2. OBJECTIVES
At the end of the presentation, the students will be
able to:
1. Describe the general goals of therapy when
administering gastrointestinal system medications
2. Enumerate the different gastrointestinal
medications
3. Identify the uses of the different gastrointestinal
medications
4. Describe nursing considerations related to
administration of gastrointestinal medications
5. List significant client education points related to
gastrointestinal system medications.
3. GASTROINTESTINAL MEDICATIONS
A. Gastrointestinal F. Antiemetics
Stimulants G. Histamine H2
B. Medications to Antagonists
Decrease GI Tone H. Proton Pump
& Motility Inhibitors
C. Antidiarrheals I. Antacids
D. Laxatives J. Mucosal
E. Emetics Protective Agents
5. Action and Use
• Decrease reflux by increasing sphincter
tone and enhancing acid clearance and
decreasing gastric emptying.
• Used for prevention and reduction of
nausea and vomiting due to
chemotherapy, and for facilitation of small
bowel intubations
• Used for gastric emptying caused by
diabetic gastroparesis, gastroesophageal
reflux, postoperative nausea and vomiting
6. Side Effects
• Drowsiness, diarrhea, restlessness,
fatigue
• Parkinson – like symptoms
Adverse Effects/ Toxicity
• Seizures
• Agranulocytosis
• Depression with suicide ideations
7. Key Points in Drug Administration
• Metoclopramide PO should be taken 30
minutes before meals and bedtime
• Metoclopramide IV should be given 30
minutes prior to chemotherapy for
antiemetic effect
• Concurrent use of macrolides and
antifungal agents may cause serious
cardiac dysrhythmias (cisapride)
8. Nursing Considerations
• Monitor for possible hypernatremia and
hypokalemia, particularly if client has
congestive heart failure (CHF) or
cirrhosis of liver
• Extrapyramidal symptoms may occur in
young adults and the elderly and with
high – dose treatment of
metoclopramide
9. Client Education
• Instruct client to report signs and
symptoms of side effects.
• Instruct client to report signs of acute
dystonia immediately.
• Advise client not to drive for a few hours
after taking metoclopramide
10. MEDICATIONS TO DECREASE GI
TONE AND MOTILITY
(ANTICHOLINERGICS AND ANTISPASMODICS)
• Dicyclomine hydrochloride (Bentyl)
• Hyoscyamine sulphate (Levsin)
• Chlordiazepoxide hydrochloride (Librax)
• Glycopyrrolate (Robinul)
11. Action and Use
• Anticholinergics: antagonize the action
of acetylcholine at the cholinergic
receptor sites
• Antispasmodics: are similar and they
are believed to relax smooth muscle
• Used for treatment of spasms of the
gastrointestinal (GI) tract such as
pyrolospasms, ileitis, irritable bowel
syndrome
13. Adverse Effects/ Toxicity
• May cause dilated, non – reactive
pupils, visual changes
• Tachycardia
• Dysphagia, decreased or absent bowel
sounds
• Hyperthermia, hypertension, increased
respiratory rate
14. Key Points in Drug Administration
• Give medications 30 to 60 minutes
before meals and at bedtime for
therapeutic effect.
• Contraindicated in narrow – angle
glaucoma, obstructive GI disease,
paralytic ileus, obstructive uropathy
15. Nursing Considerations
• An understanding of the factors contributing to the
diarrhea is essential in effective treatment
• Clients who lose significant potassium with diarrhea
are at risk for the development of paralytic ileus and
cardia dysrhythmias
• They should also be monitored for metabolic acidosis
because of loss of bicarbonate and impaired renal
excretion of acids.
• Document indications and present medications
• Monitor vital signs, urine output, and visual changes.
• Monitor intake and output (I & O)
16. Client Education
• Instruct client to avoid exposure to high
temperatures because of risk of
hyperthermia.
• Advise client to report side effects to health
care provider.
• Instruct client on dietary / fluid interventions
to decrease constipation
• Instruct client to report any additional
medications prescribed.
• Instruct client to monitor I & O.
18. Action and Use
• Slow and/ or inhibit GI motility by acting
on nerve endings of the intestinal wall,
thereby reducing the volume of stools,
increasing viscosity and decreasing fluid
and electrolyte loss.
• Used for symptomatic relief of acute
non – specific diarrhea and diarrhea of
inflammatory disease.
