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Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
Stoma   stoma patients and their medicines
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Stoma stoma patients and their medicines

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Presenter: Alasdair Macintyre …

Presenter: Alasdair Macintyre
Date: 04/11/2007
Target Audience: All

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  • 1. Stoma Patients and their Medicines Alan Timmins MSc MRPharmS Principal Pharmacist – Clinical Services Queen Margaret Hospital, Dunfermline
  • 2.
    • How do medicines affect stomas?
    • How do stomas affect medicines?
  • 3.
    • Ileum -> Ileostomy
    • Colon -> Colostomy
  • 4.
    • Ileum -> Ileostomy
    • Dehydration
    • Colon -> Colostomy
    • Constipation
  • 5. Maintaining the Balance
    • Reduce gut motility
    • Dry up secretions
    • Provide more bulk
    • Provide supplements of electrolytes etc
  • 6. Other Scenarios
    • Urostomy
    • Short Bowel
  • 7. How Drugs Affect Gut Function
    • Autonomic nervous system
    • Cholinergic
    • Adrenergic
    • Direct effect
    • Laxatives
    • Analgesics
    • Indirect Effect
    • Diuretics
  • 8. Parasympathetic stimulation
    • ↑ Peristalsis
    • ↑ Secretions
    • Relaxation of sphincters
  • 9. Parasympathetic blockade
    • ↓ Peristalsis
    • ↓ Secretions
    • Contraction of sphincters
    • ANTICHOLINERGICS
  • 10. Anticholinergics
    • Tricyclics
    • Antipsychotics
    • Antiarrhythmics
    • Sedating antihistamines
    • Oxybutynin/ tolterodine
    • Dicyclomine/ Hyoscine/ propantheline/ atropine
  • 11. Laxatives
    • Bulk – Fibre
          • lactulose
    • Stimulants – Senna/ bisacodyl
          • Glycerin
  • 12. Analgesics
    • Opioids- receptors in gut
    • Loperamide
    • Codeine
  • 13. Antibiotics
    • Upset gut flora
    • Most cause diarrhoea
    • Macrolides - prokinetic
  • 14. Antacids
    • Aluminium – constipation
    • Magnesium - diarrhoea
  • 15. Choice of Formulation
    • Should all medicines for stoma patients be given as liquids?
  • 16. Formulations
    • Solutions
    • Suspensions
    • Plain tablets/ capsules
    • E/C tablets/ capsules
    • S/R tablets/ capsules
  • 17. S/R Preps
    • Mechanism of S/R action
    • Release profile
    • Absorption profile
  • 18. Remember…
    • There could be a problem with efficacy
    • There may be an impact on stoma function
    • MONITOR
  • 19. May need to…
    • Increase dose
    • Increase frequency
    • Change formulation
    • Change treatment
  • 20.  

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