Generic Name: psylliumBrand Name: (Fiberall, Hydrocil, Konsyl, Metamucil)Drug Classification: Bulkforming laxativeDosage: 500 mg /capIndication: Diarrhea, chronic constipation

Mechanism of Action Adverse Reaction Contraindication Side Effects Nursing Considretaions

Dissolves and swells in water providingincreased bulk, moisture content instool.

Therapeutic Effect: Promotesperistalsis, bowel motility.

Esophageal/bowel obstruction may occur If administered with insufficient liquid

(less than 250 ml).

Fecal impaction, GI

obstruction, undiagnosed abdominal

pain.

Some degree of abdominal discomfort,nausea, mild abdominal cramps,Griping, faintness.

INTERVENTION/EVALUATIONEncourage adequate fluid intake. Assess bowel sounds for peristalsis. Monitor daily pattern of bowel activity, stool consistency.Monitor serum electrolytes inpts exposed to prolonged, frequent, excessive use of medication.PATIENT/FAMILY TEACHING• Take each dose with full glass (250 ml) of water. • Inadequate fluid intake may cause GI obstruction. • Institute measures to promote defecation (increase fluid intake, exercise, and high-fiber diet).

Generic Name: atropineBrand Name: AtroPen Auto Injector, Atropine-Care, Isopto Atropine, Sal-TropineDrug Classification: antispasmodicDosage: 0.25 mg/0.3 mlIndication: Preop to inhibit salivation/secretions

Mechanism of Action

Adverse Reaction Contraindication Side Effects Nursing Considerations

Competes with acetylcholine for commonbinding sites on muscarinic receptorslocated on smooth muscle ganglia

Therapeutic Effect: Decreases GImotility, secretory activity, GU muscletone (ureter, bladder

Overdose may produce tachycardia, palpitations,hot/dry/flushed skin, absenceof bowel sounds, increased respiratoryrate, nausea, vomiting, confusion, drowsiness,slurred speech, dizziness, CNS stimulation. Overdose may also producepsychosis as evidenced by agitation, restlessness,rambling speech, visual hallucinations,paranoid behavior, delusions,followed by depression.

Bladder neck obstructiondue to prostatic hypertrophy, cardiospasm,intestinal atony, myasthenia gravisin those not treated with neostigmine,narrow-angle glaucoma, obstructive diseaseof GI tract, paralytic ileus, severeulcerative colitis, tachycardia secondaryto cardiac insufficiency or thyrotoxicosis,toxic megacolon, unstable cardiovascularstatus in acute hemorrhage, hepaticdisease, bronchial asthma.

Dry mouth, nose, throat (may besevere); decreased diaphoresis; constipation;irritation at subcutaneous or IM injectionsite

Assess skin turgor,mucous membranes to evaluate hydrationstatus (encourage adequate fluidintake unless NPO for surgery), bowelsounds for peristalsis. Be alert for fever (increased risk of hyperthermia). MonitorI&O, palpate bladder for urinary retention.Monitor daily pattern of bowel

activity, stool consistency.

Generic Name: cholestyramineBrand Name: Novo-Cholamine , Prevalite, Questran, Questran LiteDrug Classification: Bile acid sequestrantDosage: 4 g 1–2 times a dayIndication: Treatment of diarrhea (due to bile acids)

Mechanism of Action Adverse Reaction Contraindication Side Effects Nursing Considretaions

Binds with bile acids in intestine, forminginsoluble complex. Binding results inpartial removal of bile acid from enterohepaticcirculation.

Therapeutic Effect:Removes LDL cholesterol from plasma.

GI tract obstruction, hyperchloremic acidosis,osteoporosis secondary to calciumexcretion may occur. High dosage mayinterfere with fat absorption, resulting insteatorrhea.

Complete biliary obstruction,hypersensitivity to cholestyramine,tartrazine (frequently seen inaspirin hypersensitivity).

Constipation (may lead to fecalimpaction), nausea, vomiting, abdominalpain, indigestion.

Monitor daily pattern of bowel activity,stool consistency. Evaluate food tolerance,abdominal discomfort, flatulence. Monitorcholesterol, triglycerides, PT, hepatic enzymes,CBC, serum electrolytes. Encourageseveral glasses of water between meals.

Generic Name: ranitidineBrand Name: Apo-Ranitidine , Zantac,Zantac-75, Zantac-150, Zantac EFFERdoseDrug Classification: AntiulcerDosage: 25 mg/ml.Indication: Prevention of duodenal ulcer recurrence.

Mechanism of Action

Adverse Reaction Contraindication Side Effects Nursing Considerations

Inhibits histamine action at histamine2 receptors of gastric parietal cells.

Therapeutic Effect: Inhibits gastricacid secretion (fasting, nocturnal, when stimulated by food, caffeine, insulin).Reduces volume, hydrogen ion concentration of gastric juice.

Reversible hepatitis, blood dyscrasias occur rarely.

None known Diarrhea.

Question present abdominal pain, GI distress.

Generic Name: pantoprazoleBrand Name: Apo-Pantoprazole , Protonix, Protonix IVDrug Classification: Proton pump inhibitorDosage: 40 mg.

Indication: treatment of hyper secretory conditions.

Mechanism of Action

Adverse Reaction Contraindication Side Effects Nursing Considerations

Irreversibly binds to, inhibits hydrogen-potassium adenosine triphosphate, an enzyme on surface of gastric parietal cells. Inhibits hydrogen ion transport into gastric lumen. Therapeutic Effect:Increases gastric pH, reduces gastric acid production.

Hyperglycemia occurs rarely.

Hypersensitivity to proton pump inhibitors.

Diarrhea, headache, dizziness, pruritus, rash.

Evaluate for therapeutic response (relief of GI symptoms). Question if GI discomfort, nausea occur.