Question

What are the Expected Pharmacological Action, Therapeutic Use, Complications, Contraindications/Precautions, Interactions, Evaluation of Medication Effectiveness, Medication Administration, Nursing Interventions, and client education of following medications below.

GI Medications:

1. aluminum hydroxide (Amphojel)

2. bisacodyl (Dulcolax)

3. cimetidine (Tagamet)

4. dicyclomine (Bentyl)

5. docusate sodium (Colace)

6. polyethylene glycol/electrolyte (Go-Lytely)

7. infliximab (Remicade)

8. lactulose (Enulose, Cholac, Constulose)

9. lanzoprazole (Prevacid)

Answer 1

1. ALUMINIUM HYDROXIDE

:- Pharmacological action : This is used as an antacid . The hydroxide reacts with excess acid in the stomach and thereby reducing its acidity.

:- Therapeutic use : It is used to treat heart burn , upset stomach , sour stomach , acid indigestion. It is also used to reduce phosphate levels in people with kidney disease.

:- Complications : constipation , stomach pain , loss of appetite , muscle weakness , bloody or tarry stools , pain while urinating

:- Contraindications : alkalosis , hypermagnesemia , severely debilitated patients or those with impaired renal function.

:- Interaction : This may reacting with phosphates to form insoluble aluminium phosphate , cause phoshorus deficiency in those patients whose diet is low in phosphorus. Antacids can interfere with the absorption of iron preparations , tetracyclines or other antibiotics.

:-- Evaluation of medication effectiveness : Decrease in gastric pain and irritation , increase in the pH of gastric secretions . In treatment of peptic ulcer , antacid therapy should be continued for atleast 4 - 6 week after symptoms have disappeared because there is no co- relation between disappearance of symptoms and healing of ulcers.

:- Medication administration : Thoroughly chew the tablet before swallowing , store between 15 - 30 °c in a tight container , follow well chewed tablet with one or half glass of water or milk , follow suspension with water to ensure passage into stomach .

:- Nursing interventions : Inform physician if epigastric or abdominal pain , monitor serum calcium and phosphorus levels with prolonged therapy or impaired renal function . Patient and family education , increase phosphorus in diet when taking large doses of antacids for prolonged periods , seek medical help if indigestion is accompanied by shortness of breath , sweating or chest pain , if stools are darknor tarry when taking this medication , check for number and consistency of stools , report if intestinal obstruction from faecal concretions .

:- Client education : Advise patient not to switch to another antacid without doctor's order., shake well or chew thoroughly and follow with sips of water or juice. , instruct the patient to restrict sodium diet , drink plenty of fluids , follow low -phosphate diet.