Download aloe - DavisPlus - FA Davis Company

Name /bks_53161_deglins_md_disk/aloe
02/11/2014 08:46AM
Plate # 0-Composite
Adverse Reactions/Side Effects
Derm: Contact dermatitis, skin irritation. Endo: hypoglycemia. F and E: HYPOKALEMIA, dehydration. GI: Cramping, diarrhea, laxative dependence (chronic use).
GU: hematuria.
1
aloe (al-oh)
Other Name(s):
Aloe vera, Cape aloe, Aloe latex, Burn plant, Curacao aloe
Classification
Therapeutic: laxatives, wound/ulcer/decubiti healing agent
Interactions
Natural Product-Drug: Combining oral aloe with potassium-wasting drugs
Common Uses
PO: Cathartic laxative. Topical: Use on burns/sunburns, wounds, irritated skin, psoriasis; topical anti-infective.
Action
PO: Exerts a laxative effect by increasing colonic motility, reducing water absorption
from the bowel and stimulating bowel, chloride secretion and water content. Topical: May help accelerate wound healing through inhibition of thromboxane A2 and
increased microcirculation, although the evidence is inconsistent. May have some activity against gram-positive, gram-negative bacteria and yeast. Therapeutic Effects: Relief of constipation. Improved wound healing.
Pharmacokinetics
Absorption: Unknown.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.
ONSET
unknown
PEAK
unknown
PO (Adults): Constipation— 100– 200 mg aloe or 50 mg of aloe extract taken in
the evening. Do not use for ⬎1– 2 wk without medical advice; Juice— 1 teaspoonful
tid after meals.
Topical (Adults): Aloe gel can be applied liberally to affected areas 3– 5 times daily.
NURSING IMPLICATIONS
Assessment
usual pattern of elimination.
DURATION
unknown
cluding Crohn’s disease); Appendicitis and abdominal pain of unknown origin ; OB:
Safety not established; Pedi: Oral aloe not appropriate for children ⬍12 yr.
Use Cautiously in: Renal disease; Fluid or electrolyte abnormalities; Diabetes; Alcohol containing products should be used cautiously in patients with known intolerance or liver disease; Pedi: Cautious use in children ⬎12 yr old.
⫽ Genetic Implication.
Route/Commonly Used Doses
● Assess color, consistency, and amount of stool produced.
● Topical: Perform baseline skin assessment prior to applying aloe to minor
Contraindications/Precautions
Contraindicated in: Intestinal obstruction; Inflammatory intestinal diseases (in-
⫽ Canadian drug name.
(e.g., diuretics, other laxatives, corticosteroids, cisplatin, amphotericin B)
may worsen hypokalemia. Hypokalemia mayqrisk of toxicity from digoxin and
some antiarrhythmics. May have additive effects with antidiabetics. Mayqbleeding risk with warfarin. Alcohol-containing preparations may interact with disulfiram and metronidazole.
Natural-Natural Products:qhypokalemia risk with licorice and horsetail.
Additive effects with stimulant laxative herbs and herbs with hypoglycemic potential.
● Constipation: Assess for abdominal distention, presence of bowel sounds, and
TIME/ACTION PROFILE
ROUTE
PO, Topical
pg 1 # 1
wounds, burns, and abrasions. Observe the size, character, and location of the affected area prior to the application of aloe.
● Note topical response assessing for increased inflammation, drainage, pain,
warmth, and/or pruritus.
● Lab Test Considerations: Monitor serum potassium in patients with chronic
use and CBC in patients who self medicate and experience bloody diarrhea or have
ulcerative colitis or Crohn’s disease.
Potential Nursing Diagnoses
Constipation (Indications)
Impaired skin integrity
Deficient knowledge, related to medication regimen
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
PDF Page #1
Name /bks_53161_deglins_md_disk/aloe
02/11/2014 08:46AM
Plate # 0-Composite
● Topical: Advise patients that topical applications should only be used for minor
2
Implementation
● PO: Administer laxative at bedtime to induce a bowel movement in the morning.
● Topical: Wash hands and then apply liberally to affected area of skin. Cover bro-
ken areas of skin with a light nonadhering dressing (e.g., band-aid dressing with
Telfa lining) to facilitate keeping area clean. Do not apply an occlusive dressing
over site of application.
Patient/Family Teaching
● Constipation: Instruct patients with preexisting intestinal disorders (e.g., ulcera●
●
●
●
●
●
●
●
●
pg 2 # 2
tive colitis, Crohn’s disease, irritable bowel syndrome) not to take aloe juice without the advice of a health care professional.
Counsel patients that the oral juice should not be taken if they are experiencing abdominal pain, nausea, vomiting, or fever.
Inform patients that occasional constipation may not be an issue but persistent
constipation may represent a more serious health problem and to consult their
health care professional.
Advise patients to expect laxative response to the oral juice in 8– 12 hr.
Caution patients that the cathartic effects may be dramatic and that accompanying
dehydration and electrolyte imbalances may occur. If severe diarrhea occurs or
persists, seek out treatment from their health care professional.
Advise patients other than those with spinal cord injury that laxatives should only
be used for short-term therapy. Although this is considered by some to be a natural
way of correcting constipation it still carries the risk of electrolyte imbalance and
dependency with chronic use.
Encourage patients to use other forms of bowel regulation: increasing bulk in the
diet, increasing fluid intake, and increasing mobility, as appropriate. Normal
bowel habits are individualized and may vary from 3 times/day to 3 times/wk.
Advise patients to consume a 1500– 2000 mL/day during therapy to prevent dehydration.
Direct patients with a known cardiac history not to take this herbal supplement
without the advice of their health care professional because of the risk of hypokalemia worsening arrhythmias.
Caution patients with cardiac history to avoid straining during bowel movements
(Valsalva maneuver).
burns, abrasions, or wounds. Wounds of larger size or more serious burns should
be treated by a health care professional.
● Instruct patients using topical application on a nonintact skin surface about signs
and symptoms of infection (milky or discolored drainage, redness, warmth, swelling, pain) and to promptly seek out treatment of a health care professional if this
occurs.
● Counsel patients that if improvement in the wound is not occurring or it worsens,
stop treatment with aloe vera and seek the advice of a health care professional.
● Warn patients with risk factors for delayed wound healing (e.g., diabetic patients,
vascular disease) not to self-medicate with aloe vera without the approval of their
health care professional.
Evaluation
●
●
●
●
A soft, formed bowel movement.
Evacuation of the colon.
Relief of sunburn pain.
Wound healing in small localized burns or abrasions.
Why was this drug prescribed for your patient?
䉷 2015 F.A. Davis Company
PDF Page #2