Stool studies, including C. Difficile is sent and is negative. He is started on IV methylprednisolone 40 mg daily.
You review his medication administration record (MAR). Which of the following medicines should not be on his MAR? (select all that apply)
Loperamide
Antidiarrheals should be avoided in active IBD flares as they can precipitate colonic dilation and obstruction
Dicyclomine
Anti-spasmodics should be avoided in IBD flares as they can precipitate bowel obstructions
Naproxen
NSAIDs should be avoided in acute flares of IBD as they have been found to precipitate and worsen flares.
Hydromorphone
Opiates should be avoided in patients with IBD as they have been shown to have an increased risk of mortality
Enoxaparin
All patients with IBD without absolute contraindication to anticoagulation should be on DVT prophylaxis since they are in a prothrombotic state
Acetaminophen
Acetaminophen is an acceptable analgesic in patients with IBD
Tramadol
As a partial opiate agonist, tramadol can be safely used in IBD
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