Pharm 3

Pharm 3
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  • Last visit you told me to let you know if I was having stomach issues from my indomethacin that I take for my rheumatoid arthritis.    Is there anything you can give me to help relieve the excess stomach acid I’m experiencing?
  • Davis's Drug Guide for Nurses 2017 misoprostol Indications See Pronunciation * Preventions of gastric mucosal injury from NSAIDs, including aspirin, in high-risk patients (geriatric patients, debilitated patients, or those with a history of ulcers).   * With mifepristone for termination of pregnancy.  Unlabeled Use:  * Treatment of duodenal ulcers. * Cervical ripening and labor induction. 
  • !
  • Dr Rheumatologist's office
  • Incoming call  555-531-8008
  • I'm not feeling so good.  I think it's related to the misoprostol.
  • The Dr may be able to prescribe you Misoprostol to prevent stomach ulcers and reduce acid.  It works by protecting the stomach from damage that can be caused by taking a nonsteroidal anti-inflammatory drug.   But first, you will need to have a negative pregnancy test before taking misoprostol. Misoprostol can cause abortion (Lilley, Collins, & Snyder, 2017, p. 808-809). 
  • Misoprostol is usually taken with meals and at bedtime. You may have nausea, stomach cramps, or diarrhea while taking this medicine, especially during the first few weeks after you start taking misoprostol. These symptoms usually last for about a week. Call your doctor if you have severe nausea, stomach pain, or diarrhea lasting longer than 8 days (Henry et al, 2017, p. 218). 
  • Are you still taking antacids?  They increase the risk of diarrhea.  Stop taking the antacids, and the Dr wants to reduce the dosage and see if that helps.  Take 100mcg 4 times a day with or after meals and at bedtime.  
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