The miscellaneous GI drugs are given with caution to patients with a known hypersensitivity to the drugs. In addition mesalamine, olsalazine, and sulfasalazine are contraindicated in patients who have hypersensitivity to the sulfonamides and salicylates or intestinal obstruction, and in children younger than 2 years. There is a possible cross-sensitivity of mesalamine, olsalazine, and sulfasalazine with furosemide, sulfonylurea antidiabetic drugs, and carbonic anhydrase inhibitors. Misoprostol is contraindicated in those with an allergy to the prostaglandins and during pregnancy (Pregnancy Category X) and lactation.
Misoprostol is used cautiously in women of child-bearing age. Mesalamine, olsalazine, sucralfate, and sul-fasalazine are Pregnancy Category B drugs; all are used with caution during pregnancy (safety has not been established) and lactation.
There is an increased risk of diarrhea in patients taking misoprostol with the magnesium-containing antacids. Sulfasalazine may increase the risk of toxic-ity of oral hypoglycemic drugs, zidovudine, methotrex-ate, and phenytoin. There is an increased risk of crys-talluria when sulfasalazine is administered with methenamine. A decrease in the absorption of iron and folic acid may occur when these agents are administered with sulfasalazine. When bismuth subsalicylate is administered with aspirin-containing drugs, there is an increased risk of salicylate toxicity. There is an increased risk of toxicity of valproic acid and methotrexate and decreased effectiveness of the corti-costeroids when these agents are administered with bismuth subsalicylate.
^Herbal Alert: Ginger
Ginger is a pungent herb used primarily for GI problems such as motion sickness, nausea, vomiting, and digestion. In addition, it is recommended for the pain and inflammation of arthritis and may help lower cholesterol. The dosage of the dried form of ginger is 1 g (1000 mg) per day. Adverse reactions are rare, although heartburn has been reported by some individuals. The herb should be used cautiously in patients with hypertension or gallstones and during pregnancy or lactation. As with all herbs, a primary care provider should be consulted before any herbal remedy is taken. Ginger, like many herbs, has been used safely as a food by millions of individuals for hundreds of years.
Deficient Fluid Volume related to uncontrolled vomiting or diarrhea
Constipation related to adverse drug effects (aluminum- or calcium-containing antacids)
Diarrhea related to adverse reactions of magnesium- or sodium-containing antacids or other digestive system drugs
Risk for Imbalanced Nutrition: Less than Body Requirements related to inability to eat, digest food, anorexia Risk for Injury related to adverse drug effects (eg, weakness, dizziness)
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