Names and pronunciation
(proo-kal′oh-pride) Motegrity, Resotran
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Drug reference
(proo-kal′oh-pride) Motegrity, Resotran
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Func. class.: GI prokinetic, serotonin 5-HT4 receptor agonist Func. class.: Adrenergic Func. class.: Bulk laxative
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USES: Treatment of chronic idio- pathic constipation USES: Nasal decongestant, adjunct for otitis media; with antihistamines USES: Chronic constipation, ulcerative colitis
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Chem. class.: Substituted phenyleth- ylamine Controlled Substance Schedule V Chem. class.: Psyllium colloid
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Do not confuse: Sudafed/sotalol
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ACTION: Primary activity through α-effects on respiratory mucosal mem- branes reducing congestion, hyperemia, edema; minimal bronchodilation sec- ondary to β-effects ACTION: Bulk-forming laxative
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Unlabeled uses: Diarrhea, diverticu losis, irritable bowel syndrome, hyper cholesterolemia
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CONTRAINDICATIONS Hypersensitivity to prucalopride or any component, intestinal perforation/obstruc- tion, Crohn disease, ulcerative colitis, toxic megacolon CONTRAINDICATIONS: Hyper sensitivity to sympathomimetics, closed- angle glaucoma Precautions: Pregnancy, breastfeeding, cardiac disorders, hyperthyroidism, dia- betes mellitus, prostatic hypertrophy, hypertension, child <4 yr CONTRAINDICATIONS: Hyper sensitivity, intestinal obstruction, abdominal pain, nausea, vomiting, fecal impaction Precautions: Pregnancy
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SIDE EFFECTS CNS: Tremors, anxiety, stimulation, insomnia, headache, dizziness, halluci- nations, seizures (geriatric patients) CV: Palpitations, tachycardia, hyperten- sion, chest pain, dysrhythmias, CV collapse EENT: Dry nose; irritation of nose and throat GI: Anorexia, nausea, vomiting, dry mouth, ischemic colitis GU: Dysuria SIDE EFFECTS GI: Nausea, vomiting, anorexia, diar rhea, cramps, intestinal or esophageal blockage
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INTERACTIONS • Do not use with MAOIs or tricyclics; hypertensive crisis may occur Increase: effect of this product—urinary alkalizers, adrenergics, β-blockers, phe- nothiazines, tricyclics Decrease: effect of this product—uri- nary acidifiers INTERACTIONS Decrease: absorption of cardiac glyco- sides, oral anticoagulants, salicylates Drug/Herb Increase: laxative effect—flax, senna
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DOSAGE AND ROUTES Chronic idiopathic constipation Adult: PO 2 mg daily; used as added laxative if no bowel movement within ≥3 days DOSAGE AND ROUTES Adult and child >12 yr: PO 60 mg q6hr; EXT REL 120 mg q12hr or 240 mg q24hr Geriatric: PO 30-60 mg q6hr prn Child 6-12 yr: PO 30 mg q6hr, max 120 mg/day Child 4-6 yr: PO 15 mg q6hr, max 60 mg/ day DOSAGE AND ROUTES • Adult: PO 1-2 tsp in 8 oz water bid or tid, then 8 oz water or 1 premeasured packet in 8 oz water bid or tid, then 8 oz water • Child >6 yr: PO 1 tsp in 4 oz water at bedtime
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Available forms: Tabs 1, 2 mg (soo-doh-eh-fed′rin) Eltor , Sudafed, Sudafed 24 Hour, Sudogest (many products) Available forms: Ext rel caps 120, 240 mg; oral sol 15 mg, 30 mg/5 mL; tabs 30, 60 mg; ext rel tabs 120, 240 mg Available forms: Chew pieces 1.7, 3.4 g/piece; effervescent powder 3.4, 3.7 g/ packet; powder 3.3, 3.4, 3.5, 4.94 g/tsp; wafers 3.4 g/wafer
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Administer: • Avoid taking at or near bedtime; stimu- lation can occur • OTC preparations require an ID for sale; tracked, Schedule V Administer: PO route • Alone for better absorption, separate from other products by 1-2 hr • In morning or evening (oral dose) • Immediately after mixing with water or will congeal • With 8 oz water or juice followed by another 8 oz of fluid
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Assess: • Nasal congestion: auscultate lung sounds; check for tenacious bronchial secretions • B/P, pulse throughout treatment • Beers: avoid in older adults; CNS stim- ulant effects, seizures, hallucinations, excitation • Pregnancy/breastfeeding: avoid in pregnancy; cautious use in breastfeeding Assess: • Blood, urine electrolytes if used often • I&O ratio to identify fluid loss • Constipation: cause of constipation; fluids, bulk, exercise missing; bowel sounds, distention, usual bowel func- tion; color, consistency, amount, cramping, rectal bleeding, nausea, vomiting; product should be discontinued • Pregnancy/breastfeeding: generally con- sidered safe in pregnancy, breastfeeding
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Evaluate: • Therapeutic response: decreased na- sal, eustachian tube, congestion Evaluate: • Therapeutic response: decrease in con- stipation, decreased diarrhea with colitis
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CLINICAL CONSIDERATIONS CLINICAL CONSIDERATIONS
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Patient and caregiver information: • About the reason for product adminis- tration • Ext rel: do not divide, crush, chew, or dissolve • Do not use within 14 days of MAOIs • Not to use continuously or to take more than recommended dose because rebound congestion may occur • To notify prescriber immediately of anxiety, slow or fast heart rate, dyspnea, seizures • To check with prescriber before using other products because product interac- P tions may occur • To avoid taking near bedtime because stimulation can occur • Not to use if stimulation, restlessness, tremors occur • That use in children may cause exces- sive agitation • To notify provider if symptoms do not improve within 7 days or if having a fever (sill′ee-um) Hydrocil, Leader Fiber Laxative, Metamucil, Natural Fiber, Natural Vegetable Fiber, Reguloid, Wal- Mucil, Konsyl Patient and caregiver information: • To maintain adequate fluid consump- tion • That normal bowel movements do not always occur daily • Not to use in presence of abdominal pain, nausea, vomiting • To notify prescriber if constipation unrelieved or if symptoms of electro- lyte imbalance occur: muscle cramps, pain, weakness, dizziness, excessive thirst
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PHARMACOKINETICS PO: Onset 15-30 min; duration 4-6 hr, 8-12 hr (ext rel); metabolized in liver; excreted in feces and breast milk; half- life 7 hr (adult), 3 hr (child) PHARMACOKINETICS Onset 12-72 hr, excreted in feces, not absorbed in GI tract
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• Adult: PO 1-2 tsp in 8 oz water bid or tid, then 8 oz water or 1 premeasured packet in 8 oz water bid or tid, then 8 oz water
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• Child >6 yr: PO 1 tsp in 4 oz water at bedtime
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