MN553 Unit 3 GI System Drug Assignment

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Unit 3 Assignment- Drug used for GI Systems

MN553 Advanced Pharmacology and Pharmacotherapeutics

Part 1

Choose a drug that is used for the GI system. Write a legal prescription for the drug for a fictitious patient. You are the provider. Be sure your prescription includes all legally correct patient information, provider information, medication information as well as any special instructions to the pharmacist. Your writing Assignment should include all the legal elements of a prescription.

Legal Prescription for Lomotil

Patient name: John Doe

Date of birth: 09/09/1969

Name of drug: Lomotil (Approval to dispense generic if brand) Dose: Lomotil 5 mg by mouth every 6hours as needed for diarrhea Total quantity to dispense: 14 tablets

Refills: 0 of 0

Date /Signature: 8-17-2020 / Lilian Somuah FNP-RN

Contact Information: Urgent Care, Telephone #: (300)-111-1111

Provider NPI #: 1111111111

Part 2

Pharmacodynamics

Lomotil is used to treat diarrhea and it has an absorbent preparation. It’s an antidiarrheal drug and its generic name is Diphenoxylate- Atropine. It produces an antidiarrheal action when it binds to opiate receptors of the intestinal wall and slows down gastric motility (Woo, 2020). Lomotil contains diphenoxylate with atropine added, atropine belongs to a class of drug known as anticholinergics. Diphenoxylate component of Lomotil is equivalent to meperidine that decreases Gastrointestinal (GI) motility. When given in high doses it may cause an opiate effect on the person taking the drug. High doses and chronic use can also cause a form of opioid activity such as physical dependence and a feeling of ecstasy (Woo, 2020). The Atropine component of Lomotil has an anticholinergic effect that helps in decreasing bowel secretions and slowing down peristalsis, and helps prevent misuse and overdose. Lomotil can also decrease fecal volume, increases fecal solidity and changes the consistency to be formed instead of loose. It also aids in reducing fluid and electrolyte loss when someone has diarrhea.

Pharmacokinetics

Lomotil is normally taken orally and it’s well absorbed in the GI tract. According to Woo (2020) the atropine component crosses the blood- brain barrier and the placenta which can get to the fetus, it also crosses over to breast milk if taken by a nursing mother. Atropine can also produce a mild to moderate anticholinergic effect. Lomotil is metabolized by the liver and excreted mainly in feces with less amounts excreted in urine. Diphenoxylate and atropine combination seen in Lomotil are quickly metabolized to diphenoxylic acid, which stays active biologically and remains as its main metabolite (Woo, 2020).

Lomotil is administered orally, onset of this drug is 45-60 minutes, peak is 2 hours, its duration is 3-4 hours with a half-life of 2.5 hours. The half-life for metabolite is 12-14 hours.

Patient education

Patients she be instructed and warned to take drug exactly as prescribed by Provider, and should not exceed recommended dose. Patient should maintain adequate fluid intake during diarrhea episode and teach them about fluid replacement to prevent dehydration. Patient will be caution to avoid driving when taking Lomotil because drowsiness and dizziness may occur and that can be dangerous when driving. Patient should call Provider if the drug is not effective within 48 hours of use. Patient should be warned that prolonged use of Lomotil can cause tolerance, and overuse or misuse may result in drug dependence.

Women breast- feeding should not take Lomotil because drug effects have been reported in infants of mothers who take this drug. Drug should not be taken by children under the age of two and children with Down’s Syndrome have an increased sensitivity to atropine content in Lomotil. The elderly patient is more susceptible to respiratory depression and it Lomotil can exacerbate glaucoma. It is important to educate the elderly patient about reporting any signs of respiratory depression. Patient should be educated on the anticholinergic adverse reactions which can cause dryness in the mouth and mucous membranes, flushing, elevated heart rates and sometimes urinary retention which can be seen in children (Woo, 2020). It is important to educate patients about adverse drug reactions so that when they experience them, they can inform their Provider immediately and stop taking the drug.

References

Woo, T.M. and Robinson, M.V. (2020). Pharmacotherapeutics for Advanced Practice Nurse Prescribers. Philadelphia, PA: F.A. Davis Company.

Wu P.E. and Juurlink D.N. (2017). Clinical Review: Loperamide Toxicity. Ann Emerg Med. 2017;70(2):245-252. Doi: 10.1016/j.annemergmed.2017.04.008

Vincent R. L., Ariel, V., Alexander, A., Ruck, B., Nelson, L. S., Wax, P., Campleman, S., Brent, J. and Calello, D. P. (2018). Loperamide misuse to avoid opioid withdrawal and to achieve a euphoric effect: high doses and high risk. Clinical Toxicology, 2018; 1 DOI: 10.1080/15563650.2018.1510128