19. Side Effects
• Nausea and vomiting
• Dry mouth, dizziness, drowsiness,
constipation
• Temporary darkening of stools and
tongue may occur with bismuth
salicylate
20. Adverse Effects/ Toxicity
• Clinical signs and symptoms of overdose
include drowsiness, decreased blood
pressure (BP), seizures, apnea, blurred
vision, dry mouth, and psychosis.
• Risk of aspirin toxicity with concurrent use of
aspirin, bismuth salicylate
• Other adverse effects include central nervous
system (CNS) depression, respiratory
depression, hypotonic reflexes, angioedema,
anaphylaxis, and paralytic ileus.
21. Key Points in Drug Administration
• Shake suspension well; chew tablets
thoroughly
• Stool may appear gray – black (may mask GI
bleeding)
• Do not give concurrently with other medications
• Seek medical care if diarrhea persists for more
than 2 days in the adult
• Do not use to treat diarrhea in children; seek
medical attention
22. Nursing Considerations
• Note allergies
• Document onset, duration, and frequency of symptoms
• Document previous therapies used.
• Note current medications
• Identify causative factors; perform stool analysis if
necessary and ordered
• Assess for evidence of dehydration or electrolyte
imbalance
• Monitor vital signs and I & O
• Note presence of co – morbid conditions
• Check abdomen for tenderness, distention, bowel sounds,
or masses
• Administer bismuth and tetracycline one hour apart.
23. Client Education
• Instruct client to drink fluids to avoid dehydration
and alleviate dry mouth
• Instruct client to follow the BRAT diet: Bananas,
Rice, Applesauce, Tea/ Toast to avoid dehydration
if recommended by healthcare provider
• Advise client not to exceed prescribed dose
• Instruct client to consult health care provider if
diarrhea persists over 2 days
• Advise client to use caution in activities requiring
alertness if dizziness/ drowsiness is present
(possible side effects)
24. Client Education
• Instruct client to report occurrence of fever,
nausea and vomiting, abdominal pain or
distension
• Advise client to avoid dairy products
• Teach good personal hygiene to avoid skin
irritation or breakdown because of diarrhea.
• Instruct client to avoid alcohol ingestion while
taking the medication
• Instruct client to notify healthcare provider if
pregnant or breastfeeding.
27. Actions & Uses
• Laxatives swell in water, forming an
emollient gel that increases bulk in the
intestines.
• Peristalsis is stimulated by the
increased fecal mass, which decreases
the transit time.
• They generally produce a laxative effect
within 12 to 14 hours but may require 2
to 3 days for full effect.
28. Side Effects
• Abdominal discomfort and/or bloating,
flatulence
• Nausea and vomiting, diarrhea
Adverse Effects/ Toxicity
• Rare reports of allergic reactions to karaya
such as urticaria, rhinitis, dermatitis,
bronchospasm
• Esophageal obstruction, swelling, or blockage
may occur when insufficient fluid is used in
mixing a bulk – forming laxative.
29. Key Points in Drug Administration
• It is essential that adequate fluids be
given for bowel absorption since these
agents rely on water to increase their
bulk.
• Each dose should be given with a full
glass of liquid (240mL)
• Fiber increases stool bulk and water
retention in the bowel.
• Do not use if fecal impaction is present.
30. Nursing Considerations
• Assess swallowing ability, adequately
mix agents in liquid and encourage
additional fluid intake.
• Monitor for aspiration.
• Add at least 8 oz (240mL) of water or
juice to drug
• Separate psyllium administration from
digoxin, salicylates, and anticoagulants
by 2 hours
31. Client Education
• Instruct client that these agents require
adequate hydration to be effective
• Encourage additional fluids and
exercise.
• Instruct client to take them 2 hours after
meals and any oral medications.
• Instruct client that full effect of
medication may not occur for 2 to 3
days.
33. Actions & Uses
• Are called stimulants because they
stimulate peristalsis via mucosal
irritation which increased motility.
• Defecation occurs between 6 to 12
hours after oral administration
• Rectal administration of bisacodyl and
senna produces catharsis within 15
minutes to 2 hours.
34. Side Effects
• Nausea and vomiting, abdominal
cramps, diarrhea, laxative dependence
• Muscle weakness, fluid/electrolyte
imbalance
• Rectal burning or irritation with
suppository use.
