Quest Ran

1 Elisabeth Fandrich NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Trade Cholestyramine Name Questran Peak unknown

Onset unknown

Classification Dose Route Time/frequency Antihyperlipidemic, 1 scoop Po in 2100 qod Bile acid juice sequestrant Duration For IV meds, compatibility with IV drips and /or solutions 4-6 hr N/A

Mechanism of action and indications (Why med ordered) Adsorbs and combines with bile acids in the intestine to form an insoluble complex that is excreted in the feces, resulting in partial removal of bile acids from the enterohepatic circulation. The increased fecal loss of bile acids leads to an increased oxidation of cholesterol to bile acids, which results in a decrease in LDL cholesterol plasma levels and serum cholesterol levels. Diarrhea, adjunctive treatment of hyperthyroidism

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity to bile acid sequestering resins; complete biliary obstruction. Common side effects Abdominal pain, discomfort, and distention; aggravation of hemorrhoids; anorexia; bleeding; constipation (can be severe and at times accompanied by fecal impaction); diarrhea; eructation; flatulence; nausea; steatorrhea; vomiting. Bleeding tendencies related to vitamin K deficiency, folic acid deficiency. Fat-soluble vitamin deficiencies, hyperchloremic acidosis, osteoporosis.

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Acetaminophen, furosemide,

Lab value alterations caused by medicine None known Be sure to teach the patient the following about this medication Instruct patients to never administer dry powder without liquid. Instruct patients to place contents of 1 single-use packet or level scoopful in glass or cup and add 2 to 6 oz (4 to 6 oz for cholestyramine light, 2 to 3 oz for Prevalite ) of any noncarbonated liquid. Stir to uniform consistency and then have patient drink suspension. Also may mix with highly fluid soups or pulpy fruits with high moisture content (eg, applesauce, crushed pineapple). Advise patients to administer with meals unless dosing interval needs to be modified to avoid interference with absorption of other medications. Cholestyramine administration should be separate from other drugs. Advise patients to take other drugs at least 1 h before or 4 to 6 h after cholestyramine. The color of the powder may vary somewhat from batch to batch, but this variation does not affect the efficacy of the product.

2 Elisabeth Fandrich Nursing Process- Assessment (Pre-administration assessment) Assess for diarrhea, cholesterol levels, fluid intake

Assessment Why would you hold or not give this med? Very low LDL cholesterol levels, intestinal obstruction, dehydration

Evaluation Check after giving Relief from diarrhea, ensure pt. not constipated.