Download Alvimopan (Entereg) Pre-Op/Post

Alvimopan (Entereg) Pre-Op/Post-Op [3041300020]
General
Alvimopan (ENTEREG) Orders
Patient Criteria for Alvimopan (ENTEREG) use:
1. Planned surgery is for partial large or small bowel resection with primary anastomosis.
2. Patient has NOT taken therapeutic doses of opioids for more than seven (7) consecutive days immediately prior to
taking Alvimopan (ENTEREG).
3. Patient does NOT have severe hepatic disorders. (Child-Pugh Class C)
4. Patient does NOT have end stage renal disease (ESRD).
5. Patient MUST receive a dose pre-operatively in order to qualify for post-operative ENTEREG therapy.
Only to be used for patients receiving parenteral / oral opioids post-op. Patients receiving ONLY epidural opioids post-op
are unlikely to benefit from Alvimopan (ENTEREG).
Residents/ Interns: Discuss appropriateness of alvimopan (ENTEREG) with the attending surgeon before ordering.
Post-op alvimopan should only be placed after the procedure is completed and it is verified that criteria are still met.
Duration of therapy should not exceed 14 doses POST-op.
[ ] PRE-Procedure alvimopan (ENTEREG)
Must be given 30 minutes to 5 hours prior to surgery.
[ ] alvimopan (ENTEREG) capsule x 1 Pre-procedure
[ ] POST-Procedure alvimopan (ENTEREG) Fast Track
Protocol- Patient WITH NG
[ ] Discontinue NG
[ ] Diet
12 mg, Oral, 60 min pre-procedure, For 1 Doses,
Pre-Procedure
[] Give in Pre-op with sip of water.
[] Do NOT open capsule.
[] Must be given 30 minutes to 5 hours prior to surgery.
Is planned/performed surgery for large or small bowel
resection with primary anastomosis?
Has patient taken therapeutic doses of opioids for more
than 7 consecutive days immediately preop?
Does patient have severe hepatic disorders (Child-Pugh
Class C)?
Does patient have end stage renal disease (ESRD)?
"And" Linked Panel
Routine, Once For 1 Occurrences
Specify: (if present) prior to first post-op dose of Alvimopan
Post-Procedure
Diet effective now, Starting S
Regular or Special Diet?: Special
Special Diet: Liquid
Liquid Diet: Clear Liquid
Fluid Restriction / 24h:
Fluid Restriction total / 24h:
Optional Preferences / Modifiers:
Post-Procedure
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[ ] Progress to target diet
[ ] Diet instructions to nursing
[ ] Ambulate patient
[ ] alvimopan (ENTEREG) capsule
[ ] POST-Procedure alvimopan (ENTEREG) Fast Track
Protocol- Patient WITHOUT NG
[ ] Diet
[ ] Progress to target diet
[ ] Diet instructions to nursing
[ ] Ambulate patient
Routine, 3 times daily with meals, Starting S+1 at 5:00 AM
Regular or Special Diet?: Special
Special Diet: Liquid
Liquid Diet: Full Liquid
Fluid Restriction / 24h:
Fluid Restriction total / 24h:
Optional Preferences / Modifiers:
As tolerated, Post-Procedure
Routine, Until discontinued, Starting S+2 at 5:00 AM
Specify: Encourage solid food beginning POD #2
Post-Procedure
Routine, Daily, Starting S+1
Specify: Encourage ambulation beginning POD #1
Post-Procedure
12 mg, Oral, 2 times daily, S+1 at 9:00 AM, For 14 Doses,
Post-Procedure
[] Discontinue drug upon first post-operative bowel
movement and tolerating fluids orally
[] NURSE to notify pharmacy to discontinue; PHARMACIST
to discontinue Alvimopan per protocol
[] FOR INPATIENT USE ONLY. DO NOT CONTINUE OR
PRESCRIBE UPON DISCHARGE
Is planned/performed surgery for large or small bowel
resection with primary anastomosis?
Did patient receive alvimopan (ENTEREG) dose preop?
"And" Linked Panel
Diet effective now, Starting S
Regular or Special Diet?: Special
Special Diet: Liquid
Liquid Diet: Clear Liquid
Fluid Restriction / 24h:
Fluid Restriction total / 24h:
Optional Preferences / Modifiers:
Post-Procedure
Routine, 3 times daily with meals, Starting S+1 at 5:00 AM
Regular or Special Diet?: Special
Special Diet: Liquid
Liquid Diet: Full Liquid
Fluid Restriction / 24h:
Fluid Restriction total / 24h:
Optional Preferences / Modifiers:
As tolerated, Post-Procedure
Routine, Until discontinued, Starting S+2 at 5:00 AM
Specify: Encourage solid food beginning POD #2
Post-Procedure
Routine, Daily, Starting S+1
Specify: Encourage ambulation beginning POD #1
Post-Procedure
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[ ] alvimopan (ENTEREG) capsule
12 mg, Oral, 2 times daily, S at 6:00 PM, For 14 Doses,
Post-Procedure
[] Discontinue drug upon first post-operative bowel
movement and tolerating fluids orally
[] NURSE to notify pharmacy to discontinue; PHARMACIST
to discontinue Alvimopan per protocol
[] FOR INPATIENT USE ONLY. DO NOT CONTINUE OR
PRESCRIBE UPON DISCHARGE
Is planned/performed surgery for large or small bowel
resection with primary anastomosis?
Did patient receive alvimopan (ENTEREG) dose preop?
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