imuran, Cyclophosphamide, remicade (Infliximab) or Certolizumab (Cimzia)
What are some important nursing implications for biologics?
Avoid crowds, monitor for bleeding/bruising/infection and monitor renal/hepatic function
What are common antibiotics prescribed for IBD?
Cipro or Flagyl
What are some other meds that can be prescribed?
Anti-diarrheals, laxatives, iron supplements, B12 shots, calcium/vitamin D
Important preop teaching?
Emotional prep, discuss managements of postop, description of external devices, preop bowel prep, intensive fluid/blood/protein replacement, continue corticosteroids via IV in postop, discontinue anticoagulants @ least 1wk before, low residue diet followed by clear liquid until NPO day of
