Pepto-Bismol oral suspension
PEPTO-BISMOL ORAL SUSPENSION
RECOMMENDING PEPTO-BISMOL ORAL SUSPENSION7
Pepto-Bismol can be used by adults and adolescents 16 years old and over for the symptomatic relief of heartburn, indigestion, nausea and upset stomach as well as to control diarrhoea.
30ml of the oral solution should be taken using the dosing cup provided. This can be repeated every half hour to 1 hour if needed, with no more than 8 doses to be taken in 24 hours. Advise customers to shake the bottle before use.
ABOUT PEPTO-BISMOL
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WHO SHOULD NOT USE IT7
Pepto-Bismol contains salicylates and therefore patients taking certain medicines shouldn’t take it without consulting their doctor. These include anti-coagulant medicines (blood thinners), medicines for gout and arthiritis, and sulfonylurea medicines for diabetes
Pepto-Bismol should not be used during pregnancy and breastfeeding
Pepto-Bismol is not suitable for children under 16 years of age
Pepto-Bismol should not be used if patients are allergic to aspirin or other salicylates, or if they are taking aspirin or other salicylates currently
Patients with a peptic ulcer or blood clotting disorders should not take Pepto-Bismol
SIDE EFFECTS7
Pepto-Bismol can cause the surface of the tongue and stools to blacken. This is short-lived and resolves when Pepto-Bismol is stopped but can be concerning to patients. It also contains the colouring amaranth (E 123) which may cause allergic type reactions including asthma.
See more information on how to report adverse reactions at the end of the module.
COUNSELLING POINTS FOR PATIENTS6,7
Pepto-Bismol can be taken before or after meals, on either an empty or full stomach
Make sure to stay hydrated using fluid and electrolyte replacement therapy, if appropriate
WHEN TO REFER6,7
Symptoms lasting more than two days should be referred to the pharmacist or doctor for further investigation
Any red flag symptoms (e.g. blood or mucus in faeces) should be referred to the pharmacist or doctor
CUSTOMER SCENARIOS
Consider how you would support these patients
A pregnant woman is complaining of heartburn and indigestion symptoms. She is otherwise well and isn’t taking any other medicines. Her pregnancy has been straightforward aside from nausea during the first trimester which has subsided. She asks for Pepto-Bismol as it effectively managed her symptoms prior to her pregnancy.
WHICH OF THE FOLLOWING OPTIONS WOULD BE MOST APPROPRIATE TO RECOMMEND?
Recommend Pepto-Bismol to the customer
INCORRECTPepto-Bismol is not suitable for people who are pregnant
Provide her with advice to help prevent symptoms such as eating small meals, not eating too close to bedtime and avoiding food and drinks that trigger symptoms such as spicy food, fatty foods, fizzy drinks.
CORRECT
Refer the customer to their GP for further investigation
INCORRECTWhile the GP may recommend some management options for the heartburn, self-care advice and other product suggestions can be given to help the customer first
A 45-year-old man asks for something that can treat his symptoms. He has had heartburn, indigestion, an upset stomach, nausea and diarrhoea after overindulging at lunch at a work networking event. He wants the convenience of only taking one product to manage all his symptoms.
WHICH OF THE FOLLOWING OPTIONS WOULD BE MOST APPROPRIATE?
Recommend Pepto-Bismol to the customer
CORRECTPepto-Bismol can be used to manage all 5 of the patient’s symptoms
Recommend a PPI to the customer
INCORRECTWhile this would manage some symptoms it wouldn’t manage the nausea and diarrhoea
Refer the patient to the GP
INCORRECTThe customer’s symptoms could be managed over the counter rather than having to wait to see a GP
A 20-year-old female requests something to help with the indigestion she’s been experiencing over the last few weeks. Her appetite has dropped off and she’s noticed she’s lost some weight.
WHICH OF THE FOLLOWING OPTIONS WOULD BE MOST APPROPRIATE?
Recommend an antacid to manage symptoms
INCORRECTThe customer has red flag symptoms and needs referral
Recommend Pepto-Bismol to manage symptoms
INCORRECTThe customer has red flag symptoms and needs referral
Refer the customer to their GP for further investigation
CORRECTThe customer has red flag symptoms that need further investigation by the GP