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7 Cards in this Set
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clonazepam
Klonopin, Rivotril, Syn-Clonazepam CLASSIFICATION(S) Therapeutic: anticonvulsants Pharmacologic: benzodiazepines Schedule IV Pregnancy Category C ACTION • Anticonvulsant effects may be due to presynaptic inhibition • Produces sedative effects in the CNS, probably by stimulating inhibitory GABA receptors • Therapeutic Effects: ○ Prevention of seizures ○ Decreased manifestations of panic disorder PHARMACOKINETICS Absorption: Well absorbed from the GI tract Distribution: Probably crosses the blood-brain barrier and the placenta Metabolism and Excretion: Mostly metabolized by the liver Half-life: 18-50 hr Contraindicated in: • Hypersensitivity to clonazepam or other benzodiazepines • Severe liver disease Use Cautiously in: • Narrow-angle glaucoma • Chronic respiratory disease • History of porphyria • Do not discontinue abruptly • OB: Pregnancy, lactation, or children (safety not established; chronic use during pregnancy may result in withdrawal in the neonate) CNS: behavioral changes, drowsiness, EENT: abnormal eye movements, diplopia, nystagmus, Resp: increased secretions, CV: palpitations, GI: constipation, diarrhea, hepatitis, GU: dysuria, nocturia, urinary retention, Hemat: anemia, eosinophilia, leukopenia, thrombocytopenia, Neuro: ataxia, hypotonia, Misc: fever, physical dependence, psychological dependence, tolerance, |
NURSING IMPLICATIONS
ASSESSMENT • Observe and record intensity, duration, and location of seizure activity • Assess degree and manifestations of anxiety and mental status prior to and periodically during therapy • Assess patient for drowsiness, unsteadiness, and clumsiness. These symptoms are dose related and most severe during initial therapy; may decrease in severity or disappear with continued or long-term therapy • Lab Test Considerations: Patients on prolonged therapy should have CBC and liver function test results evaluated periodically. May cause an ↑ in serum bilirubin, AST, and ALT ○ May cause ↓ thyroidal uptake of sodium iodide, 123I, and 131I • Toxicity and Overdose: Therapeutic serum concentrations are 20-80 mg/ml POTENTIAL NURSING DIAGNOSES • Risk for injury |
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clozapine
(kloe-za-peen) Clozaril, FazaClo CLASSIFICATION(S) Therapeutic: antipsychotics Pregnancy Category B INDICATIONS • Schizoprenia unresponsive to or intolerant of standard therapy with other antipsychotics • To reduce recurrent suicidal behavior in schizophrenic patients ACTION • Binds to dopamine receptors in the CNS • Also has anticholinergic and alpha-adrenergic blocking activity • Produces fewer extrapyramidal reactions and less tardive dyskinesia than standard antipsychotics but carries high risk of hematologic abnormalities • Therapeutic Effects: ○ Diminished schizophrenic behaviorDiminished suicidal behavior PHARMACOKINETICS Absorption: Well absorbed after oral administration Distribution: Rapid and extensive distribution; crosses blood-brain barrier and placenta Protein Binding: 95% Metabolism and Excretion: Mostly metabolized on first pass through the liver. CONTRAINDICATIONS/PRECAUTIONS Contraindicated in: • Hypersensitivity • Bone marrow depression • Lactation • Severe CNS depression/coma Use Cautiously in: • Prostatic enlargement • Narrow-angle glaucoma • Malnourished patients or patients with cardiovascular, hepatic, or renal disease • Diabetes • Seizure disorder • Geri: Elderly patients with dementia-related psychosis • Pedi: Children <16 yr ADVERSE REACTIONS/SIDE EFFECTS* *CAPITALS indicate life threatening; underlines indicate most frequent. CNS: NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES, dizziness, sedation, EENT: visual disturbances, CV: MYOCARDITIS, hypotension, tachycardia, ECG changes, hypertension, GI: constipation, abdominal discomfort, dry mouth, increased salivation, nausea, vomiting, Derm: rash, sweating, Endo: hyperglycemia, Hemat: AGRANULOCYTOSIS, LEUKOPENIA, Neuro: extrapyramidal reactions, Misc: fever, weight gain, |
INTERACTIONS
