Name /bks_53161_deglins_md_disk/sucralfate 02/17/2014 10:30AM Plate # 0-Composite pg 1 # 1 1 Adverse Reactions/Side Effects CNS: dizziness, drowsiness. GI: constipation, diarrhea, dry mouth, g
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   Canadian drug name.   Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough   Discontinued. 1 sucralfate  (soo- kral -fate) Carafate, Sulcrate Classification Therapeutic: antiulcer agents  Pharmacologic: GIprotectants PregnancyCategoryB Indications Short-term management of duodenal ulcers. Maintenance (preventive) therapy of duodenal ulcers.  Unlabeled Use:  Management of gastric ulcer or gastroesopha-gealreflux.Preventionofgastricmucosalinjurycausedbyhigh-doseaspirinorotherNSAIDs in patients with rheumatoid arthritis or in high-stress situations (e.g., inten-sive care unit).  Suspension:  Mucositis/stomatitis/rectal or oral ulcerations from variousetiologies. Action  Aluminumsaltofsulfatedsucrosereactswithgastricacidtoformathickpaste,whichselectively adheres to the ulcer surface.  Therapeutic Effects:  Protection of ul-cers,withsubsequenthealing. Pharmacokinetics  Absorption: Systemicabsorptionisminimal(  5%). Distribution: Unknown. MetabolismandExcretion:  90%iseliminatedinthefeces. Half-life: 6–20hr.TIME/ACTIONPROFILE(mucosalprotectanteffect) ROUTE ONSET PEAK DURATION PO 1–2hr unknown 6hr Contraindications/Precautions Contraindicatedin: Hypersensitivity. UseCautiouslyin: Renal failure (accumulation of aluminumcan occur); Diabe-tes ( q risk of hyperglycemia with suspension);Impairedswallowing( q riskoftablet aspiration). AdverseReactions/SideEffects CNS: dizziness, drowsiness. GI: constipation, diarrhea, dry mouth, gastric discom-fort, indigestion, nausea. Derm: pruritus, rashes. Endo: hyperglycemia (with sus-pension). Misc:  ANAPHYLAXIS . Interactions Drug-Drug: May  p absorption of   phenytoin , fat-solublevitamins , or  tetracy-cline . p effectiveness when used with  antacids ,  cimetidine , or  ranitidine . p ab-sorptionof  fluoroquinolones (separateadministrationby2hours). Route/DosageTreatmentofUlcers PO (Adults): 1 g 4 times daily, given 1 hr before meals and at bedtime; or 2 g twicedaily,onwakingandatbedtime. PreventionofUlcers PO(Adults): 1gtwicedaily,given1hrbeforeameal. GastroesophagealReflux PO(Adults): 1g4timesdaily,given1hrbeforemealsandatbedtime(unlabeled). PO (Children):  40–80 mg/kg/day divided q 6 hr, given 1 hr before meals and at bedtime(unlabeled). Stomatitis PO (Adults and Children):  5–10 mL of suspension swish and spit or swish andswallow4timesdaily. Proctitis Rect(Adults): 2gofsuspensiongivenasanenemaonceortwicedaily. NURSINGIMPLICATIONSAssessment ●  Assesspatientroutinelyforabdominalpainandfrankoroccultbloodinthestool. PotentialNursingDiagnoses  Acutepain(Indications)Constipation(SideEffects)Deficientknowledge,relatedtomedicationregimen(Patient/FamilyTeaching)    2015 F.A. Davis Company  2 Implementation ●  PO:  Administer on an empty stomach, 1 hr before meals and at bedtime. Tablet may be broken or dissolved in water before ingestion. Shake suspension well be-foreadministration. ●  Ifnasogastricorfeedingtubeadministrationisrequired,consultpharmacist;pro-tein-binding properties of sucralfate have resulted in formation of a bezoar whenadministeredwithenteralfeedingsandothermedications. ●  Ifantacidsarealsorequiredforpain,administer30minbeforeoraftersucralfatedosage. Patient/FamilyTeaching ●  Advisepatienttocontinuewithcourseoftherapyfor4–8wk,eveniffeelingbetter,to ensure ulcer healing. If a dose is missed, take as soon as remembered unlessalmosttimefornextdose;donotdoubledoses. ●  Advise patient thatincrease in fluid intake,dietarybulk,andexercisemayprevent drug-inducedconstipation. ●  Emphasizetheimportanceofroutineexaminationstomonitorprogress. Evaluation/DesiredOutcomes ●  Decreaseinabdominalpain. ●  Prevention and healing ofduodenal ulcers, seenby x-rayexaminationandendos-copy.  Whywasthisdrugprescribedforyourpatient?
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