Certified Wound Care Nurse (CWCN) Practice Exam

Which medication is considered most effective for reducing fistula output?

1. Octreotide

2. Metoclopramide

3. Loperamide

4. Diphenoxylate

The correct answer is: Octreotide

Octreotide is a synthetic somatostatin analogue that is highly effective in reducing gastrointestinal secretions, including those produced by enteric fistulas. By inhibiting gut motility and decreasing the secretion of fluid into the intestines, octreotide can significantly lower the output from fistulas. This reduction in output is crucial for managing fluid and electrolyte balance in patients, as high fistula output can lead to dehydration and other complications. The use of octreotide is particularly beneficial in clinical scenarios where a patient has a high-output fistula, as it can help in the management of the associated symptoms and allow for better wound care and nutrition. The other medications listed have different mechanisms of action or are not primarily indicated for reducing fistula output. For example, metoclopramide primarily acts as a prokinetic agent to enhance gastrointestinal motility, which does not align with the goal of reducing output. Loperamide and diphenoxylate are both antidiarrheal agents that work by slowing gastrointestinal transit time and reducing stool frequency but may not effectively target the specific mechanisms involved in fistula output reduction.