Drug-Drug: • ↑ anticholinergic effects with other agents having anticholinergic properties, including antihistamines , quinidine , disopyramide , and antidepressants • Concurrent use with SSRI antidepressants ↑ blood levels and risk of toxicity • ↑ CNS depression with alcohol, antidepressants , antihistamines , opioid analgesics , or sedative/hypnotics • ↑ hypotension with nitrates, acute ingestion of alcohol, or antihypertensives • ↑ risk of bone marrow suppression with antihypertensives or radiation therapy • Use with lithium ↑ risk of adverse CNS reactions, including seizures Drug-Natural: • Caffeine-containing herbs (cola nut, tea , coffee ) may increase serum levels and side effects • St. John's wort may decrease blood levels and efficacy NURSING IMPLICATIONS ASSESSMENT • Monitor patient's mental status (delusions, hallucinations, and behavior) before and periodically during therapy • Monitor blood pressure (sitting, standing, lying) and pulse rate before and frequently during initial dose titration • Observe patient carefully when administering medication to ensure that medication is actually taken and not hoarded • Monitor for signs of myocarditis (unexplained fatigue, dyspnea, tachypnea, fever, chest pain, palpitations, other signs and symptoms of heart failure, ECG changes, such as ST-T wave abnormalities, arrhythmisa, or tachycardia during first month of therapy). If these occur, clozapine should be discontinued and not restarted • Monitor patient for onset of akathisia (restlessness or desire to keep moving) and extrapyramidal side effects ( parkinsonian--difficulty speaking or swallowing, loss of balance control, pill-rolling motion, mask-like face, shuffling gait, rigidity, tremors and dystonic muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms or legs) every 2 mo during therapy and 8-12 wk after therapy has been discontinued. Notify physician or other health care professional if these symptoms occur; reduction in dose or discontinuation of medication may be necessary. Trihexyphenidyl or diphenhydramine may be used to control these symptoms • Although not yet reported for clozapine, monitor for possible tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities, lip smacking or puckering, puffing of cheeks, uncontrolled chewing, rapid or worm-like movements of tongue). Report these symptoms immediately; may be irreversible • Monitor frequency and consistency of bowel movements. Increasing bulk and fluids in the diet may help to minimize constipation • Clozapine lowers the seizure threshold. Institute seizure precautions for patients with history of seizure disorder • Transient fevers may occur, especially during first 3 wk of therapy. Fever is usually self-limiting but may require discontinuation of medication. Also, monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness). Notify physician immediately if these symptoms occur • Lab Test Considerations: Monitor WBC, absolute neutrophil count (ANC), and differential count before initiation of therapy and WBC and ANC weekly for the first 6 months, then biweekly during therapy and weekly for 4 wk after discontinuation of clozapine. Because of the risk of agranulocytosis, clozapine is available only in a 1-wk supply through the Clozaril Patient Management System, which combines WBC testing, patient monitoring, and controlled distribution through participating pharmacies. If WBC is <3000 mm3 or granulocyte count is <1500 mm3, withhold clozapine, increase frequency of WBC monitoring according to management system guidelines, and monitor patient for signs and symptoms of infection. If acceptable WBC and ANC levels were maintained during first 6 months of continuous therapy, monitoring may decrease to every 2 wks. If levels are maintained for second 6 months, WBC and ANC may be monitored every 4 wks thereafter • Toxicity and Overdose: Overdose is treated with activated charcoal and supportive therapy. Monitor patient for several days because of risk of delayed effects ○ Avoid use of epinephrine and its derivatives when treating hypotension, and avoid quinidine and procainamide when treating arrhythmias POTENTIAL NURSING DIAGNOSES • Risk for other-directed violence • Disturbed thought process • Risk for injury (Side Effects). IMPLEMENTATION • PO: Administer capsules with food or milk to decrease gastric irritation. ○ Leave oral disintegrating tablet in blister until time of use. Do not push