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pharm 140 > 57 gastrointestinal secretions > Flashcards

57 gastrointestinal secretions Flashcards

1
Q

GERD

A

allows stomach acid to back up into the esophagus

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2
Q

4 major symptoms of GERD

A

heartburn
regurgitation
dysphagia
waterbrash

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3
Q

H. pylori

A

gram-negative spiral bacterium that weakens the protective mucus lining of the stomach and duodenum

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4
Q

peptic ulcer disease

A

general term that refers to ulcer formation in the esophagus, stomach or duodenum

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5
Q

pancreatitis

A

occurs when digestive enzyme production is reduced or stopped

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6
Q

cause of n/v

A

stimulation of chemoreceptors in brain and GI tract

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7
Q

proton pump inhibitors

A

-prazole

suppress the secretion of HCl into the lumen of the stomach

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8
Q

omeprazole (Prilosec) action

A

suppresses the last phase of gastric acid production by suppressing the H+/K+ ATPase enzyme system

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9
Q

omeprazole (Prilosec) pharmacokinetics

A

given PO
metabolized in liver
excreted thru urine/feces

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10
Q

omeprazole (Prilosec) contraindications

A

hypersensitivity

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11
Q

omeprazole (Prilosec) adverse effects

A

headache, n/v/d

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12
Q

omeprazole (Prilosec) interactions

A

other drugs metabolized thru the cytochrome P-450 pathway

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13
Q

omeprazole (Prilosec) pregnancy category

A

category C

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14
Q

Asians + omeprazole (Prilosec)

A

longer duration of action in Asian pts

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15
Q

omeprazole (Prilosec) nursing diagnoses

A

altered comfort r/t s/s GERD, PUD

imbalanced nutrition (less than body reqs) r/t s/s GERD, PUD

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16
Q

omeprazole (Prilosec) interventions

A

max therapeutic effect: take medication daily, do not crush or chew

min adverse effect: calcium citrate supplement for elderly pts

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17
Q

histamine-2 agonists

A

-tidines

block the release of hydrochloric acid in response to gastrin

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18
Q

cimetidine (Tagamet) indications

A

active duodenal ulcer
benign gastric ulcer
hypersecretory conditions
prophylaxis of ulcers/GI bleeding

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19
Q

cimetidine (Tagamet) action

A

selectively block histamine-2 receptor sites leading to a reduction in gastric acid secretion and overall pepsin reduction

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20
Q

cimetidine (Tagamet) pharmacokinetics

A

given PO
metabolized in liver
excreted thru kidneys

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21
Q

cimetidine (Tagamet) contraindications

A

hypersensitivity

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22
Q

cimetidine (Tagamet) adverse effects

A

headache, blood count changes, GI effects, hepatitis, hypotension, arrhythmias

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23
Q

cimetidine (Tagamet) interactions

A 
warfarin
phenytoin
beta blockers
alcohol, benzodiazepines
lidocaine
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24
Q

cimetidine (Tagamet) pregnancy

A

category B

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25
Q

cimetidine (Tagamet) nursing diagnoses

A

chronic pain r/t alteration in gastric mucosa

acute pain r/t adverse drug effects such as headache

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26
Q

cimetidine (Tagamet) interventions

A

max therapeutic effect: give at least two hours apart from an antacid

min adverse effect: monitor trough levels in renal/hepatic pts

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27
Q

antacids

A

increase gastric pH
composed of inorganic salts
used for various upper GI disorders

28
Q

types of antacids

A

sodium bicarbonate
calcium carbonate (tums)
magnesium salts
aluminum salts

29
Q

aluminum hydroxide (Amphojel) action

A

neutralizes stomach acid by direct chemical reaction

raises gastric pH in stomach and duodenum

30
Q

aluminum hydroxide (Amphojel) indications

A

upset stomach r/t hyperacidity, GERD

31
Q

aluminum hydroxide (Amphojel)

