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DRUGS INDICATIONS / REACTIONS NURSING CONSIDERATIONS

/ RESPONSIBILITIES
1.) MEBENDAZOLE is a (synthetic) broad- Indications and Usage: • Your doctor has prescribed this
spectrum anthelmintic available as chewable Mebendazole tablets are indicated for the medicine to treat an infection caused
tablets, each containing 100 mg of treatment of Enterobius vermicularis by an intestinal worm. Follow your
Mebendazole. Inactive ingredients are: (pinworm), Trichuris trichiura (whipworm), doctor’s instructions carefully. In
anhydrous lactose NF, corn starch, magnesium Ascaris lumbricoides (common roundworm), addition to your doctor’s treatment,
stearate, microcrystalline cellulose, sodium Ancylostoma duodenale (common you can help prevent reinfection and
lauryl sulfate, sodium saccharin, sodium hookworm), Necator americanus (American infection of other people by
starch glycolate, stearic acid, and FD&C hookworm) in single or mixed infections. understanding a few simple facts about
Yellow #6. worms.
Contraindications: • PINWORM: Pinworms look like tiny
Mebendazole is contraindicated in persons white threads and live in the bowel.
who have shown hypersensitivity to the drug. Usually at night, they travel to the
rectal opening and lay eggs on the
Adverse Reactions: outside skin. This sometimes causes
Gastrointestinal: itching which may be very annoying.
Transient symptoms of abdominal pain and That is why restless sleep is a frequent
diarrhea in cases of massive infection and sign of pinworms, especially in
expulsion of worms. children. Scratching will cause
Hypersensitivity: pinworm eggs to stick to the fingers.
Rash, urticaria and angioedema have been Reinfection will result if the fingers are
observed on rare occasions. placed in the mouth.
To help prevent reinfection follow these
Central Nervous System: rules:
Very rare cases of convulsions have been
• Wash hands and fingernails with soap
reported.
often during the day, especially before
Liver:
eating and after using the toilet.
There have been liver function test elevations
• Wear tight underpants both day and
[AST (SGOT), ALT (SGPT), and GGT] and
night. Change them daily.
rare reports of hepatitis when Mebendazole
• For several days after treatment, clean
was taken for prolonged periods and at
dosages substantially above those the bedroom floor by vacuuming or

recommended. damp mopping. Avoid dry sweeping

Hematologic: that may stir up dust.

Neutropenia and agranulocytosis. (See • After treatment, wash bed linens and

WARNINGS). night clothes (don’t shake them).

Overdosage: • Keep the toilet seats clean

In the event of accidental overdosage,


The medication used to treat these worms
gastrointestinal complaints lasting up to a few
causes them to be expelled from the body.
hours may occur. Vomiting and purging should
Hookworms and whipworms may be seen and
be induced.
resemble small white threads. Roundworms
are much larger and easily seen.
To help prevent reinfection follow these
rules:

• Wash hands and fingernails with soap


often during the day, especially before
eating and after using the toilet.
• Wash all fruits and vegetables
thoroughly or cook them well.
• Wear shoes.
• Use the bathroom.

Follow your doctor’s advice, take the


medication he gives you and follow the rules
mentioned here. If you have other questions
about worms, be sure to ask your doctor.

WARNING: Do not take this medication if


you are pregnant or think you may be
pregnant. Consult your physician.

2.) DOMPERIDONE (trade name Motilium, Indications and Usage: Patient Consultation:
Motillium or Costi) is an antidopaminergic As an aid to patient consultation, refer to
Gastrointestinal problems:
drug, developed by Janssen Pharmaceutica, Advice for the Patient, Domperidone
and used orally, rectally or intravenously, (Systemic).
Domperidone is used, together with
generally to suppress nausea and vomiting. It In providing consultation, consider
metoclopramide, cyclizine, and 5HT3 receptor
has also been used to stimulate lactation. emphasizing the following selected
antagonists (such as granisetron) in the
information (» = major clinical significance):
treatment of nausea and vomiting.
Domperidone has also been found effective in
Before using this medication
» Conditions affecting use, especially:
the treatment of gastroparesis, a stomach
Sensitivity to domperidone
motility condition, and for paediatric
Gastroesophageal reflux (infant vomiting). Pregnancy:

Parkinson's disease: No human data is available. Not recommended


for use during pregnancy unless the benefit
It has been used in patients with Parkinson's
outweighs the potential hazard.
disease. Unlike metoclopramide: domperidone
does not cross the blood-brain barrier.
Breast-feeding:
Lactation:
Distributed into breast milk.
The hormone prolactin stimulates lactation in
humans, and its release is inhibited by the
dopamine secreted by the hypothalamus.
Use in children:
Domperidone, by acting as an anti-
dopaminergic, results in increased prolactin
Safety and efficacy of domperidone not
secretion, and thus promotes lactation. Since,
established in children
according to the American FDA, domperidone
Other medications, especially azole
is not approved for enhanced lactation in any
antifungals, human immunodeficiency virus
country, it is sometimes self-prescribed from
(HIV) protease inhibitors, macrolide
original research or prescribed "off-label" for
antibiotics, monoamine oxidase (MAO)
this use in countries around the world.
inhibitors, nefazodone, or sustained-release or
enteric-coated formulations of drugs
Anti-emetic: Proper use of this medication:
Proper dosing:
There is some evidence that domperidone has
Missed dose: Taking as soon as possible; not
anti-emetic activity. Domperidone is a first
taking if almost time for next scheduled dose;
choice anti-emetic in most countries, together
not doubling doses
with metoclopramide. It is however not
approved for prescription in the US. Although
Precautions while using this medication:
it has never been officially approved for use in
Obtaining medical attention if fainting,
the United States, domperidone is sometimes
dizziness, irregular heartbeat or pulse, or other
purchased from pharmacies in other countries
unusual symptoms occur.
for this purpose.

Side/adverse effects:
Effects:
Asthenia, change in urinary frequency, CNS
Domperidone elevates serum prolactin effects (dry mouth, headache, nervousness,
concentrations. dizziness, thirst, irritability), conjunctivitis,
dysuria, edema, endocrinological effects (hot
flushes, menstrual irregularities, mastalgia,
galactorrhea, and gynecomastia,
extrapyramidal effects (difficulty in speaking
and loss of balance or muscle control),
gastrointestinal effects (abdominal cramps,
diarrhea, heartburn, constipation, and changes
in appetite), leg cramps, lethargy, palpitations,
pruritus, stomatitis, and urticaria

General Dosing Information:


For upper gastrointestinal motility disorders,
the usual dose for adults is 10 mg 3 to 4 times
a day administered orally 15 to 30 minutes
before meals and at bedtime if required.
However, in severe or resistant cases, the dose
can be increased to a maximum of 20 mg 3 to
4 times a day.

For nausea and vomiting associated with


dopamine agonist antiparkinsonian agents, the
usual dose for adults is 20 mg 3 to 4 times a
day administered orally. However, higher
doses may be required to achieve symptom
control while titration of the antiparkinsonian
medication is occurring.

Treatment of overdose:
There is no specific antidote or specific agent
for domperidone overdose. However,
anticholinergic agents , antiparkinsonian
medications, or antihistamines with
anticholinergic properties may be useful in
controlling the extrapyramidal reactions
associated with domperidone toxicity.
To enhance elimination :
Gastric lavage as well as the administration of
activated charcoal may be useful in facilitating
the elimination of domperidone.
Supportive care:
Close observation and supportive therapy are
recommended.
Patients in whom intentional overdose is
confirmed or suspected should be referred for
psychiatric consultation.