Laxative:
Colace
Therapeutic class: Laxative. Loosens surface tension of stool to allow
water/moisture absorption to stool to soften for easier expulsion.
Side Effects: Diarrhea, flatulence, abdominal cramping. Sever side effect:
dehydration
Contraindications: Diarrhea, possible or confirmed bowel obstruction, stool
impaction.
Before admin: Date of last bm and stool consistency. If “soft” was it diarrhea? How
many movements in last 24 hr period.
Pt teaching: Increase fluid intake. Take with glass of water. Hold for diarrhea.
Senna
Therapeutic class: medication used to treat constipation and empty the large
intestine
Side effects: esophageal impaction, hypersensitivity, finger clubbing
Contraindications: Hypersensitivity, ulcerative colitis, fecal impaction, GI
obstruction or perforation, GI or rectal bleeding.
Before admin: Check last bowel movement
Pt teaching: Instruct client to report if experiencing sudden change in bowel
movements lasting more than > 2 weeks, stomach pain, and nausea and vomiting.
Miralax (Polyethylene glycol)
Therapeutic class: OSMOTIC LAXATIVE -causes water retention in stool, causing
increase in stool frequency.
Side effects: abdominal bloating, abdominal cramping, abdominal distention,
diarrhea, flatulence, ischemic colitis, and nausea.
Contraindications: Diarrhea, avoid use in patient with bowel obstruction, ulcerative
colitis, children under <2 years of age because of the risk of hypoglycemia,
dehydration, and hypokalemia.
Before admin: Check last bowel movement, and characteristics of the stool. Do not
give for more than a week. Check provider’s order.
Pt teaching: Instruct patient to hydrate adequately with water or clear liquids before
and after unless contraindicated
Protonix (Pantoprazole)
Therapeutic class: antiulcer, gastric acid proton pump inhibitor
Side effects: anxiety, chest pain, hyperglycemia, rash, bronchitis, dyspnea
Contraindications: hypersensitivity to pantoprazole, benzimidazoles, Pregnancy
category B
Pt teaching: do not chew or crush, swallow tablets whole. Relief of symptoms in 2
weeks. If taking warfarin to follow bleeding precautions
Pepcid (Famotidine)
Therapeutic class: antiulcer agent, gastric acid secretion inhibitor
Side effects: anxiety, dizziness, arrhythmias, decreased libido, bronchospasm.
Contraindications: hypersensitivity to famotidine, other H2- receptor antagonists
Before admin: shake well,
Pt teaching: to protect from freezing, store at room temperature. Chew tablets
thoroughly before swallowing. Avoid alcohol and smoking.
, Prilosec (Omeprazole)
Therapeutic class: antiulcer, proton pump inhibitor
Side effects: agitation, chest pain, hypertension, photosensitivity, agranulocytosis,
anemia
Contraindications: hypersensitivity to omeprazole, other proton pump inhibitors
Before admin: give before meals in morning, monitor patient for bone fracture, can
interfere with absorption with vitamin B12
Pt teaching: take before breakfast. Avoid alcohol, aspirin products, and foods that
may increase gastric secretions.
Diuretics:
Lasix
Therapeutic class: antihypertensive, diuretic, inhibits sodium and water
reabsorption in the loop of henle and increases urine formation to reduce edema
caused by cirrhosis, heart failure, and renal disease.
Side effects: dizziness, arrhythmias, orthostatic hypotension, blurred vision,
hyperglycemia, muscle pain
Contraindications: anuria unresponsive to furosemide, hypersensitivity to
furosemide, sulfonamides
Before admin: cautious in patients with advanced hepatic cirrhosis or electrolyte
imbalance, obtain weight before, give drug in morning
Pt teaching: take medication same time each day, take last dose hours before bed
time, change position slowly cause of orthostatic hypotenstion
Hydrochlorthiazide
Therapeutic class: antihypertensive diuretic, promotes movement of sodium,
chloride, and water from blood in peritubular capillaries into nephrons distal
convoluted tubule.
Side effects:
Contraindications: anuria, hypersensitivity to hydrochlorothiazide, other thiazides,
sulfonamide derivatives
Before admin: minor alterations in fluid and electrolyte balance may precipitate
hepatic coma in patients. Give in morning, monitor blood pressure, weight,
electrolytes, fluid intake and output. Monitor BUN and creatinine levels
Pt teaching: take in morning, weigh themselves at same time, eat diet high in
potassium, change position slowly. Orthostatic hypotension
Spirolactalone
Therapeutic class: POTASSIUM SPARING DIURETIC - Aldosterone antagonist with
diuretic and antihypertensive effects; competitive binding of receptors at
aldosterone-dependent Na-K exchange site in distal tubules results in increased
exertion of Na+, Cl-, and water retention of K+ and H+. Thereby increasing urinary
excretion of sodium and water reduces blood volume and blood pressure.
Side effects: Hyponatremia, hyperkalemia, gastritis, decrease libido.
Contraindications: acute renal insufficiency, Addison’s disease and other conditions
associated with hyperkalemia.
Before admin: evaluate patient’s serum potassium level, assess if patient has
trouble swallowing.