A

given PO

excreted thru feces

32
Q

aluminum hydroxide (Amphojel) contraindications

A

recent large GI bleed

any condition that can be exacerbated by electrolyte imbalance

33
Q

aluminum hydroxide (Amphojel) adverse effects

A 
hypercalcemia
osteomalacia
encephalopathy
rebound acidity
hypophosphatemia
alkalosis
constipation or diarrhea
34
Q

aluminum hydroxide (Amphojel) nursing diagnoses

A

chronic pain r/t alteration in gastric mucosa

potential complication: electrolyte imbalance 2/2 drug therapy

35
Q

aluminum hydroxide (Amphojel) interventions

A

max therapeutic effect: liquid preps preferred bc of rapid action; shake suspension

min adverse effect: give 2 hrs after other drugs to prevent interaction; monitor for s/s acid rebound

36
Q

prokinetic agents

A

increase effect of acetylcholine on GI system; increase peristalsis and gastric emptying

acetylcholine is responsible for normal GI function

37
Q

metoclopramide (Reglan) indications

A

diabetic gastroparesis

38
Q

metoclopramide (Reglan) pharmacokinetics

A

given PO
metabolized in liver
excreted via kidneys

39
Q

metoclopramide (Reglan) contraindications

A

GI hemorrhage/perforation

mechanical obstruction

40
Q

metoclopramide (Reglan) adverse effects

A

restlessness, confusion
depression, anxiety
headache
drowsiness, insomnia

41
Q

metoclopramide (Reglan) interactions

A

Levodopa
anticholinergic agents
narcotics

42
Q

metoclopramide (Reglan) pregnancy

A

category B

43
Q

metoclopramide (Reglan) diagnoses

A

risk for injury r/t drowsiness, fatigue, insomnia, confusion, and hallucination 2/2 adverse effects of drug therapy

44
Q

metoclopramide (Reglan) interventions

A

max therapeutic effects: give 30 min before meals, do not administer concurrently with anticholinergics

min adverse effects: monitor for depression, withhold dose if Parkinson-like symptoms occur

45
Q

antipeptic agent

A

coat any injured area in the stomach to prevent further injury from acid

46
Q

Sucralfate (Carafate) action

A

forms an ulcer-adherent complex at duodenal ulcer sites, protecting the sites against acid, pepsin, and bile salts

47
Q

Sucralfate (Carafate) interactions

A

ulcer

48
Q

Sucralfate (Carafate) pharmacokinetics

A

rapidly absorbed
metabolized in liver
excreted thru feces

49
Q

Sucralfate (Carafate) contraindications

A

allergy

renal failure

50
Q

digestive enzymes

A

responsible for breaking down food to be absorbed

digestive enzyme drug prep usually paired with anticholinergics, barbituates or antacids

51
Q

pancrelipase action

A

contains enzymes lipase, protease, and amylase which are responsible for final phase of digestion

52
Q

pancrelipase indications

A

replacement therapy for pts with deficient exocrine pancreatic secretions

53
Q

pancrelipase adverse effects

A

n/v/d

abdominal cramps

54
Q

pancrelipase interactions

A

antacids

iron preparations

55
Q

pancrelipase pregnancy

A

category C

56
Q

pancrelipase nursing diagnoses

A

imbalanced nutrition (less than body reqs) r/t impaired digestion 2/2 insufficient pancreatic enzymes

risk for pain 2/2 adverse effects of drug therapy

57
Q

pancrelipase interventions

A

max therapeutic effect: do not change brands

min adverse effect: administer exactly as prescribed to prevent excessive dosing

58
Q

how often to take pancrelipase

A

every time pt eats

59
Q

pancrelipase and sensitivity

A

pts sensitive to pork should not use pancrelipase

60
Q

antiemetics

A

suppress stimulation of CTZ and VC to treat n/v

61
Q

ondansetron (Zofran) action

A

blocks VC receptor sites to prevent n/v

62
Q

ondansetron (Zofran) indication

A

n/v

n/v associated with chemotherapy

63
Q

ondansetron (Zofran) adverse effects

A

headache, constipation, malaise

altered cardiac output, arrhythmia

64
Q

ondansetron (Zofran) pregnancy

A

category B

65
Q

ondansetron (Zofran) nursing diagnoses

A

imbalanced nutrition (less than body reqs) r/t n/v

potential complication (altered cardiac output) r/t adverse effects of drug therapy

risk for altered comfort r/t n/v

66
Q

ondansetron (Zofran) interventions

A

max therapeutic effect: give 30 min before chemo; infuse over 15 min

min adverse effect: dilute in 5% dextrose or 0.9% Na; do not mix with alkaline solutions

pharm 140 (18 decks)

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