sucralfate Nursing Considerations & Management

Drug Name

Generic Name : sucralfate

Brand Name: Apo-Sucralfate (CAN), Carafate, Novo-Sucralfate (CAN), Sulcrate (CAN)

Classification: Antiulcer drug

Pregnancy Category B 

Dosage & Route

Available forms :Tablets—1 g; suspension—1 g/10 mL

ADULTS
  • Active duodenal ulcer: 1 g PO qid on an empty stomach (1 hr before meals and at bedtime). Continue treatment for 4–8 wk.
  • Maintenance: 1 g PO bid.
PEDIATRIC PATIENTS
  • Safety and efficacy not established.
Therapeutic actions
  • Sucralfate protects GI lining against peptic acid, pepsin and bile salts by binding with positively-charged proteins in exudates forming a viscous paste-like adhesive substance thus forming a protective coating.
Indications
  • Short-term treatment of duodenal ulcers, up to 8 wk
  • Maintenance therapy for duodenal ulcer at reduced dosage after healing
  • Orphan drug use: Treatment of oral and esophageal ulcers due to radiation, chemotherapy, and sclerotherapy
  • Unlabeled uses: Accelerates healing of gastric ulcers, long-term treatment of gastric ulcers, treatment of reflux and peptic esophagitis, treatment of NSAID or aspirin-induced GI symptoms and GI damage, prevention of stress ulcers in critically ill patients
Adverse effects
  • Constipation, diarrhea, nausea, dizziness, dry mouth. GI disturbances, rash, pruritus, headache, vertigo, back pain, drowsiness.
Contraindications
  • Contraindicated with allergy to sucralfate, chronic renal failure or dialysis (buildup of aluminum may occur with aluminum-containing products).
  • Use cautiously with pregnancy, lactation.
Nursing considerations
Assessment
  • History: Allergy to sucralfate; chronic renal failure or dialysis; pregnancy, lactation
  • Physical: Skin color, lesions; reflexes, orientation; mucous membranes, normal output
Interventions
  • Give drug on an empty stomach, 1 hr before or 2 hr after meals and at bedtime.
  • Monitor pain; use antacids to relieve pain.
  • Administer antacids between doses of sucralfate, not within 30 min before or after sucralfate doses.
  • Measure and record regular weight to monitor mobilization of edema fluid.
  • Avoid giving food rich in potassium.
  • Arrange for regular evaluation of serum electrolytes, BUN.
Teaching points
  • Take the drug on an empty stomach, 1 hour before or 2 hours after meals and at bedtime.
  • If you are also taking antacids for pain relief, do not take antacids 30 minutes before or after taking sucralfate.
  • You may experience these side effects: Dizziness, vertigo (avoid driving or operating dangerous machinery); indigestion, nausea (eat frequent small meals); dry mouth (use frequent mouth care, suck on sugarless lozenges); constipation (request aid).
  • Report severe gastric pain.