Paralytic ileus

Paralytic ileus 4. Increased AEA levels participate in inhibition of small intestine motility 4. CB antagonists... 

Some patients with parkinsonism communicate poorly and do not tell the primary health care provider or nurse that problems are occurring. The nurse observes the patient with parkinsonism for outward changes that may indicate one or more adverse reactions. For example a sudden change in the facial expression or changes in posture may indicate abdominal pain or discomfort, which may be caused by urinary retention, paralytic ileus, or constipation. Sudden changes in behavior may indicate hallucinations, depression, or other psychotic episodes. 

Helicobader pylori hydrochloric acid hypersecretory paralytic ileus photophobia proton pump inhibitor... 

Anorexia, nausea, vomiting, mental depression, confusion, delayed or impaired thought processes, drowsiness, abdominal distention, decreased bowel sounds, paralytic ileus, muscle weakness or fatigue, flaccid paralysis, absent or diminished deep tendon reflexes, weak irregular pulse, paresthesias, leg cramps, ECG changes Hyperkalemia... 

Fulminant colitis Acute abdomen and systemic symptoms such as fever, tachycardia, dehydration, and hypotension. Some patients have marked leukocytosis (up to 40,000 white blood cells/mm3). Diarrhea is usually prominent but may not occur in patients with paralytic ileus and toxic megacolon. 

Severe disease is defined as the presence of complications of colitis, such as sepsis, volume depletion, electrolyte imbalance, hypotension, paralytic ileus, and toxic megacolon. Patients with signs of severe disease should receive oral vancomycin as initial therapy. Surgical intervention may be indicated and lifesaving, particularly in cases complicated by toxic megacolon or colonic perforation. 

An additional important component of therapy is nutrition. Intraabdominal infections often involve the GI tract directly or disrupt its function (paralytic ileus). The return of GI motility may take days, weeks, and occasionally, months. In the interim, enteral or parenteral nutrition as indicated facilitates improved immune function and wound healing to ensure recovery. 

Severe hemorrhagic pancreatitis Severe necrotizing pancreatitis Necrotizing enterocolitis Diffuse peritonitis Small bowel obstruction Paralytic ileus... 

Nasogastric aspiration is beneficial in patients with profound pain, severe disease, paralytic ileus, and intractable vomiting. 

Weight loss of 9% to 10% is considered severe and requires IV fluid replacement with Ringer s lactate or 0.9% sodium chloride. IV therapy is also indicated in patients with uncontrolled vomiting, the presence of paralytic ileus, stool output greater than 10 mL/kg/hour, shock, or loss of consciousness. 

Alimentary canal sympathetic dilates, parasympathetic constricts, especially the rectum (see effect of D.F.P. in treatment of post-operative paralytic ileus, p. 196). Furthermore, parasympathetic stimulates glandular secretion. 

Passing reference has already been made to experiments with D.F.P. in cases of glaucoma, post-operative paralytic ileus and myasthenia gravis. The intra-ocular tension in glaucoma appears... 

More will now be said about the conditions of paralytic ileus and myasthenia gravis. 

One definition of post-operative paralytic ileus is the failure of the patient to pass faeces or flatus within 60 hr. of the termination of a surgical abdominal operation . A somewhat similar condition may arise in cases of gross mechanical obstruction of the gut. It is well known also that operations involving handling of the gut or the peritoneum are especially liable to cause paralytic ileus. Peritonitis and post-operative pain, inadequately treated with morphia, also precipitate paralytic ileus. Pneumonia, meningitis and typhoid predispose to paralytic ileus, whilst severe hypothyroidism can also be complicated by a paralytic ileus. 

Historically, the first effective pharmacologic agents for lowering the blood pressure were the ganglionic blockers. At the level of the ganglia, these compounds block both sympathetic and parasympathetic transmission. The decrease in parasympathetic function is responsible for urinary retention, for the failure to develop an erection in the male patient and for the paralytic ileus. 

