Adverse effects transient abdominal pain diarrhea

Adverse effects: Transient abdominal pain, diarrhea, fever.
Contraindications and Cautions
Overall contraindications to the use of anthelmintic drugs include the presence of known allergy
to any of these drugs to prevent hypersensitivity reactions; lactation, because the drugs can enter
breast milk and could be toxic to the infant—women are advised to refrain from breast-feeding
when using these drugs; and pregnancy (in most cases), because of reported associated fetal
abnormalities or death. Women of childbearing age should be advised to use barrier
contraceptives while taking these drugs. Pyrantel has not been established as safe for use in
children younger than 2 years. Albendazole should be used only after the causative worm has
been identified because it can cause adverse effects on the liver, which could be problematic if
the patient has liver involvement. Use caution in the presence of renal or hepatic disease that
interferes with the metabolism or excretion of drugs that are absorbed systemically and in cases
of severe diarrhea and malnourishment, which could alter the effects of the drug on the intestine
and any preexisting helminths.
Clinically Important Drug–Drug Interactions
The effects of albendazole, which are already severe, may increase if the drug is combined with
dexamethasone, praziquantel, or cimetidine. These combinations should be avoided if at all
possible; if they are necessary, patients should be monitored closely for the occurrence of
adverse effects.
Implementation with Rationale

■Arrange for appropriate culture and sensitivity tests before beginning therapy to ensure
identification of the correct cause and use of the appropriate drug.
■Administer the complete course of the drug to obtain the full beneficial effects. Ensure that
chewable tablets are chewed. Give the drug with food if necessary, but avoid giving the drug
with high-fat meals, which might interfere with drug effectiveness.
■Monitor hepatic and renal function before and periodically during treatment to allow for early
identification and prompt intervention if signs of failure due to albendazole administration occur.
■Provide comfort and safety measures if CNS effects occur (e.g., side rails and assistance with
ambulation in the presence of dizziness and weakness) to protect the patient from injury. Provide
oral hygiene and ready access to bathroom facilities as needed to cope with GI effects.
■Provide small, frequent, nutritious meals if GI upset is severe to ensure adequate nutrition.
Monitor nutritional status and arrange a dietary consultation as needed. Taking the drug with
food may also decrease GI upset.
■Instruct the patient about the appropriate dosage regimen and other measures to enhance patient
knowledge about drug therapy and to promote compliance
■Provide the following patient teaching:
■Take safety precautions, including changing position slowly and avoiding driving and
hazardous tasks, if CNS effects occur.