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List of Medications to Avoid

Many years ago I received a list of medications to avoid, which I lost a long time ago. Does anyone have it, or know where I can get a copy?

I remember it having some antibiotics, calcium containing antacids, and time release medications. I can't remember any of the others. I'm training a new PCP and would like to add it to my medical record. That's probably what happened to the old list, but transferred medical records don't contain everything that was in the original file (but that's another story).

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Helo debleeri,

I never heard of a list only that gel capsules, time release and enteric-coated tablets are all a waste of time (and money) as they get flushed through. Seems that the best way is to crush the tablet and mix with food. Some antacids (with a lot of magnesium and aluminium) can be harmful for people with kidney problems. People already taking calcium supplements might get an overdose. I'm allergic to penicillin and have to argue whenever I need antibiotics. I now have a letter from an allergy specialist but have just been told by one of my local doctors "We don't believe in that (the existence of allergies)" Fortunately there are others in the practice who are not still living in the 12 century.

Good luck with the training, as you are a serial trainer may I suggest that after completing this mission you write a short training handbook? It would be really useful, I always forget half the things I should say-

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I'll think about the book. I've always had to deal with my ostomy by myself, I never realized there might be others who share my frustration. I'm sure there are many here that could provide input. In the mean time, I'll keep looking for that med list. I'm sure it' been updated from the one I had so long ago.

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Hello Debleeri,
I would suggest you to check http://www.badgut.org/information-centre/drug-therapy-and-the-compromised-b owel-1.html
This web article doesn't contain the list of medications by name, but it explains general principles to follow. I hope it will be helpful for you.

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Thank you Ashchem. This is a good resource, I read it and saved a copy. It covers the types of medications that were on the list I had. The list showed the type of medication and what the problems were. I remember birth control pills being on the list and that they were not absorbed, not that I need them, but some women do.

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This link it to the UOA's Ostomy nutrition guide and has a partial list of medications to avoid. http://www.ostomy.org/ostomy_info/pubs/OstomyNutritionGuide.pdf

This link is to a page on the UOA site that has some good reference information.
http://www.ostomy.org/ostomy_info/#diet_nutrition

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Dear Ashchem & debleerl, Thank you both for the links you have provided. The info was truly valuable to me. I have four different doctors involved in my care: surgeon, family doc, oncologist, infectious disease doc. It is OUR responsibility to inform/remind them, when prescribing new meds, of our malabsorption! With any new oral medication, I will check my pouch content for evidence of un-digested pill.

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I don't understand this. If meds disolve in the stomach and then go through your system,
how does an ostomy interfere with their absorbtion?

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Hello Wilmac,

An ilostomate is like a racing car with a strait though exhaust system - food passes very quickly and anything wrapped up is unlikely to dissolve on the way because it does not stay long enough.

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In addition to what Happy says, some medications are formulated to be absorbed in the colon, like enteric coated and time release meds. Also, even though a medication is disolved in the stomach, absorbtion is done by the intestines. You need to know how long it takes you to pass food from your mouth to your pouch. I recommend the beet test, I posted in another thread. Some foods take longer than others to pass, however you need to know the fastest time. Then you need to know how long the medication takes to absorb (not dissolve). Any medication you take needs to be absorbed in less than or no more than the amount of time it takes you to pass the med to your pouch. For example, a 12 hour time release med, you may only get 3 hours worth of medication and the rest goes in the pouch. Enteric coated medications will end up in the pouch undissolved. It's best to have your doctor look up the absorption time before prescribing, although the pharmacist can give you that information too. However, if the med is already prescribed and you find it's not likely to be absorbed, there is no sense in taking it or paying for it. I've learned by trial and error on many meds, if you find yourself taking something and it's not doing the expected job, most likely it's not being absorbed.

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HappyS: Good analogy, had to laugh!
debleerl: What an excellent explanation. You must be a nurse, or a physician(?) I wish I had heard all this in the beginning, instead of patches from trial and error. Also didn't know that pharmacist could tell me 'absorption' times! The other night I ate a little stove-top stuffing. The small green bits of herbs started showing up in my pouch approx 1.5 hrs later, not much time in the body, had it been a pill. I have only 5-10% of my small intestine. I do take simethicone prn for gas/indigestion; it is a gel cap. It seems to be effective.....

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Dear Deb,
What's the beet test?
Randy

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Randy, don't know about the beet test, but once had some beet soup (pink) for dinner and it came out blood red in the morning. I thought I was hemorhaging.

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The "beet test" eat a few slices of canned beets, not to many as you don't want a blockage. Note the time you ate them and the time they show up in the pouch. It's easy to tell because of the color. This will give you a good indication of how long it takes food to pass from mouth to pouch. You can do this with any brightly colored food, like twizzlers; however, I like to use beets because the color is natural, not an artificial dye. Don't rely on colored beverages like Koolaid as liquids pass faster.

AMT, thanks for the compliment. No, I'm not a nurse, I've been living with an ileostomy for almost 30 years and have learned from trial and error. It gets pretty frustrating getting prescriptions that don't work so I've had to keep on top of this issue with my doctors. I'ts also good to know your digestion time for OTC meds and vitamin/mineral supplements.

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One thing my doctor told me is that liquid medicine is the best for anyone with an ileostomy, because its absorbed easier. The same goes for pills that can be crushed in a pill crusher and mixed with applesauce or pudding. I do know that laxitives CANNOT be used by an ileostomate, because they will cause rapid dehydration.

When I first got my ileostomy, no one told me I couldn't take extended release pills, so I was still on an extended release form of my seizure medicine (Tegretol XR). About 3 weeks after having my surgery, I was rushed back to the ER because a lot of the pills bunched up in my small intestine and formed a huge blockage. I was in severe pain and throwing up a lot. The doctor manually extracted 6 pills out of my ostomy stoma and all of a sudden, a huge gush of output followed. I felt so much better after that, because there was not that severe pain and pressure in my abdomen. After that, my doctor put me on liquid medicine for all of my meds (except for 2 pills that are not made in liquid form), and I haven't had that problem since.

Jessie

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This is just a little correction about a "beet test" for people who like my children don't consider beets as a food: not only beets change color of the inside of a pouch. Tomato juice and most of food dyes can also change it.

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I take Kepra for my seizures. I had my first ostomy surgery in'09. I was not aware that l am not getting all of my medication! I do not know if Kepra comes in liquid form however l will be calling the pharmacy asap! Any suggestions if it doesn't?

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I take Kepra for my seizure disorder. I was unaware that l might not be getting my full dose or any for that matter! I had my first ostomy surgery in '09. I do not know if Kepra comes in liquid form but l will be contacting the pharmacy asap in the morning! Has anybody else had this problem?

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Liz, How did you make out with the pharmacist? I absolutely cannot take Naproxen (Aleve) in any form. I had an orthopaedic surgeon prescribe it in liquid form. He prescribed the highest dose possible and it still had no effect. I have the same problem with antibiotics that you take only once. I respond best to the old ones you take every 4 hours.

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I think everyone should be aware of the fact that the 'transit' time (from your mouth to output) can change and sometimes drastically. I have had it as long as 8 hrs and as short as 45 min. I have a colostomy but it acts like an illiostomy, thanks to radiated intestines, so I will be the first to admit that I am not normal but then who is?

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