RNpedia.

com
Nursing Notes and Community

Drug Name cholestyramin e (koe less' tir a meen) Cholestyramine Light, Prevalite, Questran, Questran Light Pregnancy Category Not Established Drug classes Antihyperlipid emic Bile acid sequestrant

Dosages Adults Initially, 4 g one to two times per day PO. Individualize dose based on response. For maintenance, 8 16 g/day divided into two doses. Increase dose gradually with periodic assessment of lipid/lipoprotein levels at intervals of > 4 wk. Maximum dose 6 packets or scoopfuls. May be administered 1 6 doses/day. Dosage may be as high as 36 g every day. o Skin and skin structure infections: 500 mg PO q 12 hr. Larger doses may be needed in severe cases; do not exceed 4 g/day. Pediatric Patients Safety and

Therapeutic Actions Binds bile acids in the intestine, allowing excretion in the feces; as a result, cholesterol is oxidized in the liver to replace the bile acids lost; serum cholesterol and LDL are lowered.

Indications Adjunctive therapy: Reduction of elevated serum cholesterol in patients with primary hypercholesterolem ia (elevated LDL) Pruritus associated with partial biliary obstruction Unlabeled uses: Antibiotic-induced pseudomembranou s colitis; chlordecone (Kepone) pesticide poisoning to bind the poison in the intestine; treatment of thyroid hormone overdose, treatment of digitalis toxicity

Adverse effects Constipation; fecal impaction; hemorrhoids; abdominal discomfort or pain; heartburn; flatulence; nausea; vomiting; diarrhea; increased bleeding tendency (chronic use); osteoporosis; stetorrhea (high doses); skin rashes; pruritus of the tongue, skin and perianal region; hyperchloremic acidosis.

Contraindication s Complete biliary obstruction; hypersensitivity.

Nursing considerations Assessment History: Allergy to bile acid sequestrants, tartrazine; complete biliary obstruction; abnormal intestinal function; lactation, pregnancy Physical: Skin lesions, color, T; orientation, affect, reflexes; P, auscultation, baseline ECG, peripheral perfusion; liver evaluation, bowel sounds; lipid studies, LFTs, clotting profile Interventions Mix contents of one packet or one level scoop of powder with 26 fluid oz of beverage (water, milk, fruit juices, noncarbonates), highly fluid soup, pulpy fruits (applesauce, pineapple); do not give drug in dry form. Administer drug before meals. WARNING: Monitor intake of other oral drugs due to risk of binding in the intestine and delayed or decreased absorption, give oral medications 1 hr before or 4 6 hr after the cholestyramine. Alert patient and concerned others about high cost of drug. Teaching points

RNpedia.com
Nursing Notes and Community

efficacy not established.

Take drug before meals; do not take the powder in the dry form; mix one packet or one scoop with 26 ounces of fluidwater, milk, juice, noncarbonated drinks, highly fluid soups, cereals, pulpy fruits such as applesauce or pineapple. Take other medications 1 hour before or 46 hours after cholestyramine. You may experience these side effects: Constipation (ask about measures that may help); nausea, heartburn, loss of appetite (eat frequent small meals); dizziness, drowsiness, vertigo, fainting (avoid driving and operating dangerous machinery); headache, muscle and joint aches and pains (may lessen with time). Report unusual bleeding or bruising, severe constipation, severe GI upset, chest pain, difficulty breathing, rash, fever.

http://RNpedia.com- Nursing Notes and Community