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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
Inhibits gastric acid secretion and protects mucosa - Used for induced labor (Stillbirth)
Prostaglandin Analogue (Misoprostol)
26
Bulk-Forming Drugs
Psyllium
27
Absorbs water into intestines - Increases bulk & peristalsis - Results (8-12 hrs)
Bulk-Forming (Psyllium)
28
How do you administer Psyllium?
- 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
"Stool softeners" - Lowers surface tension of feces - Promotes water accumulation in the intestines - Emulsifies & lubricates feces
Emollients
30
- Docusate Calcium - Docusate Sodium
Emollient Drugs
31
What are Emollient drugs used for?
- After surgery or heart attacks to prevent constipation - Pregnancy
32
Saline Laxative Drugs - Milk in Magnesia - Magnesium citrate - Fleet enema - Epsom salts
Saline Laxative Drugs
33
Pulls water rapidly into the colon - Results (3-6hrs)
Saline Laxatives
34
What happens when Saline Laxatives are abused?
Hypermagnesemia
35
- Bisacodyl - Senna
Stimulant Drugs
36
Increases peristalsis by irritating sensory nerve endings in the intestinal mucosa - Orally Results (6-12hrs) - Rectally Results (15-60mins)
Stimulants (Bisacodyl & Senna)
37
Side effects: - Reddish brown urine - Diarrhea - Hypokalemia - Hypocalcemia
Stimulants Side Effects
38
- Polyethylene Glycol - Lactulose - Glycerin
Osmotic Drugs
39
Used for bowel prep for colonoscopies - Goal Clear stools
Polyethylene Glycol
40
Used for constipation - Used for patients with Liver Disease (Hepatic Encephalopathy) - Lowers Ammonia levels - Goal: 3-4 stools a day
Lactulose
41
What Assessment should u do when a patient is on Laxatives?
- Assess the ability to swallow - Assess Diagnosis of bowel obstruction - Assess fluid & electrolyte status
42
Implementation for (Psyllium)
- Mix in 8oz of water or juice - Stir & administer immediately - Follow up with 8oz of water (Do Not Admisinster as dry powder)
43
Implementation for (Lactulose)
- Given to decrease ammonia levels in liver disease patients - Contact prescriber once goal is met (Goal: 3-4 stools a day)
44
Implementation for (Polyethylene glycol)
- Administer full amount (3-4L) as bowel prep - Check stool transparency prior to colonoscopy
45
Implementation of (Saline laxatives)
- Monitor electrolytes (Magnesium) - Poor renal function = hypermagnesemia
46
Implementation for (Bisacodyl)
- If given (Rectally) monitor for electrolyte imbalances (hypokalemia & hypocalcemia)
47
What can chronic use of laxatives lead to?
- Megacolon - Electrolyte imbalances
48
- dimenhydrinate (Dramamine) - meclizine - diphenhydramine
Nonprescriptive Antiemetics (Antihistamine) Drugs
49
Helps prevent nausea by helping with the inner ear & helping with balance issues - Helps with motion sickness
Antihistamines
50
When should antihistamines be taken?
30 minutes to 1 hour before activity
51
Scopolamine
Anticholinergic - Used for motion sickness
52
- Dry Mouth - Blurry Vision - Constipation - Urinary retention Are signs of what effect?
Anticholinergic effects
53
Anticholinergic contraindications
Glaucoma patients
54
Dopamine Antagonist: Phenothiazine Anti-emetics - Blocks dopamine receptors in the chemoreceptor trigger zone (CTZ)
Promethazine (Phenergan)
55
- CNS depression - Extrapyramidal syndrome (EPS) - Anticholinergic symptoms These are side effects of what drug?
Promethazine (Dopamine Antagonist)
56
How is Promethazine administered?
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
What happens if infiltration (leaking) of promethazine occurs in tissues?
It goes into the tissues surrounding the vein resulting in tissue necrosis
58
Serotonin Antagonist - Blocks the serotonin receptors in the GI tract & vomiting center in the medulla
"Setron" - Ondansetron
59
Ondansetron is often used for?
Pregnancy to help with nausea
60
- Headache, diarrhea, dizziness, & fatigue - Birth defects - QT prolongation These are side effects of what drug?
Ondansetron
61
Cholinergic agonist - Suppress impulses to CTZ (Speeds up gastric emptying) - Used in treatment of Post-Op emesis, gastroparesis, chemotherapy, & radiation therapy
Metoclopramide
62
Metoclopramide contraindictions
- GI obstructions - GI hemorrhage - GI perfusion
63
What drug can cause EPS & is more prevalent in children?
Metoclopramide
64
Assessments for (Promethazine)
Assess sedation level - Assess IV site to ensure it is patent
65
Assessments for (Ondansetron)
Assess cardiac history (Prolonged QT)
66
Nursing intervention for (Promethazine)
- Think about risk of tissue necrosis - Turn on bed alarm (CNS depression effects) - Look for S/s of EPS or (Tardive Dyskinesia)
67
Nursing intervention for (Metoclopramide)
- Monitor signs of EPS
68
When should antiemetics be given when the patient is on chemotherapy for induced nausea?
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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