tablet through foil. Just before use, peel foil and gently remove disintegrating tablet. Immediately place tablet in mouth and allow to disintegrate and swallow with saliva. If ½ tablet dose used, destroy other half of tablet PATIENT/FAMILY TEACHING • Instruct patient to take medication exactly as directed. Patients on long-term therapy may need to discontinue gradually over 1-2 wk • Inform patient of possibility of extrapyramidal symptoms. Instruct patient to report these symptoms immediately • Advise patient to change positions slowly to minimize orthostatic hypotension • May cause seizures and drowsiness. Caution patient to avoid driving or other activities requiring alertness while taking clozapine • Caution patient to avoid concurrent use of alcohol, other CNS depressants, and OTC medications without consulting health care professional • Instruct patient to use frequent mouth rinses, good oral hygiene, and sugarless gum or candy to minimize dry mouth • Advise patient to notify health care professional of medication regimen before treatment or surgery • Instruct patient to notify health care professional promptly if unexplained fatigue, dyspnea, tachypnea, chest pain, palpitations, sore throat, fever, lethargy, weakness, malaise, or flu-like symptoms occur or if pregnancy is planned or suspected • Advise patient of need for continued medical follow-up for psychotherapy, eye exams, and laboratory tests EVALUATION/DESIRED OUTCOMES • Diminished schizophrenic behavior • Diminished suicidal behavior |
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VALPROATES
divalproex sodium (dye-val-proe-exsoe -dee-um) Depakote, Depakote ER, Epival valproate sodium (val-proe-atesoe -dee-um) Depacon valproic acid (val-proe-ikas -id) Depakene CLASSIFICATION(S) Therapeutic: anticonvulsants, vascular headache suppressants Pregnancy Category D = Canadian drug name. INDICATIONS • Simple and complex absence seizures • Partial seizures with complex symptomatology • Divalproex only: ○ Manic episodes associated with bipolar disorder (delayed-release only) ○ Prevention of migraine headache (delayed and extended release) • Unlabelled Uses: • IV: Treatment of migraine headache ACTION • Increase levels of GABA, an inhibitory neurotransmitter in the CNS • Therapeutic Effects: ○ Suppression of absence seizures ○ Decreased manic behavior ○ Decreased frequency of migraine |
Contraindicated in: • Hypersensitivity
• Hepatic impairment • Some products contain tartrazine; avoid in patients with known hypersensitivity • Known/suspected urea cycle disorders (may result in fatal hyperammonemic encephalopathy) Use Cautiously in: • Bleeding disorders • History of liver disease • Organic brain disease • Bone marrow depression • Renal impairment • Pedi: Children, especially under 2 yr, are at increased risk for potentially fatal hepatotoxicity • OB: Use during pregnancy is linked to developmental defects, low IQ, birth defects, congenital anomalies, and hepatic dysfunction in the neonate. Use with extreme caution. Lactation: Valproates pass into breast milk. Consider discontinuing nursing when valproates are administered to the nursing mother ADVERSE REACTIONS/SIDE EFFECTS* *CAPITALS indicate life threatening; underlines indicate most frequent. CNS: confusion, dizziness, headache, sedation, EENT: visual disturbances, GI: HEPATOTOXICITY, indigestion, nausea, vomiting, anorexia, constipation, diarrhea, hypersalivation, increased appetite, PANCREATITIS, Derm: rashes, Hemat: leukopenia, prolonged bleeding time, thrombocytopenia, Metab: hyperammonemia, Neuro: ataxia, paresthesia, INTERACTIONS Drug-Drug: • ↑ risk of bleeding with antiplatelet agents (including aspirin , NSAIDs , tirofiban , eptifibatide , and abciximab ), cefoperazone , cefotetan , heparins and thrombolytic agents , or warfarin • ↓ metabolism of barbiturates and primidone , ↑ risk of toxicity • Blood levels and toxicity may be ↑ by carbamazepine , cimetidine , erythromycin , or felbamate • ↑ CNS depression with other CNS depressants , including alcohol , antihistamines , antidepressants , opioid analgesics , MAO inhibitors , and sedative/hypnotics • ↑ doses of salicylates (in children) increase the effects of valproic acid • May ↑or ↓ effects and toxicity of phenytoin • MAO