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Pharmacology Exam 3 Review > Acid Controlling Drugs, Laxatives, & Antimetics > Flashcards

Acid Controlling Drugs, Laxatives, & Antimetics Flashcards

1
Q

Neutralizes hydrochloric acid & reduces pepsin activity

A

Antacids

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2
Q
  • Sodium Bicarbonate (Alka-Seltzer)
  • Calcium Carbonate (Tums)
  • Magnesium hydroxide/aluminum Hydroxide
A

Antacids

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3
Q

When taking Antiacids what happens when the calcium levels are high? What happens to the phosphorus levels?

A

Hypercalcemia can lead to kidney stones
- Phosphorus levels gets low = Hypophosphatemia

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4
Q

Overuse of antacids leads to?

A

Metabolic alkalosis

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5
Q

What assessments should u do when a patient is on Antiacids?

A

Assess fluid & electrolyte imbalances (Ca & phosphate lvls)
- Check renal function (Risk for hyperphosphatemia)

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6
Q

What implementation should u do when a patient is on Antiacids?

A
  • Reports of pain, coughing, or vomiting blood (S/s of GERD) - Antacids not controlling s/s of GERD
  • Warn that taking unlimited amt of Antiacids is contraindicted
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7
Q

-tidine

A

Histamine 2 Blockers

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8
Q
  • Cimetidine
  • Famotidine
A

Histamine 2 Blockers

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9
Q

Reduces gastric acids by blocking H2 receptors of parietal cells in the stomach.
- Promotes healing of gastric ulcers

A

Histamine 2 Blockers

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10
Q

What should you be cautious with when taking Histamine 2 Blockers?

A

Renal or hepatic disease

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11
Q

What assessments should u do when a patient is on Histamine 2 Blockers?

A

Assess Liver function (AST/ALT) & Renal Function (Creatinine lvl & urine output)

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12
Q

What implementation should u do when a patient is on Histamine 2 Blockers?

A

OTC H2 blockers should only be used for (Short-Term) treatment of GERD (2 weeks)
- Report pain, coughing, or vomiting of blood (S/s of GERD)

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13
Q

-prazole

A

Proton Pump Inhibitors

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14
Q
  • Omeprazole
  • Pantoprazole
  • Lansoprazole
A

Proton Pump Inhibitors

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15
Q

Reduces gastric acid by inhibiting hydrogen/potassium ATPase

A

Proton Pump Inhibitors

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16
Q

Long-Term use of what drug causes:
- CDAD (Clostridium Difficile-associated diarrhea)
- Pneumonia
- Osteoporosis
- Hypomagnesium

A

Proton Pump Inhibitor

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17
Q

Before administering Pantoprazole IV, what should you do?

A

Administer it over a minimum of 2 minutes IV push
- Dilute in 10mL of normal saline (Concentration shouldn’t exceed 4mg/mL)

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18
Q

What assessments should u do when a patient is on a Proton Pump Inhibitor?

A

Assess electrolyte levels (Magnesium)
- History diagnosis (Ulcers, GERD, H. Pylori)

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19
Q

What implementation should u do when a patient is on a Proton Pump Inhibitor?

A

Administer Pantoprazole over a minimum of 2 minutes IV push
- Dilute in 10mL of normal saline (Concentration shouldn’t exceed 4mg/mL)
- Monitor bowel function (signs of diarrhea, bloody stool, fever = CDAD)
- OTC meds should not be taken after (14 days of use)

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20
Q

Pepsin Inhibitor: (Mucosal protective drug)

A

Sucralfate

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21
Q

Combines with proteins to form a thick paste covering the ulcer (Protects ulcers from acids & pepsin)
- Mucosal protectant
- Treats existing ulcers
- Can be added to H. Pylori Tx

A

Sucralfate

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22
Q

What implementation should u do when a patient is on Sucralfate?

A
  • Given 30 minutes before meals & at bedtime
  • Separate antacid & pepsin inhibitors by 1 hr
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23
Q

What are the side effects of taking sucralfate?

A
  • Constipation
  • High blood sugar (Diabetics)
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24
Q

Prostaglandin Analogue Drug

A

Misoprostol

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25
Q

Inhibits gastric acid secretion and protects mucosa
- Used for induced labor (Stillbirth)

A

Prostaglandin Analogue (Misoprostol)

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26
Q

Bulk-Forming Drugs

A

Psyllium

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27
Q

Absorbs water into intestines
- Increases bulk & peristalsis
- Results (8-12 hrs)

A

Bulk-Forming (Psyllium)

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28
Q

How do you administer Psyllium?

A
  • Mix the drug in a glass of water or juice (8oz)
  • Stir mixture & pt must drink it immediately, followed with another glass of water
29
Q

“Stool softeners”
- Lowers surface tension of feces
- Promotes water accumulation in the intestines
- Emulsifies & lubricates feces

A

Emollients

30
Q
  • Docusate Calcium
  • Docusate Sodium
A

Emollient Drugs

31
Q

What are Emollient drugs used for?

A
  • After surgery or heart attacks to prevent constipation
  • Pregnancy
32
Q

Saline Laxative Drugs
- Milk in Magnesia
- Magnesium citrate
- Fleet enema
- Epsom salts

A

Saline Laxative Drugs

33
Q

Pulls water rapidly into the colon
- Results (3-6hrs)

A

Saline Laxatives

34
Q

What happens when Saline Laxatives are abused?