Adverse Effects/ Toxicity
• Hypokalemia, hypocalcemia
• Metabolic acidosis or alkalosis
35. Key Points in Drug Administration
• Bedtime administration of dose
promotes a morning bowel movement
• Swallow tablet whole; do not crush
• Do not take within 1 hour of antacids or
milk
• Castor oil may induce premature labor
• If taken with antacids may result in GI
irritation or cramping
36. Nursing Considerations
• Evaluate for nausea and vomiting,
abdominal pain or diarrhea
• Evaluate for medication effectiveness
• Monitor for fluid/ electrolyte imbalances
• Administer medication 1 hour before or
after ingestion of milk or an antacid
• Evaluate for laxative dependence and
offer counselling.
37. Client Education
• Discourage client from chronic use of
laxatives; use beyond 1 week should be
avoided.
• Instruct client to increase fluid intake
and diet high in fiber
• Instruct to take medications 1 hour
before or after ingestion of milk or an
antacid.
39. Actions & Uses
• They increase osmotic pressure within
the intestinal lumen, which results in
luminal retention of water, softening of
stool.
• Used for treatment of occasional
constipation
• Used to reduce ammonia levels
(Lactulose)
• May take 2 to 4 days to take effect.
40. Side Effects
• Glycerin: rectal irritation and
burning, hyperaemia of the rectal
mucosa
• Lactulose and Miralax:
flatulence, abdominal cramps/
bloating, diarrhea
Adverse Effects/ Toxicity
• Fluid and electrolyte imbalances
41. Key Points in Drug Administration
• Contraindicated in bowel obstruction
• Antibiotics may decrease laxative effect
by elimination of bacteria needed to
digest in active form.
42. Nursing Considerations
• Miralax should always be dissolved in 8
oz of water
• Dilute lactulose in water or juice to
decrease sweet taste
• Monitor frequency and consistency of
stools
• Monitor for electrolyte imbalances
especially in the elderly.
43. Client Education
• Instruct client that Miralax should be
dissolved in 8 oz of water
• Instruct client that the medication may take 2
to 4 days for effect
• Advise client to contact physician if unusual
bloating, cramping or diarrhea occurs
• Instruct client that prolonged use may result
in electrolyte imbalance and laxative
dependence.
• Instruct client to take medication with juice to
improve taste
45. Actions & Uses
• Used on scheduled basis for clients who are
likely to become constipated, such as with
hospitalization, bed rest, post – surgical status,
and for those receiving opioid analgesic
medications.
• Stool softeners are often referred to as
emollient laxatives.
• Softening of feces generally occurs after 1 to 3
days.
• Used for constipation associated with dry, hard
stools and to decrease strain of defecation.
46. Side Effects
– Mild abdominal cramping, diarrhea
– Dependence with long – term use or
excessive use
– Bitter taste
Adverse Effects/ Toxicity
– Throat irritation has occurred with docusate
sodium solution
– Docusate has been associated with
hepatotoxicity when used in combination with
oxyphenisatin or dantrol
47. Key Points in Drug Administration
• Offer fluids after each PO dose
• Contraindicated with intestinal
obstruction, undiagnosed abdominal
pain, vomiting or other signs of
appendicitis, fecal impaction, or acute
abdomen
48. Nursing Considerations
• Monitor frequency and consistency of
stools
• Monitor for electrolyte imbalances
especially in the elderly
49. Client Education
• Instruct client to take medication with
milk or juice to decrease bitter taste.
• Encourage client to increase fluid intake
• Inform client that it may require 1 to 3
days to soften fecal matter.
51. Actions & Uses
• Magnesium, sulphate, phosphate, and
citrate salts are used when rapid bowel
evacuation is required, as in bowel
evacuation in preparation for
procedures or surgery.
• Orally administered magnesium and
sodium phosphate salts are effective
within 30 minutes to 6 hours.
52. Side Effects
• Cramping and urgency to defecate
Adverse Effects/ Toxicity
• Safe when administered for short – term
management
• They may cause significant fluid and
electrolyte imbalances when used for
prolonged periods or in certain clients.
53. Key Points in Drug Administration
• Saline agents are not recommended for
children under 2 years of age because
of potential for hypocalcemia
• Contraindicated in the presence of
abdominal pain, nausea and vomiting,
or other signs and symptoms of
appendicitis or acute abdomen
• Concomitant use with antacids may
inactivate both.
