Page 1548 - Saunders Comprehensive Review For NCLEX-RN

deficiency of pancreatic enzymes can compromise digestion,
especially the digestion of fats)

C. Should be taken with all meals and snacks

D. Side and adverse effects include abdominal cramps or pain,
nausea, vomiting, and diarrhea.
E. Products that contain calcium carbonate or magnesium hydroxide
interfere with the action of these medications.
X. Treatment for Inflammatory Bowel Disease (Box 49-4)
A. Inflammatory bowel disease has 2 forms, Crohn’s disease and
ulcerative colitis.
B. Antimicrobials: May be prescribed to prevent or treat secondary
infection (see Chapter 63 for information on antimicrobials)
C. 5-Aminosalicylates (5-ASAs): Decrease gastrointestinal
inflammation; side and adverse effects include nausea, rash,
arthralgia, and hematological disorders.
D. Corticosteroids: Act as an antiinflammatory to decrease
gastrointestinal inflammation (see Chapter 47 for information on
glucocorticoids and corticosteroids)
E. Immunomodulators: Monoclonal antibodies modulate the
immune response to induce and maintain remission (see Box 49-4
for specific immunomodulators).
XI. Treatment for Irritable Bowel Syndrome (IBS)
A. Irritable bowel syndrome is a gastrointestinal disorder that is
characterized by crampy abdominal pain accompanied by
diarrhea, constipation, or both.
B. Pharmacological treatment depends on the main symptom,
constipation or diarrhea.
C. Constipation-predominant IBS (IBS-C) treatment
1. Bulk-forming laxatives, usually taken at mealtimes
with a full glass of water.
2. Lubiprostone: Chloride channel activator that
increases fluid in the intestines to promote bowel
elimination; needs to be taken with food and water.
3. Linaclotide: Stimulates receptors in the intestines to
promote bowel transit time; taken daily 30 minutes
before breakfast.
4. See Box 49-6 for a list of additional medications to treat
constipation.
D. Diarrhea-predominant IBS (IBS-D) treatment
1. Alosetron
a. A selective serotonin receptor
antagonist
b. Can cause adverse effects such as
constipation, impaction, bowel
obstruction, perforation of the bowel,
and ischemic colitis.
c. A strict risk management procedure

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