Colleen OConnell PharmD TMC Pharmacist September 25 2016 Objectives Describe potential medication concerns with ostomies List factors that influence medication availability and absorption with ostomies ID: 532089
Download Presentation The PPT/PDF document "Medication Considerations for Individual..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Medication Considerations for Individuals with Ostomies
Colleen O’Connell, PharmDTMC PharmacistSeptember 25, 2016Slide2
Objectives
Describe potential medication concerns with ostomiesList factors that influence medication availability and absorption with ostomiesReview important medication considerations with ostomiesSlide3
Ileostomy vs. ColostomySlide4
Potential Medication Concerns
Medications in stoma outputLaxative ingredients in medicationsMedications not absorbedMedications with side effectsOther concerns? Slide5
Individual Factors
The type of stomaMore ileum lost = absorptionThe amount of small bowel that remains and the quality of the remaining bowelDescending/sigmoid colostomies have the same medication absorption as patients without stomasSlide6
Individual Factors
The type and volume of stoma outputIntestinal content transit timesMedication forms Tablets, liquids, sublingual, topical, injections
Size of the tabletSlide7
Specific Medication Considerations
Avoid enteric-coated and slow-release medicationsAvoid laxativesSorbitol, found in liquid formulations, should be avoided as it is has a laxative effectBowel preparations to cleanse the bowel are not needed
Clear liquids for 24 hours prior to procedures
Bowel cleanses and laxatives risk of electrolyte imbalancesSlide8
Specific Medication Considerations
Suitable medication forms include solutions, suspensions, gelatin capsules, and uncoated tabletsShould also consider sublingual and transdermal
Simethicone
and Beano can reduce gas production related to the breakdown of complex sugarsSlide9
Specific Medication Considerations
Detailed individual assessment is important especially if you have epilepsy, chronic pain, or Parkinson’s diseaseSpecific drugs with documented absorptionOral contraceptivesDigoxin
Levothyroxine
Mesalamine
Monitor medication levels as appropriateSlide10
Helpful Medication Tips
Inform each provider that you have an ostomyLook for remnants of undigested medications when you empty your pouch and report what you observe (if present)Do not crush pills unless a doctor or pharmacist says it is okaySlide11
Resources
United Ostomy Associations of Americahttp://www.ostomy.org/Home.htmlOstomy Support Group of Tucson, AZ
http://www.tucsonostomysupportgroup.org/index.htmlSlide12
Summary
Factors that affect medication availability and absorption include:Stoma type, quality and quantity of small bowel, and medication formsAvoid enteric-coated and slow release medications and laxativesUse liquids, sublingual, or transdermal medication delivery forms if possibleSlide13
References
Moore S. Medication absorption for patients with an ileostomy. Br J Nurs. 2015;24(5):S12-5.Turnbull GB. The issue of oral medications and a fecal
ostomy
.
Ostomy
Wound Manage. 2005;51(3):14, 16.
United
Ostomy
Associations of America, Inc. Diet and Nutrition Guide. 2011. http://www.ostomy.org/uploaded/files/ostomy_info/OstomyNutritionGuide.pdf?direct=1. Accessed May 19, 2016.
Ostomy
Support Group of Tucson, Arizona. http://www.tucsonostomysupportgroup.org/ostomyinfo.html. Accessed May 19, 2016.
United
Ostomy
Associations of America, Inc. http://www.ostomy.org/Home.html. Accessed May 19, 2016.
Medications and your
Ostomy
.
Stomawise
. The
Ostomy
Support Charity. http://www.stomawise.co.uk/types-of-stoma/medications-and-your-ostomy. Accessed May 19, 2016.Slide14
Questions?