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NURS 2516 Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Classification Dose Route Time/frequency

Cholestyramine Name Antihyperlipidemic, 1 scoop Po in 2100 qod
Questran Bile acid juice
sequestrant
Peak Onset Duration For IV meds, compatibility with IV drips and /or solutions
unknown unknown 4-6 hr N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(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
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 Lab value alterations caused by medicine
medicines (ask patient specifically) None known
Acetaminophen, furosemide,
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.
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Nursing Process- Assessment Assessment Evaluation

(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess for diarrhea, cholesterol levels, fluid med? Relief from diarrhea, ensure
intake Very low LDL cholesterol levels, pt. not constipated.
intestinal obstruction, dehydration