It is important to remember that 5 ASA compounds even if generally tolerable, are associated with diarrhea in some patients and some clinicians thus prefer not to use them in patients with severe acute ulcerative colitis. Many reports cite impaired renal function from prolonged 5 ASA use and therefore renal function must be monitored in patients receiving long term therapy. Other side effects of 5 ASA agents include dizziness, fever, headache, abdominal pain, nausea and rash. Due to a hypersensitivity to 5 ASA, a small percentage of patients may experience worsening diarrhea and abdominal pain. However, in general 5 ASA agents are considered safe and effective for induction and maintenance of remission in mild to moderate
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Are there any contraindications for this drug? Hypersensitivity, cross-sensitivity with other NSAID’s such as aspirin, history of allergic reactions, asthma, advanced renal disease, hepatic dysfunctions, perioperative pain.
B.S. is an 81 year old Caucasian female presenting with abdominal pain, diarrhea, nausea and vomiting in the emergency room on February 3, 2013. B.S. has a history of glaucoma, hypothyroidism, degenerative arthritis and diverticulosis. She has allergies to iodine and vicodin. B.S. is admitted for diverticulitis with possible partial bowel obstruction and hydronephrosis. B.S. was admitted on February 3, 2013 here at Verdugo Hills Hospital.
This 72-year-old claimant sustained a work-related injury on 04/22/07. The claimant continues to have discomfort in the right thigh, buttock area, and lumbar spine. She has a pain rating of 2-7/10. She takes Voltaren more regularly and the Tylenol only when the pain is greater. It was noted that she has been taking these medications for years with benefit. The claimant’s pain has decreased and the claimant is able to complete activities of daily living with the use of medications. However, this medication is listed as a “Non-Preferred” drug in the formulary. There is no documentation of failed trials of “Preferred” drugs and documentation indicating that this medication is more beneficial to the claimant than a “Non-Preferred”
There is a selection of appropriate interventions taken when treating Crohn’s disease which will vary for different patients however there is no cure. Early treatment of the disease has proven to be effective through trials with immunomodulators and anti-TNF agents. Anti-inflammatory drugs or antibiotics are helpful in treating colon and minor bowel inflammation. 5-aminosalicylic acid derivative agents such as sulfasalazine and balsalazide are used to treat mild and moderate Crohn’s disease and to maintain remission.
DS is a 57-year-old white female whit a history of diverticulitis who presents to the clinic for an evaluation of abdominal pain. She stated that she began experiencing left lower quadrant pain last night that worsened through the night and into this morning. The pain is described as dull, occasionally cramping, rated 7/10 in severity. The patient also stated that this pain is similar to previous episodes of diverticulitis. The patient stated that she took Gas-X this morning with little relief. She was able to move her bowels yesterday and this morning, both reportedly normal. The patient denied any fever, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, melena, hematochezia, or any other symptoms. At this time, there were
Adverse reactions to this medication are migraine, speech disorders, rhinitis, sinusitis, hyperglycemia, elevated liver function, elevated serum creatinine level, pancytopenia, bronchitis, dyspnea, toxic epidermal necrolysis, anaphylaxis, elevated creatine kinase, generalized pain, and infection. Nursing considerations with this medication is to have the patient swallow the whole tablet and not to chew. Watch for aspiration while watching the patient take the medication. Educate the patient about the medication and inform them to notify a physician if bleeding
Assessent criteria: Remission: <2.6 points; significant response: reduction ≥1.2 points; continued improvement: reduction <1.2 points, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with AS (remission: <2.0; significant response: reduction ≥2.0 points; continued improvement: reduction <2.0 points. CT-P13 demonstrated comparable effectiveness to its RP. All patients who switched to the biosimilar maintained or improved their clinical response, including two who remained in remission and three who moved into remission. Switching from the RP to CT-P13 did not affect the safety or effectiveness of treatment in patients with different inflammatory diseases in this study.
Attending to her ulcerative colites, she was initially treated with messalazine 3g/day without response and subsequently with prednisolone 20 to 40 mg/day and azathioprine 100mg/day (2mg/kg/day). Other medications included calcium and vitamin D. Nevertheless she presented several acute episodes of ulcerative colitis and was started on anti-TNFα, Infliximab (IFX) intravenously administered at a standard dose of 5 mg/Kg at week 0, 2, 6 and then every 8 weeks. After 12 months of anti-TNF α therapy she presented complete pain relief. Radiological evolution, which is difficult to analyze due to irregular hyperostosis, showed no evidence of disease progression (Figure 1B). Bone densitometry (dual-energy X-ray absorptiometry, DEXA) showed lumbar osteopenia (L1-L4; T score -1.8 and Z score -1.7) and increased bone density of femur neck and forearm (T score -3.6 and 6.7). These results indicated an increase in bone density at the lumbar level and decrease in density in femur neck, to values found 10 years before anti-TNF alfa therapy. Also, for bone scintigraphy lower radionuclide uptake was observed after treatment. (Figure
Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,
In this experiment, alum was synthesized from aluminum. The goal was to calculate the number if water moles that are part of alum’s crystalized structure. This research into the number of moles of water in alum’s structure is important because the number of moles of water within the alum contribute to it’s structure. Alum is a hydrated crystal, or a number of hydrates bonded to an ion that can also be referred to as potassium aluminum sulfate dodecahydrate. There are 12 hydrates bonded to the potassium aluminum sulfate ion.
Regarding her medications, at admission she was taking Nucynta (Tapentadol ER) 250mg, every morning and bedtime, in addition to 1 to 3 tablets of hydromorphone 8mg per day. She notes that tapentadol maintains her pain level at a 6/10 on average, however the intensity of her pain can spike to an 8/10 or higher. When her pain is severe, she takes one dose of hydromorphine and finds it can relieve her pain by 2 to 3 points on the pain scale for a duration of 3 to 4 hours. She reports opioid-induced side effects of constipation and dry mouth. She has tried Restoralax, Lansoyl, and lactulose, however none of these laxatives were effective in restoring her bowel function. She was encouraged to push fluids throughout the day, and to take 2 to