Flexiseal and tylenol suppository

[jtanga]

Is there a note in the manual saying that we cannot put tylenol suppository when pt currently has flexiseal? I know its kinda common sense but just wondering.. tylenol dissolved fast

[KatieMI, BSN, MSN, RN]

Flexiseal is used for patients with diarrhea, who therefore have quick stool passage/high volume, and, therefore, most possibly will not hold the supp in upper anal canal (where epithelium is still columnar and adsorbs meds well).

I had this situation before, took some time to get provider to understand why it won't work that way

[blondy2061h, MSN, RN]

We used to have Zassi which was nice. It had a port just for giving rectal medications. You could stop stool flow while giving it to force retention. You had better be brave when clamping it off in someone with diarrhea, though, lest you have someone with a stoolsplosion.

[jtanga]

But even though its not effective is it contraindicated to give it ?

[KatieMI, BSN, MSN, RN]

It is not contraindicated, it is just plain darn stupid. Like giving metoprolol to patient on Levophed drip or stop tubefeed 1 h before and after a med given q4h.

[LovingLife123]

Why would you do it?

[miss.amy-sue]

Don't think its contraindicated, just think it isn't the best route for a patient with frequent loose stools. Even if you gave it, no guarantee that it would be absorbed. Big fan of stoolsplosion. *thumbs up* to blondy2061h

If the patient couldn't take it orally, you could drop an NGT or DHT and give liquid. Also IV tylenol available but very expensive and not approved all the time due to cost.

[Double-Helix, BSN, RN]

miss.amy-sue said:

Also IV tylenol available but very expensive and not approved all the time due to cost.

IV Tylenol is not very expensive. It was more expensive when first released, but since has become quite reasonable. The wholesale cost is around $13/1gm, which is certainly higher than the PO form, but within a couple dollars of the cost of a dose of IV Toradol. It's use in the preoperative setting is becoming quite common, and it's in no way cost-prohibitive.