Stoma Care Flashcards
What formulations are not suitable for stoma pts? Soluble tabs Liquids Uncoated Capsules Enteric coated Modified release
EC and MR as there may be insufficient release of drug. When a solid dosage form is given the contents of the bag should be checked formant remnants. Preparations containing sorbitol should be avoided as it is a laxative.
What analgesics are most appropriate?
Paracetamol, opioids should be avoided due to constipation, nsaid avoided as may cause GI irritation and bleeding, faecal output should be monitored for blood.
What is the purpose of antisecretory drugs (PPIs, somatostatin analogues) in stoma pts?
Gastric acid secretions can increase stoma output, by reducing gastric acid secretions stoma output is also reduced
What differences are there in diarrhoea treatment for a normal pt and a stoma pt?
Higher doses of loperamide may be required as loperamide circulates through the enterohepatic circulation which is disrupted in stoma pt, codeine phiosphate may also be used if loperamide alone is not adequate. Loperamide and codeine also decrease water and sodium output from an ileostomy.
What cautions should you take in pts taking digoxin?
Particularly susceptible to hypokalaemia if taking digoxin, due to sodium and fluid depletion. Potassium supps or potassium sparing diuretic may be required and monitoring for early signs of toxicity- liquid formulations are preferred to MR, daily dose should be split to avoid osmotic diarrhoea.
What diuretic is recommended in these pts?
Potassium sparing diuretics as pts are susceptible to dehydration and potassium depletion can easily occur,.
Some pts can suffer from iron related anaemia, in this case what iron preparations are recommended?
IM preparations as normal preparations can cause loose stools and sore skin.
What are the recommendations for laxative use?
Avoid if possible as can cause rapid water and electrolyte losses. Treatment with adequate fluid intake and a high fibre is recommended, bulk formers can be tried, if not helping a small dose of stimulatn can be used with caution.
