Question

R.J is being seen in the clinic today for follow up. The nurse is taking a drug history and finds the patient has been taking sucralfate four times a day for the past 3 months, ondansetron as needed, and bisacodyl as needed.

1. What are the classifications and uses for the three drugs R.J. is taking?
2. What are the side effects/adverse reactions of sucralfate the nurse must know for sucralfate?
3. How can the nurse minimize the side effects/adverse reactions of sucralfate?
4. How does ondansetron work? How is it different from promethazine? How is it different from metoclopramide?
5. What are common side effects/adverse reactions of ondansetron?
6. What concerns would the nurse have with the patient taking bisacodyl too often?
7. What assessment will the nurse make to determine if the drugs had a therapeutic effect?

Answer 1

1- Sucralfate is in the class of medications called protectants.It sticks to damaged ulcer tissue and protects againist acid and enzymes so healing will happen.This is used to prevent and treat a number of disease in the gastrointestinal tract such as duodenal ulcer,GERD,gastritis,peptic ulcer disease, stress ulcer in addition to dispepsia.It is a cytoprotective agent,protecting the gastrointestinal tract from damage by gastric acid,bile ,alochol and aspirin.

Ondaseteron belongs to a class of drugs called serotonin 5-HT3 receptor antagonist.These drug are antiemetics,meaning they block nausea and vomitting.

Biscodyl is a class of medication called stimulant laxatives.It works by increasing activity of the intestines to cause a bowel movement.

2 - Common side effects of sucrafil are

• Constipation ,diarrhoea
• Nausea ,vomitting,upset stomach
• itching ,rash
• Dizziness,drowsiness
• Sleep problems
• Headache
• Back pain
• Dry mouth
• Indigestion

3 - there are some measures to be taken for reducing the side effects of sucrafil

For the best action it should take on an empty stomach,one hour before or two hours after each meal and at bedtime.Swallow the tablet whole,don not alter or chew.With the liquid ,shake the suspension well before measuring.Do not drink or eat for atleast one hour after taking medication.Ondaseteron is used

• Do not take if have any history of allergic reaction to sucralfate
• Do not take any antacids within in 30 minutes of sucralfate dose,
• Aliminium absorption is increased ,so caution must be taken when use in patients with chronic renal failure or undergoing dialysis.
• Always check for drug interactions
• In diabetic patients it will increase the blood sugar.

4- Ondaseteron is used to prevent nausea and vomotting.It is in the class of serotonin 5-HT3 receptor antagonist.It works by blocking the action of serotonin a natural substance that may cause nausea and vomitting.It works in the stomach to block the signals to brain that cause nausea and vomitting.

5- Promethazine is a phenothazine in the same class chlorpromazine and trifluoperazine.For tretament of vertigo promethazine is better and for nausea and vomitting ondasetron is good.If we are taking together it will increase the risk of an irregular heart rhytham that may be serious and potentially life threatening.There is no significant difference between two ondaseteron and metclopromide.Both are used to treat nausea and vomitting.

6- Common side effects of ondasetron include

• Headache
• Dizziness
• Drowsiness
• Tiredness
• Constipation

7-Frequent or continued use of bisacodyl may make the patient dependent on laxatives and cause the bowels to lose their normal activity.Do not take bisacodyl everyday for more than 5 days.Overdose symptoms may include diarrhoea,stomach cramps,muscles weakness or urinating less than usual. Nurse must watch for these symptoms and educate the patient regarding overdose.

8- Therapeutic effect refers to the response after a treatment of any kinds ,the results of which are judged to be useful or favorable.It can be identified by improving clinical sgns and symptoms.