C H A P T E R 5 8
Drugs affecting gastrointestinal motility
925
nausea and in some cases vomiting) and an increase in
activity below the point of irritation. The body is trying to
flush the invader from the body. A low-grade fever may
occur as a reaction to the toxins released by the bacteria.
Muscle aches and pains, malaise and fatigue are often
common symptoms. It is important at this stage of the
disease to maintain fluid intake to prevent dehydration from
occurring.
P.F. may want to return home, but with intense
cramping and diarrhoea it might not be a good idea.
Bovine colostrum (
Travelan
) has been effective in
preventing traveller’s diarrhoea and associated problems.
It is available OTC and is readily accessible for travellers.
Taken during a course of traveller’s diarrhoea, it may relieve
the stomach upset and nausea, and some of the discomfort
of the diarrhoea. It should not be used if the person has
bloody diarrhoea or diarrhoea that worsens or persists for
more than 48 hours.
The best course of action, however, is prevention.
Several measures can be taken to avoid ingestion of the
local bacteria: drinking only bottled or mineral water;
avoiding fresh fruits and vegetables that may have been
washed in the local water, unless they are peeled; avoiding
ice cubes in drinks because the ice cubes are made
from the local water; avoiding any food that might be
undercooked or rare, including shellfish; and even being
cautious about using water to brush teeth or gargle. People
who have suffered a bout of traveller’s diarrhoea are very
cautious about exposure to local bacteria when they travel
again, often combining prophylactic drug therapy with
careful avoidance of local pathogens. P.F. can be reassured
that in a few days the diarrhoea and associated signs and
symptoms should pass and he will regain his strength and
energy.
CARE GUIDE FOR P.F.: ANTIDIARRHOEALS
Assessment: History and examination
Assess the person’s health history for allergies to any of
these drugs, acute abdominal pain, concurrent use
of aspirin products, methotrexate, sodium valproate,
corticosteroids, oral tetracyclines, oral hypoglycaemic
agents or sulfinpyrazone.
Focus the physical examination on the following:
Neurological: orientation, reflexes
GI: abdominal evaluation, bowel sounds
Respiratory: respiratory rate and depth
Laboratory tests: serum electrolyte levels
Genitourinary: renal function
Other: temperature
Implementation
Administer an antidiarrhoeal agent only as a temporary
measure.
Provide comfort and safety measures, including assistance,
access to bathroom and safety precautions if necessary.
Monitor bowel function.
Provide support and reassurance for coping with drug
effects and discomfort.
Provide teaching regarding drug name and dosage, adverse
effects and precautions, and warning signs of serious
adverse effects to report.
Evaluation
Evaluate drug effects: relief of GI symptoms.
Monitor for adverse effects: GI alterations, dizziness,
confusion, salicylate toxicity.
Monitor for drug–drug interactions as indicated.
Evaluate the effectiveness of teaching program and comfort
and safety measures.
TEACHING FOR P.F.
• The drug you are taking is called bovine colostrum
(
Travelan
). This drug is called an antidiarrhoeal agent.
It forms a protective coating over the inner lining of the
intestine and soothes the irritated areas.
• Take this drug exactly as indicated. Shake the bottle
well before using the liquid preparation. If you are using
tablets, make sure that you chew them thoroughly; do
not swallow them whole.
• Common effects of this drug include:
•
Darkening of the stools
: Do not become concerned; this is
a normal effect that will go away when you stop taking
the drug.
• Report any of the following conditions to your
healthcare provider:
diarrhoea that does not stop within
2 days, ringing in the ears, rapid respirations, fever and/or
intense abdominal pain.
• Stay away from any food or beverage that may be
contaminated with bacteria. Use bottled water for
drinking, as well as for brushing your teeth. Do not wash
fruit or vegetables with water from the local supply.
• Tell any doctor, nurse or other healthcare provider
involved in your care that you are taking this drug.
• Keep this drug and all medications out of the reach of
children.
