Generic Name:

psyllium
Brand Name:
(Fiberall, Hydrocil, Konsyl, Metamucil)
Drug Classification:
Bulkforming laxative
Dosage:
500 mg /cap
Indication: Diarrhea, chronic constipation
Mechanism of Action
Dissolves and swells in
water providing
increased bulk, moisture
content in
stool.
Therapeutic Effect:
Promotes
peristalsis, bowel motility.

Adverse Reaction
Esophageal/bowel
obstruction may occur If
administered
with
insufficient liquid
(less than 250 ml).

Contraindication
Fecal impaction, GI
obstruction, undiagnosed
abdominal
pain.

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

Nursing Considretaions
INTERVENTION/EVALUATION
Encourage adequate fluid intake.
Assess bowel sounds for
peristalsis. Monitor daily pattern
of bowel activity, stool
consistency.
Monitor serum electrolytes in
pts 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:
Brand Name:
Drug Classification:
Dosage:
Indication:

atropine
AtroPen Auto Injector, Atropine-Care, Isopto Atropine, Sal-Tropine
antispasmodic
0.25 mg/0.3 ml
Preop to inhibit salivation/secretions

Mechanism of
Action

Adverse Reaction

Contraindication

Competes with
acetylcholine for
common
binding sites on
muscarinic
receptors
located on smooth
muscle ganglia
Therapeutic Effect:
Decreases GI
motility, secretory
activity, GU muscle
tone (ureter, bladder

Overdose may produce

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

Bladder neck obstruction

due to prostatic hypertrophy,
cardiospasm,
intestinal atony, myasthenia
gravis
in those not treated with
neostigmine,
narrow-angle glaucoma,
obstructive disease
of GI tract, paralytic ileus,
severe
ulcerative colitis, tachycardia
secondary
to cardiac insufficiency or
thyrotoxicosis,
toxic megacolon, unstable
cardiovascular
status in acute hemorrhage,
hepatic
disease, bronchial asthma.

Generic Name:
Brand Name:
Drug Classification:
Dosage:

Side Effects

Dry mouth, nose, throat

(may be
severe); decreased
diaphoresis;
constipation;
irritation at
subcutaneous or IM
injection
site

cholestyramine
Novo-Cholamine , Prevalite, Questran, Questran Lite
Bile acid sequestrant
4 g 12 times a day

Nursing Considerations

Assess skin turgor,

mucous membranes to
evaluate hydration
status (encourage adequate
fluid
intake unless NPO for surgery),
bowel
sounds for peristalsis. Be alert
for fever (increased risk of
hyperthermia). Monitor
I&O, palpate bladder for urinary
retention.
Monitor daily pattern of bowel
activity, stool consistency.

Indication:

Mechanism of Action
Binds with bile acids in
intestine, forming
insoluble complex. Binding
results in
partial removal of bile acid
from enterohepatic
circulation.
Therapeutic Effect:
Removes LDL cholesterol
from plasma.

Generic Name:
Brand Name:
Drug Classification:
Dosage:
Indication:

Treatment of diarrhea (due to bile acids)

Adverse Reaction
GI tract obstruction,
hyperchloremic acidosis,
osteoporosis secondary to
calcium
excretion may occur. High
dosage may
interfere with fat absorption,
resulting in
steatorrhea.

Contraindication
Complete biliary obstruction,
hypersensitivity to
cholestyramine,
tartrazine (frequently seen in
aspirin hypersensitivity).

Side Effects
Constipation (may lead to
fecal
impaction), nausea,
vomiting, abdominal
pain, indigestion.

ranitidine
Apo-Ranitidine , Zantac,Zantac-75, Zantac-150, Zantac EFFERdose
Antiulcer
25 mg/ml.
Prevention of duodenal ulcer recurrence.

Nursing Considretaions
Monitor daily pattern of
bowel activity,
stool consistency. Evaluate
food tolerance,
abdominal discomfort,
flatulence. Monitor
cholesterol, triglycerides, PT,
hepatic enzymes,
CBC, serum electrolytes.
Encourage
several glasses of water
between meals.

Mechanism of
Action
Inhibits histamine
action at histamine
2 receptors of
gastric parietal cells.

Adverse Reaction

Contraindication

Reversible
hepatitis, blood
dyscrasias occur
rarely.

None known

Side Effects

Nursing Considerations
Question present abdominal pain, GI distress.

Diarrhea.

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

Generic Name:
Brand Name:
Drug Classification:
Dosage:

pantoprazole
Apo-Pantoprazole , Protonix, Protonix IV
Proton pump inhibitor
40 mg.

Indication:

treatment of hyper secretory conditions.

Mechanism of
Action
Irreversibly binds to,
inhibits hydrogenpotassium
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.

Adverse Reaction

Contraindication

Side Effects

Hyperglycemia
occurs rarely.

Hypersensitivity to
proton pump
inhibitors.

Diarrhea,
headache,
dizziness,
pruritus, rash.

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