54. Nursing Considerations
• Dehydration and electrolyte imbalances
may occur from repeated administration
without appropriate fluid replacement
• Encouraged increased fluid intake
• Monitor drug effectiveness
55. Client Education
• Instruct client on drug dosing
• Instruct client to avoid frequent or
prolonged use due to laxative
dependence
• Instruct client to report side effects to
health care provider
• Advise client to report health care
provider if ineffective
• Encourage client to increase fluid intake.
56. EMETICS
• Ipecac Syrup
Action and Use
• Directly irritate the GI mucosa and
stimulate chemoreceptor trigger zone
• Emetics are used to induce vomiting
after oral poisoning or drug overdose
57. Side Effects
– Drowsiness
– Arrythmias
– Diarrhea
– Mild CNS depression
Adverse Effects/ Toxicity
– May be cardiotoxic if not vomited and
allowed to absorb, leading to heart
conduction disturbances.
58. Key Points in Drug Administration
• Ipecac syrup dose is 15 to 30 mL orally
• Onset of action usually occurs in 20 minutes
• Follow dose with 240cc water for adults and children
older than 12, ½ to 1 glass of water for infants up to 1
year, and 1 to 2 glasses of water for children younger
than 12 years of age.
• Do not give to infants less than 6 months of age.
• Do not use with corrosive or petrolatum distillates
(gasoline, kerosene, volatile oils or caustic
substances)
• Do not give to semicomatose or unconscious clients
during intoxication, seizures, shock or any loss of gag
reflex.
59. Nursing Considerations
• Evaluate origin of agent ingested
• There is a risk of aspiration of vomitus in children
less than 12 months, the elderly, and in anyone
with altered level of consciousness or gag reflex
• Drug may be abused by clients with eating
disorders
• Monitor medication effect
• Administer with at least 200 to 300 cc of water
• Assess respiratory status and level of
consciousness
• Review abuse potential
60. Client Education
• Instruct client to contact poison control before
administering ipecac syrup
• Advise client to seek immediate medical attention when
poisoning is suspected
• Instruct client to keep all medications out of reach of
children
• Advise client to check the expiration date periodically as
drug is available over the counter
• Avoid drinking milk or carbonated beverages that may
alter effectiveness
• Instruct client that vomiting does not occur, go
immediately to health care provider/emergency room to
decrease toxic absorption of drug
62. Action and Use
• Emesis is a complex reflex brought about by
activation of the vomiting center (a nucleus of
neurons located in the medulla oblongata)
• Certain stimuli activate the vomiting center
directly (e.g. gastrointestinal irritation) while
other stimuli (e.g. drugs, toxins, radiation) act
within the medulla to stimulate the
chemoreceptor zone (CTZ); presumably by
altering the function of these neuroreceptors that
emetogenic compounds and antiemetic drugs
produce their effects.
63. Side Effects
• Phenothiazines can produce
extrapyramidal reactions, anticholinergic
effects, hypotension and sedation.
• Butyrophenones can also produce
extrapyramidal reactions, sedation and
hypotension
• Cannbinoids may cause temporal
disintegration, dissociation,
depersonalization and dysphoria
64. Adverse Effects/ Toxicity
• Cannbinoids are contraindicated for
clients with psychiatric disorders
• Phenothiazines: agranulocytosis,
thrombocytopenia
65. Key Points in Drug Administration
• In cancer chemotherapy antiemetic combinations are
more beneficial than single – drug treatment: this may
suggest that there is more than one mechanism
triggering the emesis.
• Parenteral preparations should be given deep IM to
avoid leakage of the drug into the subcutaneous tissues
• Anticipatory nausea and vomiting should be treated 1
hour before meals or treatment.
• Contraindicated with CNS depression and coma
• Use cautiously in clients with glaucoma, seizures,
intestinal obstruction, prostatic hyperplasia, asthma,
cardiac, pulmonary or hepatic disease.