Colace
Therapeutic class: Laxative. Loosens surface tension of stool to allow
water/moisture absorption to stool to soften for easier expulsion.
Side Effects: Diarrhea, flatulence, abdominal cramping. Sever side effect:
dehydration
Contraindications: Diarrhea, possible or confirmed bowel obstruction, stool
impaction.
Before admin: Date of last bm and stool consistency. If “soft” was it diarrhea? How
many movements in last 24 hr period.
Pt teaching: Increase fluid intake. Take with glass of water. Hold for diarrhea.
Senna
Therapeutic class: medication used to treat constipation and empty the large
intestine
Side effects: esophageal impaction, hypersensitivity, finger clubbing
Contraindications: Hypersensitivity, ulcerative colitis, fecal impaction, GI
obstruction or perforation, GI or rectal bleeding.
Before admin: Check last bowel movement
Pt teaching: Instruct client to report if experiencing sudden change in bowel
movements lasting more than > 2 weeks, stomach pain, and nausea and vomiting.
Miralax (Polyethylene glycol)
Therapeutic class: OSMOTIC LAXATIVE -causes water retention in stool, causing
increase in stool frequency.
Side effects: abdominal bloating, abdominal cramping, abdominal distention,
diarrhea, flatulence, ischemic colitis, and nausea.
Contraindications: Diarrhea, avoid use in patient with bowel obstruction, ulcerative
colitis, children under <2 years of age because of the risk of hypoglycemia,
dehydration, and hypokalemia.
Before admin: Check last bowel movement, and characteristics of the stool. Do not
give for more than a week. Check provider’s order.
Pt teaching: Instruct patient to hydrate adequately with water or clear liquids before
and after unless contraindicated
Protonix (Pantoprazole)
Therapeutic class: antiulcer, gastric acid proton pump inhibitor
Side effects: anxiety, chest pain, hyperglycemia, rash, bronchitis, dyspnea
Contraindications: hypersensitivity to pantoprazole, benzimidazoles, Pregnancy
category B
Pt teaching: do not chew or crush, swallow tablets whole. Relief of symptoms in 2
weeks. If taking warfarin to follow bleeding precautions
Pepcid (Famotidine)
Therapeutic class: antiulcer agent, gastric acid secretion inhibitor
Side effects: anxiety, dizziness, arrhythmias, decreased libido, bronchospasm.
Contraindications: hypersensitivity to famotidine, other H2- receptor antagonists
Before admin: shake well,
Pt teaching: to protect from freezing, store at room temperature. Chew tablets
thoroughly before swallowing. Avoid alcohol and smoking.
, Prilosec (Omeprazole)
Therapeutic class: antiulcer, proton pump inhibitor
Side effects: agitation, chest pain, hypertension, photosensitivity, agranulocytosis,
anemia
Contraindications: hypersensitivity to omeprazole, other proton pump inhibitors
Before admin: give before meals in morning, monitor patient for bone fracture, can
interfere with absorption with vitamin B12
Pt teaching: take before breakfast. Avoid alcohol, aspirin products, and foods that
may increase gastric secretions.
Diuretics:
Lasix
Therapeutic class: antihypertensive, diuretic, inhibits sodium and water
reabsorption in the loop of henle and increases urine formation to reduce edema
caused by cirrhosis, heart failure, and renal disease.
Side effects: dizziness, arrhythmias, orthostatic hypotension, blurred vision,
hyperglycemia, muscle pain
Contraindications: anuria unresponsive to furosemide, hypersensitivity to
furosemide, sulfonamides
Before admin: cautious in patients with advanced hepatic cirrhosis or electrolyte
imbalance, obtain weight before, give drug in morning
Pt teaching: take medication same time each day, take last dose hours before bed
time, change position slowly cause of orthostatic hypotenstion
Hydrochlorthiazide
Therapeutic class: antihypertensive diuretic, promotes movement of sodium,
chloride, and water from blood in peritubular capillaries into nephrons distal
convoluted tubule.
Side effects:
Contraindications: anuria, hypersensitivity to hydrochlorothiazide, other thiazides,
sulfonamide derivatives
Before admin: minor alterations in fluid and electrolyte balance may precipitate
hepatic coma in patients. Give in morning, monitor blood pressure, weight,
electrolytes, fluid intake and output. Monitor BUN and creatinine levels
Pt teaching: take in morning, weigh themselves at same time, eat diet high in
potassium, change position slowly. Orthostatic hypotension
Spirolactalone
Therapeutic class: POTASSIUM SPARING DIURETIC - Aldosterone antagonist with
diuretic and antihypertensive effects; competitive binding of receptors at
aldosterone-dependent Na-K exchange site in distal tubules results in increased
exertion of Na+, Cl-, and water retention of K+ and H+. Thereby increasing urinary
excretion of sodium and water reduces blood volume and blood pressure.
Side effects: Hyponatremia, hyperkalemia, gastritis, decrease libido.
Contraindications: acute renal insufficiency, Addison’s disease and other conditions
associated with hyperkalemia.
Before admin: evaluate patient’s serum potassium level, assess if patient has
trouble swallowing.