Mebeverine is an antispasmodic that reduces gastric and intestinal motility by direct relaxation of the intestinal smooth muscle. It can be used to relieve pain in irritable bowel syndrome and diverticular disease. Like all antispasmodics, mebeverine is contraindicated in paralytic ileus. 

Incidents of vincristine overdosage have been reported relatively frequently in the medical literature. Some of these have involved inadvertent administration of the intravenous formulation into the central nervous system by the intrathecal route this produces devastating results by a combination of chemical damage to sensitive neuronal tissue as well as biochemical perturbations. Two representative cases of vincristine overdose were described (46) involving administration of vincristine to patients scheduled to receive vinblastine. In one patient toxicity initially involved vomiting and diarrhea with subsequent constipation and paralytic ileus (inhibition of motor activity in the small intestine). Muscle pain... 

Other adverse reactions include nausea diarrhea pyrexia dermatitis exfoliative dermatitis urticaria alopecia sore mouth mouth ulcers fever abdominal cramping leukopenia red-orange urine priapism (causal relationship not established) paralytic ileus and intestinal obstruction from submucosal or intramural hemorrhage. 

Possible adverse reactions include headache anorexia nausea vomiting diarrhea palpitations tachycardia angina pectoris toxic reactions (particularly the LE cell syndrome) lacrimation conjunctivitis dizziness tremors psychotic reactions rash urticaria pruritus fever chills arthralgia eosinophilia constipation paralytic ileus lymphadenopathy splenomegaly nasal congestion flushing edema muscle cramps hypotension paradoxical pressor response dyspnea urination difficulty ... 

Gi disorders Doses administered to patients with ulcerative colitis may suppress Gl motility and produce paralytic ileus and precipitate or aggravate toxic megacolon. Administer ER tablets with caution to patients with Gl obstructive disorders because of the risk of gastric retention. 

Oral/Suppositories - Use on as-needed basis respiratory depression acute or severe bronchial asthma paralytic ileus obstetrical analgesia (8 mg tablets, oral solution, and suppositories only) intracranial lesion associated with increased intracranial pressure (2 and 4 mg tablets only). 

IR concentrated oral solution and tablets/suppositories - Respiratory insufficiency or depression severe CNS depression attack of bronchial asthma heart failure secondary to chronic lung disease cardiac arrhythmias increased intracranial or CSF pressure head injuries brain tumor acute alcoholism delirium tremens convulsive disorders after biliary tract surgery suspected surgical abdomen surgical anastomosis concomitantly with MAOIs or within 14 days of such treatment paralytic ileus. 

DepoDur- Respiratory depression acute or severe bronchial asthma upper airway obstruction paralytic ileus head injury increased intracranial pressure circulatory shock. 

CR/IR tablets (15 and 30 mg)/IR capsules (5 mg)/ER/Concentrated solution -Significant respiratory depression acute or severe bronchial asthma hypercarbia paralytic ileus. 

Oxymorphone Hypersensitivity to morphine analogs acute asthma attack severe respiratory depression or upper airway obstruction paralytic ileus pulmonary edema secondary to a chemical respiratory irritant. 

Acute abdominal conditions Narcotics may obscure diagnosis or clinical course. Do not give SR morphine to patients with Gl obstruction, particularly paralytic ileus, as there is a risk of the product remaining in the stomach for an extended period and the subsequent release of a bolus of morphine when normal gut motility is restored. Special risk patients Exercise caution in elderly and debilitated patients and in those suffering from conditions accompanied by hypoxia or hypercapnia when even moderate therapeutic doses may dangerously decrease pulmonary ventilation. Also exercise caution in patients sensitive to CNS depressants, including those with cardiovascular disease myxedema convulsive disorders increased ocular pressure acute alcoholism delirium tremens cerebral arteriosclerosis ulcerative... 

Gl Obstructive disease (eg, achalasia, pyloroduodenal stenosis or pyloric obstruction, cardiospasm) paralytic ileus intestinal atony of the elderly or debilitated severe ulcerative colitis toxic megacolon complicating ulcerative colitis hepatic disease. 

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