A

Hypermagnesemia

35
Q
  • Bisacodyl
  • Senna
A

Stimulant Drugs

36
Q

Increases peristalsis by irritating sensory nerve endings in the intestinal mucosa
- Orally Results (6-12hrs)
- Rectally Results (15-60mins)

A

Stimulants (Bisacodyl & Senna)

37
Q

Side effects:
- Reddish brown urine
- Diarrhea
- Hypokalemia
- Hypocalcemia

A

Stimulants Side Effects

38
Q
  • Polyethylene Glycol
  • Lactulose
  • Glycerin
A

Osmotic Drugs

39
Q

Used for bowel prep for colonoscopies
- Goal Clear stools

A

Polyethylene Glycol

40
Q

Used for constipation
- Used for patients with Liver Disease (Hepatic Encephalopathy)
- Lowers Ammonia levels
- Goal: 3-4 stools a day

A

Lactulose

41
Q

What Assessment should u do when a patient is on Laxatives?

A
  • Assess the ability to swallow
  • Assess Diagnosis of bowel obstruction
  • Assess fluid & electrolyte status
42
Q

Implementation for (Psyllium)

A
  • Mix in 8oz of water or juice
  • Stir & administer immediately
  • Follow up with 8oz of water
    (Do Not Admisinster as dry powder)
43
Q

Implementation for (Lactulose)

A
  • Given to decrease ammonia levels in liver disease patients
  • Contact prescriber once goal is met
    (Goal: 3-4 stools a day)
44
Q

Implementation for (Polyethylene glycol)

A
  • Administer full amount (3-4L) as bowel prep
  • Check stool transparency prior to colonoscopy
45
Q

Implementation of (Saline laxatives)

A
  • Monitor electrolytes (Magnesium)
  • Poor renal function = hypermagnesemia
46
Q

Implementation for (Bisacodyl)

A
  • If given (Rectally) monitor for electrolyte imbalances
    (hypokalemia & hypocalcemia)
47
Q

What can chronic use of laxatives lead to?

A
  • Megacolon
  • Electrolyte imbalances
48
Q
  • dimenhydrinate (Dramamine)
  • meclizine
  • diphenhydramine
A

Nonprescriptive Antiemetics (Antihistamine) Drugs

49
Q

Helps prevent nausea by helping with the inner ear & helping with balance issues
- Helps with motion sickness

A

Antihistamines

50
Q

When should antihistamines be taken?

A

30 minutes to 1 hour before activity

51
Q

Scopolamine

A

Anticholinergic
- Used for motion sickness

52
Q
  • Dry Mouth
  • Blurry Vision
  • Constipation
  • Urinary retention
    Are signs of what effect?
A

Anticholinergic effects

53
Q

Anticholinergic contraindications

A

Glaucoma patients

54
Q

Dopamine Antagonist: Phenothiazine Anti-emetics
- Blocks dopamine receptors in the chemoreceptor trigger zone (CTZ)

A

Promethazine (Phenergan)

55
Q
  • CNS depression
  • Extrapyramidal syndrome (EPS)
  • Anticholinergic symptoms
    These are side effects of what drug?
A

Promethazine (Dopamine Antagonist)

56
Q

How is Promethazine administered?

A

If given IV
- Use IV pump
- Dilute in at least 25ml of NS
- Given slowly over 10-15 minutes
- Avoiding wrist & arm veins
- Use port farthest away from site

57
Q

What happens if infiltration (leaking) of promethazine occurs in tissues?

A

It goes into the tissues surrounding the vein resulting in tissue necrosis

58
Q

Serotonin Antagonist
- Blocks the serotonin receptors in the GI tract & vomiting center in the medulla

A

“Setron”
- Ondansetron

59
Q

Ondansetron is often used for?

A

Pregnancy to help with nausea

60
Q
  • Headache, diarrhea, dizziness, & fatigue
  • Birth defects
  • QT prolongation
    These are side effects of what drug?
A

Ondansetron

61
Q

Cholinergic agonist
- Suppress impulses to CTZ (Speeds up gastric emptying)
- Used in treatment of Post-Op emesis, gastroparesis, chemotherapy, & radiation therapy

A

Metoclopramide

62
Q

Metoclopramide contraindictions

A
  • GI obstructions
  • GI hemorrhage
  • GI perfusion
63
Q

What drug can cause EPS & is more prevalent in children?

A

Metoclopramide

64
Q

Assessments for (Promethazine)

A

Assess sedation level
- Assess IV site to ensure it is patent

65
Q

Assessments for (Ondansetron)

A

Assess cardiac history (Prolonged QT)

66
Q

Nursing intervention for (Promethazine)

A
  • Think about risk of tissue necrosis
  • Turn on bed alarm (CNS depression effects)
  • Look for S/s of EPS or (Tardive Dyskinesia)
67
Q

Nursing intervention for (Metoclopramide)

A
  • Monitor signs of EPS
68
Q

When should antiemetics be given when the patient is on chemotherapy for induced nausea?

A

Given the night before
- Morning of (right before the dose starts)
- During treatment
- After treatment

Pharmacology Exam 3 Review (3 decks)

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