[11] FINALS | GIT Flashcards
ANTIEMETICS
NON-PRESCRIPTION ANTIEMETICS
Antihistamine
* Dimenhydrinate (Dramamine, Dimetabs)
* Cyclizine HCl (Marezine)
* Diphenhydramine hydrochloride (Benadryl)
Bismuth Subsalicylate
* Bismuth subsalicylate (Pepto-Bismol)
Phosphorated Carbohydrate Solution
* Phosphorated carbohydrate solution (Emetrol)
ANTIEMETICS
PRESCRIPTION ANTIEMETICS
Antihistamines
* Hydroxyzine (Vistaril, Atarax, Iterax)
* Promethazine (Phenargan)
Anticholinergics
* Hyoscine (Buscopan) – antispasmodic
* Scopolamine (Transderm-Scop)
* S/E: drowsiness, blurred vision (pupillary dilation), tachycardia, constipation, dry mouth
ANTIEMETICS
PRESCRIPTION ANTIEMETICS: Dopamine Agonists
Phenothiazine Antiemetics
* Drug Interaction: alcohol, narcotics, sedatives, general anesthesia
* S/E: moderate sedation, hypotension, EPS, CNS effects, mild anticholinergic signs
* Ex.: Chlorpromazine (Thorazine) and Prochlorperazine Meleate (Compazine)
Butyrophenones
* Treat post-op N&V and emesis associated with calcium chemotherapy, toxins, and radiation therapy
* S/E: EPS, hypotension
* Ex.: Haloperidol (Haldol), Droperidol (Reglan, Plasil)
Metoclopramide (Reglan, Plasil)
* Blocks dopamine and serotonin receptors in the CTZ
* S/E: sedation and diarrhea
ANTIEMETICS
BENZODIAZEPINES
* Ex. Diazepam (Valium) and Lorazepam (Ativan) - DOC
SEROTONIN (5-HT3) RECEPTOR AGONISTS
* Used for calcium chemotherapy-induced emesis
* MOA: blocks serotonin receptors in the CTZ and specialized cells in the GIT
* S/E: headache, dizziness, diarrhea, fatigue
* Ex. Ondansetron (Zofran), Dolasetron (Anzemet)
GLUCOCORTICOIDS (Corticosteroids)
* Dexamethasone (Decadron)
* Methylprednisolone (Solu-Medrol)
ANTIEMETICS
CANNABINOIDS
* Active ingredient in Marijuana
* Dronabinol (Marinol) and Nabilone (Cesamet)
* S/E: mood changes, euphoria, drowsiness, dizziness, headaches, depersonalization, nightmares, confusion, incoordination, memory lapse, dry mouth, orthostatic hypotension or HPN, tachycardia
MISCELLANEOUS ANTIEMETICS
* Suppresses the impulses to the chemoreceptor trigger zone, tjus inhibiting the activity of the vomiting center
* Diphenidol (Vontrol) and Trimethobenzamide (Tigan)
* S/E: dry mouth, blurred vision, constipation, increased heart rate
* A/R: dizziness, anxiety, skin rash, diarrhea
ANTIEMETICS
NURSING RESPONSIBILITIES
* Observe the characteristic of vomitus
* Obtain hx of present illness
* Check VS
* Encourage to maintain oral hygiene
* Instruct not to consume alcohol
* Don’t give antiemetics to pregnant women in their 1st
* trimester
* Instruct the patient not to drive.
* Encourage the use of nonpharmacological methods.
EMETICS
NURSING RESPONSIBILITIES
* Determine the toxic substances ingested.
* Caustic substances: ammonia, chlorine bleach, toilet cleaners
* Petroleum distillates: gasoline, kerosene, paint thinners
* Check VS and report abN findings.
* Call the poison control center.
* Offer sufficient fluids should be given.
* Don’t offer Ipecac or fluid to a semi-conscious or unconscious patient.
* Keep away from children.
ANTIDIARRHEALS
OPIATES
* Action: decrease intestinal motility, decreasing peristalsis
* S/E: constipation
* Ex.: tincture of opium (Paregoric, Codeine)
OPIATE-RELATED AGENTS
* Action: decrease intestinal peristalsis and can be used as combination with opiates; decreased abdominal cramping
* Ex.: Diphenoxilate (Lomotil), Difenoxin (Motofen), Loperamide (Imodium)
* S/E: drowsiness, dizziness, constipation, dry mouth, weakness, rashes, flushing, blurred vision, mydriasis urine retention
* A/R: paralytic ileus, severe allergic reaction
ANTIDIARRHEALS
ADSORBENTS
Action: Coats the wall of the GI tract and adsorbs the bacteria or toxins that cause the diarrhea
Ex. Kaolin and Pectin (Kaopectate) and Bismuth Salts (Pepto-Bismol)
S/E: Constipation
A/R: Fecal impaction or ulceration in infants and elderly
ANTIDIARRHEALS
SOMATOSTATIN ANALOG
Inhibit the gastric acid, pepsinogen, gastrin, cholecystokinin, and serotonin secretions and intestinal fluid
It decreases smooth muscle contractility
Ex. Octreotide Acetate (Sandostatin)
MISCELLANEOUS
Used to control diarrhea
Ex. Furazolidone (Furoxone), Lactobacillus, and Parepectolin (CSS V)
ANTIDIARRHEALS
NURSING RESPONSIBILITIES
* Assess for hx of infection and other causes of diarrhea.
* Check VS.
* Assess freq and char of stools, S/S of DHN
* Check clients BS.
* Instruct patient to avoid taking sedatives, tranquilizers, and other narcotics because CNS depression may result.
* Encourage to increase OFI
* Monitor electrolytes
LAXATIVES
Action: promote evacuation of the bowel, promote softening of the stools
TYPES:
Osmotic/Saline
Stimulants
Bulk-forming
Emollients (Stool Softener)
LAXATIVES
OSMOTIC LAXATIVES
Action: pull water into the colon and incrase water in the feces to increase bulk which stimulates peristalsis
Include salts and saline products (Na, K, and Mg), lactulose, and glycerine
Lactulose
Draws water into the intestines to form a soft stool; dereases serum ammonia
Glyerine
Increases water in the feces in the large intestine
S/E: flatulence, diarrhea, abdominal cramps, nausea, and vomiting
C/I: renal insufficiency, DM
LAXATIVES
STIMULANT (CONTACT LAXATIVES)
Acts directly on the intestine, causing an irritation to the sensory nerve endings that promotes peristalsis and evacuation
S/E: nausea, abdominal cramps, weakness, and reddish-brown urine (phenolphthalein, senna, or cascara)
Prolonged use of Senna (Senokot) - damages nerve; loss of intestinal muscular tone
Ex.
Castor Oil - stimulates urine contaction; for bowel preparation
Bisacodyl (Dulcolax) - barium enema
Senna (Senokot)
Phenolphthalein (Ex-Lax, Doxidan)
LAXATIVES
BULK-FORMING LAXATIVES
Action: natural fibrous substances that promote large, soft stools by absorbing water into the intestine, increasing fecal bulk and peristalsis
This group of laxative not absorbed by the body, no systemic S/E and does not cause laxative dependence
Ex. Psyllium (Metamucil) and Methylcellulose (Citrucel)
S/E: nausea, vomiting, flatus, diarrhea, abdominal cramps
