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|DRUG NAME||ursodiol / ursodeoxycholic acid / UDCA (Urso, Actigall), |
chenodiol / chenodeoxycholic acid (Chenodal)
|MECHANISM OF ACTION||Decrease intestinal absorption of cholesterol, and reduce liver secretion of cholesterol into bile → change bile composition → facilitate bile flow, and dissolve gallstones|
|INDICATIONS||Prevention or treatment of cholelithiasis|
|ROUTE(S) OF ADMINISTRATION||PO|
|CONTRAINDICATIONS AND CAUTIONS|
|NURSING CONSIDERATIONS: GALLSTONE-DISSOLVING AGENTS|
|ASSESSMENT AND MONITORING|
Gallstone-dissolving agents are medications used to treat cholelithiasis, more commonly known as gallstones, as an alternative for clients who can’t or prefer not to undergo surgery to remove them, as well as for treatment of clients with primary biliary cirrhosis, and to prevent gallstones in obese clients who are rapidly losing weight, such as after bariatric surgery.
Gallstone-dissolving agents include ursodiol, also known as ursodeoxycholic acid, or UDCA for short, as well as chenodiol, also known as chenodeoxycholic acid, which are bile acids that can be taken orally.
Now, once gallstone-dissolving agents are administered, their mechanism of action is not totally clear, but they primarily seem to act on the intestines by reducing cholesterol absorption, as well as on the liver by reducing the secretion of cholesterol into bile.
Some clients may present with respiratory side effects like infection or cough; as well as urinary side effects, such as a frequent urge to urinate, as well as difficult, burning, or painful urination, and even bloody or cloudy urine. Finally, chenodiol has a boxed warning for hepatotoxicity, so it requires monitoring for liver function.
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