(Bentyl) Dicyclomine Med Sheet

Pharmacology Medsheet Medication Generic Medication Brand name Therapeutic class Indications Route and Dosage Action Pharmacokinetics Contraindications/precautions Adverse reactions Side Effects Interactions Dicyclomine Bentyl Antispasmodics Management of irritable bowel syndrome in patients who do not respond to usual interventions (sedation/change in diet)  PO (adult): 10-20 mg 3-4 times daily (up to 160 mg/day)  PO (children 60 mo.- 2 yr.): 5-10 mg 3-4 times daily, adjusted as tolerated.  IM (Adult): 20 mg every 4-6 hours, adjusted as tolerated. May have a direct and local effect on GI smooth muscle, refusing motility and tone. Absorption: well-absorbed after oral and IM administration Hypersensitivity; Obstruction of the GI or GU tract; reflux esophagitis; severe ulcerative colitis (risk of paralytic ileus); unstable cardiovascular status; glaucoma; myasthenia gravis; Infants <6 months; lactation.  CNS: confusion (increased in geriatric patients), drowsiness, light-headedness (IM only). ENNT: blurred vision, increased intraocular pressure. CV: palpitations, tachycardia.  GI: Paralytic Ileus, constipation, heartburn, decreased salivation, dry mouth, nausea, vomiting.  GU: Erectile dysfunction, urinary hesitancy, urinary retention.  Derm: Decreased sweating.  ENDO: Decreased lactation.  Local: Pain/redness at IM site.  MISC: Allergic reactions including anaphylaxis.  CNS: confusion (increased in geriatric patients), drowsiness, light-headedness (IM only). ENNT: blurred vision, increased intraocular pressure. CV: palpitations, tachycardia.  GI: Paralytic Ileus, constipation, heartburn, decreased salivation, dry mouth, nausea, vomiting.  GU: Erectile dysfunction, urinary hesitancy, urinary retention.  Derm: Decreased sweating.  ENDO: Decreased lactation.  Local: Pain/redness at IM site.  MISC: Allergic reactions including anaphylaxis. Drug-Drug: Additive anticholinergic effects with other anticholinergics, including antihistamines, quinidine, and disopyramide. May alter the absorption of other orally administrated drugs by slowing the motility of the GI tract. Antacids or adsorbent antidiarrheals decrease the absorption of anticholinergics. May increase GI Assessment Nursing diagnosis Implementation Patient/family teaching Evaluation/Desired Outcomes mucosal lesions in patients taking oral potassium chloride tablets. Increased risk of adverse cardiovascular reaction with cyclopropane anesthesia.  Assess the patient for all allergies  Assess the patient for symptoms of irritable bowel syndrome (abdominal cramping, alternating constipation and diarrhea, mucus in stool before and periodically during therapy.  Assess patient routinely for abdominal distention and auscultate for bowel sounds. If constipation becomes a problem, increasing fluids and adding bulk to the diet may help alleviate constipation effects of the drug.  Monitor intake and output ratios; may cause urinary retention.  Acute pain (indications)  Diarrhea (indications)  PO: Administer dicyclomine 30 min-1 hr. before meals.  IM: Monitor patient after administration; may cause light-headedness and irritation at injection site.  Instruct patient to take dicyclomine exactly as directed and not to take more than the prescribed amount. Missed doses should be taken as soon as remembered if not just before next dose.  Medication may cause drowsiness and blurred vision. Caution patient to avoid driving or other activities requiring alertness until response to the mediation is known.  Inform patient that frequent oral rinses, sugarless gum or candy, and good oral hygiene may help relieve dry mouth. Consult health care professional regarding use of saliva substitute if dry mouth persists for more than 2 weeks.  Advise patient receiving dicyclomine to make position changes slowly to minimize the effect of drug0induced orthostatic hypotension.  Caution patient to avoid extremes of temperature. This medication decreases the ability to sweat and may increase the risk of heat stroke.  Advice patient to consult health care professional before taking any OTC medications concurrently with this therapy.  Advise patient to notify health care professional immediately if eye pain or increased sensitivity to light occurs. Emphasize the importance of routine eye exams throughout therapy. A decrease in the symptoms of irritable bowel syndrome.