inhibitors and other antidepressants may ↓ seizure threshold and ↓ effectiveness of valproates NURSING IMPLICATIONS ASSESSMENT • Seizures: Assess location, duration, and characteristics of seizure activity. Institute seizure precautions • Bipolar Disorder: Assess mood, ideation, and behavior frequently • Migraine Prophylaxis: Monitor frequency of migraine headaches • Geri: Assess geriatric patients for excessive somnolence • Lab Test Considerations: Monitor CBC, platelet count, and bleeding time prior to and periodically during therapy. May cause leukopenia and thrombocytopenia Toxicity and Overdose: Therapeutic serum levels range from 50-100 mcg/ml. Doses are gradually ↑ until a predose serum concentration of at least 50 mcg/ml is reached. However, a good correlation among daily dose, serum level, and therapeutic effects has not been established. Patients receiving near the maximum recommended 60 mg/kg/day should be monitored for toxicity |
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risperidone
(riss-per-i-done) Risperdal, Risperdal M-TAB, Risperdal Consta CLASSIFICATION(S) Therapeutic: antipsychotics Pharmacologic: benzisoxazoles Pregnancy Category C INDICATIONS • Schizophrenia (treatment and prevention of relapse) • Bipolar mania (oral only); can be used with lithium or valproate ACTION • May act by antagonizing dopamine and serotonin in the CNS • Therapeutic Effects: ○ Decreased symptoms of psychoses or bipolar mania PHARMACOKINETICS Absorption: 70% after administration of tablets, solution or orally disintegrating tablets. Following IM administration, small initial release of drug, followed by 3-wk lag ; the rest of release starts at 3 wk and lasts 4-6 wk Distribution: Unknown Metabolism and Excretion: Extensively metabolized by the liver. Metabolism is genetically determined; extensive metabolizers (most patients) convert risperidone to 9-hydroxyrisperidone rapidly. Poor metabolizers (6-8% of whites) convert it more slowly. The 9-hydroxyrisperidone is an antipsychotic compound. Risperidone and its active metabolite are renally eliminated Half-life: Extensive metabolizers--3 hr for risperidone, 21 hr for 9-hydroxyrisperidone. Poor metabolizers--20 hr for risperidone and 30 hr for 9-hydroxyrisperidone CONTRAINDICATIONS/PRECAUTIONS Contraindicated in: • Hypersensitivity Use Cautiously in: • Geri: Geriatric or debilitated patients, patients with renal or hepatic impairment (initial dosage reduction recommended) • Geri: Geriatric patients (may ↑ cardiovascular morbidity/mortality in elderly patients with dementia-related psychoses) • Underlying cardiovascular disease (may be more prone to arrhythmias and hypotension) • History of seizures • History of suicide attempt or drug abuse • Diabetes or risk factors for diabetes (may worsen glucose control) • OB: Pedi: Pregnancy, lactation, or children (safety not established) ADVERSE REACTIONS/SIDE EFFECTS* *CAPITALS indicate life threatening; underlines indicate most frequent. CNS: NEUROLEPTIC MALIGNANT SYNDROME, aggressive behavior, dizziness, extrapyramidal reactions, headache, increased dreams, increased sleep duration, insomnia, sedation, fatigue, impaired temperature regulation, nervousness, tardive dyskinesia, EENT: pharyngitis, rhinitis, visual disturbances, Resp: cough, dyspnea, rhinitis, CV: arrhythmias, orthostatic hypotension, tachycardia, GI: constipation, diarrhea, dry mouth, nausea, abdominal pain, anorexia, dyspepsia, increased salivation, vomiting, GU: decreased libido, dysmenorrhea/menorrhagia, difficulty urinating, polyuria, Derm: itching/skin rash, dry skin, increased pigmentation, increased sweating, photosensitivity, seborrhea, Endo: galactorrhea, hyerglycemia, MS: arthralgia, back pain, Misc: weight gain, weight loss, polydipsia, |
INTERACTIONS
Drug-Drug: • May ↓ the antiparkinsonian effects of levodopa or other dopamine agonists • Carbamazepine , phenytoin , rifampin , phenobarbital , and other enzyme inducers ↑ metabolism and may ↓ effectiveness; dose adjustments may be necessary • Fluoxetine and paroxetine ↑ blood levels and may ↑ effects; dose adjustments may be necessary • Clozapine ↓ metabolism and may ↑ effects of risperidone • ↑ CNS depression may occur with other CNS depressants , including alcohol , antihistamines , sedative/hypnotics , or opioid analgesics |