66. Nursing Considerations
• Dronabinol and nabilone have a high potential
for abuse
• Check vital signs regularly for risk of
hypotension or tachycardia
• Observe for side effects and adverse reactions
• Monitor I & O for urine retention
• Observe for mood changes or involuntary
movements
• Monitor lab values: liver function test,
electrolytes and renal function (blood urea
nitrogen and creatinine)
67. Client Education
• Avoid activities that require alertness
• Teach signs and symptoms to report to health care
provider
• Instruct client to avoid alcohol and CNS depressant
drugs
• Instruct diabetic clients to monitor blood glucose
• Teach client to take medications as prescribed
• Instruct client to avoid excessive sunlight/ UV light
because of potential photosensivity
• Advise clients to increase fluids and dietary fiber to
decrease risk of constipation
• To be more effective instruct client to take medication 30
to 60 minutes
69. Action and Use
• Reduce gastric acid secretion by blocking
histamine 2 in the gastric parietal cells
• Histamine H2 antagonists are used to treat
duodenal ulcer, gastric ulcer, hypersecretory
conditions such as Zollinger – Ellison
syndrome, reflux esophagitis
• Used for prevention of stress ulcers in
critically ill clients, combination therapy to
treat Helicobacter pylori (bacteria found in
gastric mucosa)
70. Side Effects
– Somnolence, diaphoresis, rash, headache
– Taste disorder, diarrhea, constipation, dry
mouth
Adverse Effects/ Toxicity
– Rare but may include agranulocytosis,
neutropenia, thrombocytopenia, aplastic
anemia, pancytopenia
– Anaphylaxis
71. Key Points in Drug Administration
• IV administered drugs should not be mixed with
other medications
• Avoid antacid use within 1 hour of administration
• May be given as single dose, twice daily or with
meals and at bedtime
• Decreased ketaconazole absorption with
Famotidine
• Nizatidine may increase salicylate levels with
high dose of aspirin
• Cimetidine: decreased metabolism of beta
adrenergic blockers
72. Nursing Considerations
• Reduce dosages usually required for
clients with hepatic or renal impairment
• Assess medications for possible
interactions
• Evaluate nutritional status and dietary
interventions
• Evaluate need for smoking cessation
and alcohol abuse programs
73. Client Education
• Instruct client to avoid smoking, which causes
gastric stimulation
• Advise client to avoid antacid (agent reducing
acidity) use within 1 hour of dose
• Instruct clients to take medications only as
directed.
• Inform client that once – a – day dosage should
be taken at bedtime; if prescribed more than daily,
take before meals
• Instruct client to avoid gastric irritants such as
alcohol, aspirin or non-steroidal anti-inflammatory
drugs (NSAIDS)
75. Action and Use
• Block acid production by inhibiting the H+ - K+ ATPhase
at the secretory surface of the gastric parietal cells,
thereby blocking the formation of gastric acid
• Used for treatment of erosive or ulcerative
gastroesophageal reflux disease (GERD) or duodenal
ulcers, active benign gastric ulcers, and nonsteroidal anti
– inflammatory drug (NSAID) – associated gastric ulcers
(short term)
• Used for healing and reduction in relapse rates of
heartburn symptoms in erosive or ulcerative GERD
(maintenance)
• Used for treatment of pathological hypersecretory
conditions such as Zollinger Ellison syndrome (long –
term)
76. Side Effects
• Headache, diarrhea, constipation,
abdominal pain, nausea, flatulence
• Rash, hyperglycemia, dizziness,
pruritus, dry mouth
• Injection site reaction with pantoprazole
78. Key Points in Drug Administration
• May give with antacids
• If unable to swallow capsules, lansoprazole
and esomeprazole capsules may be opened
and sprinkled on applesauce before taking
• To give per nasogastric (NG) tube, dilute
capsule contents in 40-cc juice
• Omeprazole, pantoprazole, and rabeprazole
must be swallowed whole
• Not recommended in children or nursing
mothers.
• May increase liver enzymes.
79. Nursing Considerations
• Dosage should be reduced in severe liver
disease
• Document reason for therapy, duration of
symptoms and drug efficacy
• Monitor for side effects
• Monitor laboratory test results including
liver function test, CBC, and renal function
(BUN, creatinine)
• Review any diagnostic findings
• Assess for pregnancy or lactation
80. Client Education
• Review side effects with clients, instruct to report diarrhea
• Instruct client to take medications as prescribed; do not
increase dose
• Advise client to follow prescribed diet and activities to
decrease symptoms
• Inform client that medication is generally for short – term
therapy; instruct client to keep health care appointments
for continued signs and symptoms
• Instruct client that esomeprazole and omeprazole should be
taken before meals
• Advise client to notify health care provider of any difficulty
swallowing since omeprazole, pantoprazole, and
rabeprazole must be swallowed whole
• Instruct client that lansoprazole and esomeprazole
capsules may be opened and sprinkled.
