Dipentum

Dipentum

olsalazine

(ole-sal-a-zeen) ,

Dipentum

(trade name) Pregnancy Category: C

Indications

Action

Pharmacokinetics

Time/action profile (levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1 hr; 4–8 hr	12 hr

Contraindications/Precautions

Adverse Reactions/Side Effects

Central nervous system

• ataxia
• confusion
• dizziness
• drowsiness
• headache
• mental depression
• psychosis
• restlessness

Gastrointestinal

• diarrhea (most frequent)
• abdominal pain
• anorexia
• exacerbation of colitis
• drug-induced hepatitis
• nausea
• vomiting

Dermatologic

• itching
• rash

Hematologic

• blood dyscrasias

Interactions

Drug-Drug interaction

↑ risk of bleeding after neuraxial anesthesia with low molecular weight heparins and heparinoids ; discontinue olsalazine before initiation of therapy or monitor closely if discontinuation not possible.May ↓ metabolism, and ↑ effects/toxicity of mercaptopurine or thioguanine with and ↑ risk of myelosuppression (use lowest possible dose and monitor closely).↑ risk of developing Reye's syndrome; avoid olsalazine during 6 wk after varicella vaccine.

Route/Dosage

Availability

Nursing implications

Nursing assessment

• Assess patient for allergy to sulfonamides and salicylates. Patients allergic to sulfasalazine may take mesalamine or olsalazine without difficulty, but therapy should be discontinued if rash or fever occur.
• Monitor intake and output ratios. Fluid intake should be sufficient to maintain a urine output of at least 1200–1500 mL daily to prevent crystalluria and stone formation.
• Inflammatory Bowel Disease: Assess abdominal pain and frequency, quantity, and consistency of stools at the beginning of and throughout therapy.
• Lab Test Considerations: Monitor urinalysis, BUN, and serum creatinine prior to and periodically during therapy.
  • Olsalazine may cause ↑ AST and ALT levels.
• Lab Test Considerations: Monitor CBC prior to and every 3–6 mo during prolonged therapy. Discontinue olsalazine if blood dyscrasias occur.

Potential Nursing Diagnoses

Acute pain (Indications)
Diarrhea (Indications)

Implementation

• Oral: Administer with food in evenly divided doses every 12 hr.

Patient/Family Teaching

• Instruct patient to take medication as directed, even if feeling better. Take missed doses as soon as remembered unless almost time for next dose.
• May cause dizziness. Caution patient to avoid driving or other activities that require alertness until response to medication is known.
• Advise patient to notify health care professional if skin rash, sore throat, fever, mouth sores, unusual bleeding or bruising, wheezing, fever, or hives occurs.
• Instruct patient to notify health care professional if symptoms do not improve after 1–2 mo of therapy.
• Instruct patient to notify health care professional if symptoms worsen or do not improve. If symptoms of acute intolerance (cramping, acute abdominal pain, bloody diarrhea, fever, headache, rash) occur, discontinue therapy and notify health care professional immediately.
• Inform patient that proctoscopy and sigmoidoscopy may be required periodically during treatment to determine response.

Evaluation/Desired Outcomes

• Decrease in diarrhea and abdominal pain.
• Return to normal bowel pattern in patients with inflammatory bowel disease. Effects may be seen within 3–21 days. The usual course of therapy is 3–6 wk.
• Maintenance of remission in patients with inflammatory bowel disease.
• Decrease in pain and inflammation, and increase in mobility in patients with rheumatoid arthritis.