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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
cimetidine (Tagamet) nursing diagnoses
chronic pain r/t alteration in gastric mucosa acute pain r/t adverse drug effects such as headache
26
cimetidine (Tagamet) interventions
max therapeutic effect: give at least two hours apart from an antacid min adverse effect: monitor trough levels in renal/hepatic pts
27
antacids
increase gastric pH composed of inorganic salts used for various upper GI disorders
28
types of antacids
sodium bicarbonate calcium carbonate (tums) magnesium salts aluminum salts
29
aluminum hydroxide (Amphojel) action
neutralizes stomach acid by direct chemical reaction raises gastric pH in stomach and duodenum
30
aluminum hydroxide (Amphojel) indications
upset stomach r/t hyperacidity, GERD
31
aluminum hydroxide (Amphojel)
given PO | excreted thru feces
32
aluminum hydroxide (Amphojel) contraindications
recent large GI bleed | any condition that can be exacerbated by electrolyte imbalance
33
aluminum hydroxide (Amphojel) adverse effects
``` hypercalcemia osteomalacia encephalopathy rebound acidity hypophosphatemia alkalosis constipation or diarrhea ```
34
aluminum hydroxide (Amphojel) nursing diagnoses
chronic pain r/t alteration in gastric mucosa potential complication: electrolyte imbalance 2/2 drug therapy
35
aluminum hydroxide (Amphojel) interventions
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
prokinetic agents
increase effect of acetylcholine on GI system; increase peristalsis and gastric emptying acetylcholine is responsible for normal GI function
37
metoclopramide (Reglan) indications
diabetic gastroparesis
38
metoclopramide (Reglan) pharmacokinetics
given PO metabolized in liver excreted via kidneys
39
metoclopramide (Reglan) contraindications
GI hemorrhage/perforation | mechanical obstruction
40
metoclopramide (Reglan) adverse effects
restlessness, confusion depression, anxiety headache drowsiness, insomnia
41
metoclopramide (Reglan) interactions
Levodopa anticholinergic agents narcotics
42
metoclopramide (Reglan) pregnancy
category B
43
metoclopramide (Reglan) diagnoses
risk for injury r/t drowsiness, fatigue, insomnia, confusion, and hallucination 2/2 adverse effects of drug therapy
44
metoclopramide (Reglan) interventions
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
antipeptic agent
coat any injured area in the stomach to prevent further injury from acid
46
Sucralfate (Carafate) action
forms an ulcer-adherent complex at duodenal ulcer sites, protecting the sites against acid, pepsin, and bile salts
47
Sucralfate (Carafate) interactions
ulcer
48
Sucralfate (Carafate) pharmacokinetics
rapidly absorbed metabolized in liver excreted thru feces
49
Sucralfate (Carafate) contraindications
allergy | renal failure
50
digestive enzymes
responsible for breaking down food to be absorbed digestive enzyme drug prep usually paired with anticholinergics, barbituates or antacids
51
pancrelipase action
contains enzymes lipase, protease, and amylase which are responsible for final phase of digestion
52
pancrelipase indications
replacement therapy for pts with deficient exocrine pancreatic secretions
53
pancrelipase adverse effects
n/v/d | abdominal cramps
54
pancrelipase interactions
antacids | iron preparations
55
pancrelipase pregnancy
category C
56
pancrelipase nursing diagnoses
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
pancrelipase interventions
max therapeutic effect: do not change brands min adverse effect: administer exactly as prescribed to prevent excessive dosing
58
how often to take pancrelipase
every time pt eats
59
pancrelipase and sensitivity
pts sensitive to pork should not use pancrelipase
60
antiemetics
suppress stimulation of CTZ and VC to treat n/v
61
ondansetron (Zofran) action
blocks VC receptor sites to prevent n/v
62
ondansetron (Zofran) indication
n/v | n/v associated with chemotherapy
63
ondansetron (Zofran) adverse effects
headache, constipation, malaise altered cardiac output, arrhythmia
64
ondansetron (Zofran) pregnancy
category B
65
ondansetron (Zofran) nursing diagnoses
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
ondansetron (Zofran) interventions
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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