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MULTIPLE VITAMINS
multiple vitamins (oral)Adavite, Certagen, Dayalets, Hexavitamin, LKV Drops, Multi-75, Multi-Day, Nutrox, One-A-Day, Optilets, Poly-Vi-Sol, Quintabs, Ru-lets, Sesame Street Vitamins, Sigtab, Syrvite, Tab-A-Vite, Therabid, Theragran, Thera Multi-Vitamin, Theravee, Theravim, Theravite, Therems, Unicaps, Vita-Bob, Vita-Kid, Zymacap multivitamin infusion (intravenous)B complex with C and B, Cernevit-12, Multi Vitamin Concentrate, M.V.I.-12, M.V.I. Pediatric CLASSIFICATION(S) Therapeutic: vitamins Pregnancy Category UK INDICATIONS • PO: Treatment and prevention of vitamin deficiencies. Special formulations are available for patients with particular needs, including: ○ Prenatal multiple vitamins (with larger doses of folic acid) ○ Preconceptional multiple vitamins ○ Multiple vitamins with iron ○ Multiple vitamins with fluoride ACTION • Contain fat-soluble vitamins (A, D, and E) and most water-soluble vitamins (B-complex vitamins B1, B2, B3, B5, B6, B12, vitamin C, biotin, and folic acid). These vitamins are a diverse group of compounds necessary for normal growth and development. Many act as coenzymes or catalysts in numerous metabolic processes • Liquid products do not contain folic acid • Therapeutic Effects: ○ PO: Prevention of deficiency or replacement in patients whose nutritional status is questionable ○ IV: Replacement in patients who are unable to ingest oral feedings or vitamins PHARMACOKINETICS Absorption: Well absorbed from the GI tract after oral administration; some processes are active, some are passive. Absorption of water-soluble vitamins generally increases in deficiency states. Absorption of some lipid-soluble vitamins may require bile acids Distribution: Widely distributed; cross the placenta and enter breast milk. Fat-soluble vitamins (A, D, E, and K) are stored in fatty tissues and the liver Metabolism and Excretion: Utilized in various biologic processes. Excess amounts of water-soluble vitamins |
interations
In recommended doses, adverse reactions are extremely rare GU: urine discoloration (preparations with B vitamins), Misc: allergic reactions to preservatives, additives, or colorants, INTERACTIONS Drug-Drug: • Large amounts of vitamin B may interfere with the beneficial effect of levodopa |
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ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS
benazepril (ben-aye-ze-pril) Lotensin captopril (kap-toe-pril) Capoten enalapril/enalaprilat (e-nal-a-pril/e-nal-a-pril-at) Vasotec, Vasotec IV fosinopril (foe-sin-oh-pril) Monopril lisinopril (lyse-in-oh-pril) Prinivil, Zestril moexipril (moe-eks-i-pril) Univasc perindopril (pe-rin-do-pril) Aceon quinapril (kwin-a-pril) Accupril ramipril (ra-mi-pril) Altace trandolapril (tran-doe-la-pril) Mavik CLASSIFICATION(S) Therapeutic: antihypertensives Pharmacologic: ACE inhibitors Pregnancy Category C (first trimester) D (second and third trimesters) INDICATIONS • Alone or with other agents in the management of hypertension • Captopril, enalapril, fosinopril, lisinopril, perindopril, quinapril, ramipril, trandolapril: Management of CHF • Captopril, lisinopril, ramipril, trandolapril: Reduction of risk of death or development of CHF following MI • Slowed progression of left ventricular dysfunction into overt heart failure (selected agents) • Ramipril: Reduction of the risk of MI, stroke, and death from cardiovascular disease in patients at risk (>55 years old with a history of cardiovascular disease, stroke, peripheral vascular disease, or diabetes with another risk factor such as hypercholesterolemia or cigarette smoking) • Captopril: Decreased progression of diabetic nephropathy • Unlabelled Uses: • Lisinopril: Prevention of migraine headaches ACTION • ACE inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE also inactivates the vasodilator bradykinin and other vasodilatory prostaglandins. ACE inhibitors also increase plasma renin levels and reduce aldosterone levels. Net result is systemic vasodilation |
Contraindicated in: • Hypersensitivity
