Antispasmodics (GI): Nursing pharmacology

Gastrointestinal antispasmodics are medications used to treat spasms of the gastrointestinal tract muscles, which can occur in diseases like irritable bowel syndrome, or IBS for short, biliary colic, and pancreatitis.The most commonly used gastrointestinal antispasmodics include antimuscarinic medications like dicyclomine, which can be administered orally, as well as hyoscyamine, which can be given orally and sublingually.Once administered, these medications bind to the muscarinic receptors on gastrointestinal smooth muscles.

As a result, they block acetylcholine from binding to these receptors, which ultimately decreases smooth muscle contraction and relieves the spasm.Now, gastrointestinal antispasmodics may cause anticholinergic side effects, such as blurred vision, dry mouth, decreased sweating, urinary retention, and constipation.

Some clients may also present with headaches, dizziness, and tachycardia.Now, contraindications of gastrointestinal antispasmodics include severe ulcerative colitis, stenosing peptic ulcer, paralytic ileus, gastrointestinal obstruction, and toxic megacolon.

In addition, these medications are contraindicated in clients with closed- or narrow-angle glaucoma, myasthenia gravis, cardiovascular disease, prostatic hypertrophy, and bladder obstruction.

Finally, gastrointestinal antispasmodics should be used with caution during pregnancy and breastfeeding, in elderly clients, as well as in clients with hypertension, and hepatic or renal disease.Okay, if a client with irritable bowel syndrome or IBS is prescribed a gastrointestinal antispasmodic like dicyclomine, first perform a baseline assessment, including vital signs, fluid intake and output, and gastrointestinal status.

Be sure to make note of their current IBS symptoms, such as diarrhea, abdominal pain, or bloating, as well as stool characteristics and frequency.

Then, review recent laboratory test results, specifically renal and hepatic function; and diagnostic test results, including endoscopy, colonoscopy, or CT scans.

Then, explain to your client how the medication will help relieve their gastrointestinal spasms. Instruct them to take their medication four times daily with plenty of water, with or without food, and at the same time consistently each day.

Next, let your client know about some of the side effects they could experience during treatment. To help manage urinary retention, instruct them to empty their bladder before taking their medication and remind them to empty their bladder regularly, at least every 3-4 hours, even if they don’t feel the need.

Emphasize the importance of contacting their healthcare provider if they experience symptoms consistent with a urinary tract infection, such as pain or burning during urination, or a frequent need to urinate without being able to pass much urine, flank pain, as well as pain felt on either side of the back just below the rib cage and above the waist.

If they experience dry mouth, suggest they use sugar-free hard candy or gum, as well as frequent sips of water. Remind your client that their medication decreases their ability to sweat, so stress the importance of being cautious when exercising or during hot weather.

Lasty, instruct your client to seek immediate medical attention if they experience an increased temperature with flushed or red skin, a rapid or pounding heartbeat, extremely dry mucous membranes, an altered mental status, or blurry vision.

Now, to help decrease the occurrence of IBS symptoms, encourage your client to increase their dietary fiber intake and avoid common gas-producing foods, such as broccoli and cabbage.

Lastly, encourage them to keep a diary of their symptoms, diet, and episodes of stress, in order to identify their IBS triggers and avoid them.

Finally, during treatment with a gastrointestinal antispasmodic like dicyclomine, be sure to monitor your client’s gastrointestinal and urinary status, development of side effects, and evaluate for the desired therapeutic effect of a decrease in their IBS symptoms.

Alright, as a quick recap… Gastrointestinal antispasmodics are medications used to help relieve symptoms of irritable bowel syndrome, biliary colic, and pancreatitis.

These medications work by reducing smooth muscle contraction and spasms in the gastrointestinal tract. Some common side effects include blurred vision, dry mouth, decreased sweating, urinary retention, and constipation.When caring for a client prescribed a gastrointestinal antispasmodic, nursing considerations include performing a baseline assessment, as well as monitoring for side effects and the desired therapeutic effect.

Client teaching is focused on safe self-administration, and learning to recognize and manage side effects, as well as when to notify the healthcare