Constipation evaluation

During the preadministration assessment, the nurse reviews the patient s chart for the medical diagnosis and reason for administration of the prescribed drug. The nurse questions the patient regarding the type and intensity of symptoms (such as pain, discomfort, diarrhea, or constipation) to provide a baseline for evaluation of the effectiveness of drug therapy. 

A complete history should be obtained so that the patient s symptoms can be evaluated and the diagnosis of constipation confirmed. The diagnosis of constipation is suggested by fewer than three bowel movements per week, consistency of hard lumpy stool, excessive straining, prolonged defecation time, or need to support the perineum or digitally manipulate the anorectum. 

Laxatives should not be given to children younger than 6 years of age unless prescribed by a physician. Because children may not be able to describe their symptoms well, they should be evaluated by a physician before being given a laxative. Treating secondary causes may resolve the constipation without the use of laxatives. As in adults, children benefit from a healthy balanced diet, adequate fluid, and regular exercise. 

The most common adverse effects are dizziness, headache, constipation, and nausea. Ranolazine should be started at 500 mg twice daily and increased to 1,000 mg twice daily if needed based on symptoms. Baseline and followup ECGs should be obtained to evaluate effects on the QT interval. 

Bevacizumab is also associated with GI perforation. This rare, but potentially fatal, complication necessitates prompt evaluation of abdominal pain associated with vomiting or constipation. 

The most common side effects of clonidine are constipation, dizziness, drowsiness, dryness of mouth, and unusual tiredness or weakness. However, there are more severe side effects that clinicians and patients should be aware of, such as allergic reaction, decreased heart rate, or unusually elevated or decreased blood pressure, as well as contraindications and drug interactions that should be evaluated prior to prescription. 

All were double-blind controlled evaluations and established iprindole as at least as effective as imipramine, and one study [195] included an examination of the doctor-patient interaction as a factor in such work (a similar discussion was felt necessary, as noted above [179] in the evaluation of oxpertine). In only two [192, 194] of the above reports is it possible to estimate the frequency and severity of anticholinergic side effects, thou in the one case [192] the care taken in the experimental design and the number of patients observed leaves little doubt that the dry mouth, constipation, etc. characteristic of imipramine therapy is either greatly reduced or even absent during iprindole treatment. This point is confirmed in an extension of this team s work to include a 12 month toxicity study [197] which, in addition, failed to produce evidence of haemopoitic, hepatic, cardiac, ocular or renal damage. Similar results followed other work. 

The standard pharmacokinetic parameters of the compound such as a half-life or bioavailability cannot be reliably calculated, because the concentrations in plasma are below lOpg/mL. As analogously expected from the results on the shift in keto-alcohol equilibrium of 16,16-difluoro-PGE2, it is rapidly metabolized by C-15 reduction mediated by the ubiquitously expressed carbonyl reductase. The metabolism followed by jS-oxidation and co-oxidation forms a mixture of a and fi epimers at the 15-hydroxy moiety as a sole measurable metabolite [46], In 2006, the US Food and Drug Administration approved the drug application for an oral treatment of chronic idiopathic constipation in adults, estimating that 4-5 million Americans are affected. Lubiprostone has also completed a phase II trial in constipation-predominant irritable bowel syndrome, and has been further evaluated for other bowel dysfunctions. 

The possibility of fatal intestinal dilatation, although very rare, warrants careful evaluation of persistent complaints of constipation, particularly in patients who also have vomiting and abdominal pain, distension, or tenderness (518). Acute intestinal pseudo-obstruction (Ogilvie s syndrome) has been reported in a patient taking haloperidol plus benzatropine (519). 

In a retrospective review, 33 mentally retarded patients were evaluated adverse effects were mild and transient, constipation being the most common (n = 10) (12). There were no significant cardiovascular adverse effects and no seizures no patient discontinued treatment because of agranulocytosis. Small sample sizes, short durations of treatment, and lack of controls in these studies preclude definite conclusions. 

There have been reports that selective serotonin reuptake inhibitors, which inhibit CYP1A2, increase plasma olanzapine concentrations (SEDA-24, 71 SEDA-26, 63). In a recent open add-on trial, 21 patients with obsessive-compulsive disorder unresponsive to treatment with paroxetine 60 mg/day for at least 12 weeks, took additional olanzapine 10 mg/day (280). Steady-state plasma concentrations of paroxetine were not changed, and 7 patients were rated as responders at final evaluation. Sedation (n = 12), weight gain up to 3 kg (n = 8), dry mouth (n = 6), and constipation (n = 3) were the most frequent adverse effects. 

The ability of carbohydrates and other macromolecules to imbibe large quantities of water is put to use both medicinally and industrially for example in absorbent paper and sanitary towels, incontinence pads and surgical dressings. Medically, use is made of the swelling properties in the treatment of constipation and in appetite suppression. Three properties are of importance in the in vitro evaluation of bulk laxatives ... 

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