• Cross-sensitivity among ACE inhibitors may occur • OB: Pregnancy • Angioedema (hereditary or idiopathic) Use Cautiously in: • Geri: Renal impairment, hepatic impairment, hypovolemia, hyponatremia, elderly patients, concurrent diuretic therapy (initial dose reduction recommended for most agents) • Black patients with hypertension (monotherapy less effective, may require additional therapy) • Aortic stenosis/hypertrophic cardiomyopathy • Cerebrovascular or cardiac insufficiency • Surgery/anesthesia (hypotension may be exaggerated) • Pedi: Lactation or children (safety not established for most agents; benazepril may be used in children >6 yr) Exercise Extreme Caution in: • Family history of angioedema ADVERSE REACTIONS/SIDE EFFECTS* *CAPITALS indicate life threatening; underlines indicate most frequent. CNS: dizziness, fatigue, headache, insomnia, weakness, Resp: cough, eosinophilic pneumonitis, CV: hypotension, angina pectoris, tachycardia, GI: taste disturbances, anorexia, diarrhea, hepatotoxicity (rare), nausea, GU: proteinuria, impotence, renal failure, Derm: rashes, F and E: hyperkalemia, Hemat: AGRANULOCYTOSIS, NEUTROPENIA (CAPTOPRIL ONLY), Misc: ANGIOEDEMA, fever, INTERACTIONS Drug-Drug: • Excessive hypotension may occur with concurrent use of diuretics , other antihypertensives , nitrates , phenothiazines , acute ingestion of alcohol , and during surgery or general anesthesia • Hyperkalemia may result from concurrent use of potassium supplements , potassium-sparing diuretics , indomethacin , salt substitutes , or cyclosporine • Antihypertensive response may be ↓ by NSAIDs • Absorption may be decreased by antacids • ↑ levels and may ↑ risk of lithium or digoxin toxicity • Probenecid ↓ elimination and ↑ levels of captopril • Risk of hypersensitivity reactions ↑ with allopurinol • Capsaicin may ↑ incidence of cough • Rifampin may ↓ effectiveness of enalapril • Tetracycline absorption is ↓ by quinapril NURSING IMPLICATIONS ASSESSMENT • Hypertension: Monitor blood pressure and pulse frequently during initial dose adjustment and periodically during therapy. Notify health care professional of significant changes ○ Monitor frequency of prescription refills to determine adherence • CHF: Monitor weight and assess patient routinely for resolution of fluid overload (peripheral edema, rales/crackles, dyspnea, weight gain, jugular venous distention) • Lab Test Considerations: Monitor BUN, creatinine, and electrolyte levels periodically. Serum potassium may be ↑ and BUN and creatinine transiently ↑, whereas sodium levels may be ↓. If ↑ BUN or serum creatinine concentrations occur, dose reduction or withdrawal may be required ○ Monitor CBC periodically during therapy. May rarely cause slight ↓ in hemoglobin and hematocrit ○ May cause ↑ AST, ALT, alkaline phosphatase, serum bilirubin, uric acid, and glucose ○ Assess urine protein prior to and periodically during therapy for up to 1 yr in patients with renal impairment or those receiving >150 mg/day of captopril. If excessive or ↑ proteinuria occurs, re-evaluate ACE inhibitor therapy |
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DOCUSATE
(dok-yoo-sate) docusate calcium DC Softgels, Dioctocal, Pro-Cal-Sof, Sulfolax, Surfak docusate sodium Colace, Correctol Stool Softener Soft Gels, Diocto, Docu, Docusoft S, DOK, DOS Softgels, DOS, DOSS, DSS, Dulcolax Stool Softener, Ex-Lax Stool Softener, Fleet Sof-Lax, Modane Soft, Philliips Liqui-Gels, Regulax-SS, Regulex, Silace, Soflax, Stool Softener, Therevac SB CLASSIFICATION(S) Therapeutic: laxatives Pharmacologic: stool softeners Pregnancy Category C = Canadian drug name. INDICATIONS • PO: Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery) • Rect: Used as enema to soften fecal impaction ACTION • Promotes incorporation of water into stool, resulting in softer fecal mass • May also promote electrolyte and water secretion into the colon • Therapeutic Effects: ○ Softening and passage of stool |
Contraindicated in: • Hypersensitivity
• Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen Use Cautiously in: • Excessive or prolonged use may lead to dependence • Should not be used if prompt results are desired • OB: Has been used during pregnancy and lactation ADVERSE REACTIONS/SIDE EFFECTS* *CAPITALS indicate life threatening; underlines indicate most frequent. EENT: throat irritation, GI: mild cramps, Derm: rashes, INTERACTIONS Drug-Drug: • None significant |