82. Action and Use
• Gastric acid neutralizing agent
• Used for symptomatic relief of
hyperacidity associated with GI
disorders
• Used as an antiflatulent to alleviate
symptoms of gas and bloating
84. Adverse Effects/ Toxicity
• Hypophosphatemia (anorexia, malaise,
tremors, muscle weakness)
• Aluminum toxicity (dementia) may occur with
repeated dosing
• Hypercalcemia and metabolic alkalosis may
occur with antacids containing calcium
carbonate
• May worsen hypertension and heart failure
from increased sodium intake with use of
those antacids containing sodium carbonate
85. Key Points in Drug Administration
• Antacids should be taken at least 2 hours apart
from other drugs where a drug interaction may
occur
• Magnesium hydroxide is contraindicated in the
presence of abdominal
pain, nausea, vomiting, diarrhea, severe renal
dysfunction, fecal impaction, rectal
bleeding, colostomy, ileostomy
• Aluminum carbonate antacids: prolonged use of
high doses in presence of low serum phosphate
86. Key Points in Drug Administration
• Calcium carbonate antacids: hypercalcemia
and hypercalciuria, severe renal disease,
renal calculi, GI hemorrhage or obstruction,
dehydration
• Dihydroxyaluminum sodium carbonate:
aluminum sensitivity, severe renal disease,
dehydration, clients on sodium – restricted
diets.
• Antacids may bind with other drugs, therefore
decreasing the drug’s absorption and
effectiveness, such as tetracycline.
87. Nursing Considerations
• Shake suspension well
• Flush NG tube with water after
administration
• Observe for signs and symptoms of
altered phosphate levels: anorexia,
muscle weakness, and malaise
88. Client Education
• Instruct client on methods to avoid
constipation
• Instruct client to take as directed; do not
exceed maximum dose
• Instruct client to keep out of reach of children
• Advise client to drink plenty of fluids
• Explain antacids may interact with certain
medications; notify health care provider of
any prescribed medications
• Warn client not to use if diagnosed with
kidney disease
90. Action and Use
• Misoprostol (Cytotec) inhibits gastric secretion, protects
gastric mucosa by increasing bicarbonate and mucus
production and decreases pepsin levels.
• Sucralfate (Carafate) protects the site of ulcer from
gastric acid by forming an adherent coating with
albumin and fibrinogen; it absorbs pepsin decreasing its
activity
• Misoprostol (Cytotec) is used for the prevention of
gastric ulcers, investigational use with duodenal ulcers.
• Sucralfate (Carafate) is used for short – term treatment
of duodenal ulcers with continued maintenance
treatment at lower doses; investigational use for gastric
ulcers.
91. Side Effects
• Dizziness, headache, constipation, diarrhea,
nausea, vomiting, flatulence, dry mouth and
rash
• Misoprostol may cause spotting, cramping,
dysmenorrhea, menstrual disorders, and
postmenopausal bleeding
Adverse Effects/ Toxicity
• Angioedema
• Respiratory difficulty, laryngospasm
• Seizures
92. Key Points in Drug Administration
• Sucralfate should be taken 1 hour before meals
and bedtime or 2 hours after meals
• Sucralfate should be taken 2 hours after
medications and not within 2 hours of antacids
• Misoprostol should be taken with food
• Misoprostol is contraindicated in clients who are
allergic to prostaglandins or who are pregnant
or lactating
• Misoprostol may cause miscarriage with
serious bleeding
93. Nursing Considerations
• Assess GI symptoms
• Assess for pregnancy
• Monitor concomitant medications
• Give medications according to
prescription
• Monitor for side effects
• Assess respiratory status, swallowing or
change in gag reflex
94. Client Education
• Instruct client to avoid gastric irritants such as
caffeine, alcohol, smoking, and spicy foods
• Instruct client to take medication as prescribed
and do not share with others.
• Advise client to report side effects to
healthcare provider for possible dosage
change
• Instruct client in contraceptive practices while
on misoprostol
• Instruct female clients to report any abnormal
vaginal bleeding
95. Client Education
• Instruct client not to take misoprostol if
pregnant; if client becomes pregnant while
taking misoprostol, she should stop taking it
• Inform client to avoid pregnancy at least 1
month or 1 menstrual cycle after stopping
medication
• Instruct client to increase fluids and fiber to
decrease constipation
• Instruct on antacid use to decrease interaction
• Advise client to report immediately any difficulty
swallowing or breathing
