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Nursing Pharmacology > C7- Upper GI Medications > Flashcards

C7- Upper GI Medications Flashcards

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1
Q

Anti-Emetics:

A

Reduce Nausea
Prevent vomiting
ID cause first

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2
Q

Serotonin antagonist Generic medication name

A

Odansetron

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3
Q

Ondansetron mechanism of action

A

Prevent emesis by blocking serotonin (5HT) receptors in the chemoreceptor trigger zone

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4
Q

Ondansetron therapeutic effects

A

chemotherapy
radiation
postoperative recovery

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5
Q

Ondansetron administration:

A

Give 30mins prior to chemotherapy or anesthesia emergence

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6
Q

Ondansetron Side effects:

A

Headache
Constipation/diarrhea
Dizziness/sedation

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7
Q

Ondansetron Nursing Considerations (contraindications)

A

Pregnancy category B

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8
Q

Dopamine Antagonist (generic name) (2)

A

Prochlorperazine

Promethazine

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9
Q

Prochlorperazine/Promethazine mechanism of action:

A

Prevent emesis by blocking dopamine receptors in the CTZ

	-also by blocking histamine (H1)
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10
Q

Therapeutics associated with Prochlorperazine/Promethazine:

A

Prevent emesis after:
chemotherapy
opioids
postop recovery (anesthesia)

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11
Q

Prochlorperazine/Promethazine administration guidelines:

A

Give 30min prior to
chemotherapy
anesthesia emergence

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12
Q

Prochlorperazine/Promethazine side effects

A

Extrapyramidal Symptoms
restlessness
anxiety
spasms of face and neck
Hypotension
Sedation
Respiratory depression
IV infiltration
causes tissue necrosis

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13
Q

Prochlorperazine/Promethazine Nursing considerations (side effects)

A

Extrapyramidal Symptoms
Hypotension
Sedation

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14
Q

Prochlorperazine/Promethazine Contraindications

A

Children and older adults
increased risk of Extrapyramidal symptoms

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15
Q

Extrapyramidal Symptoms (define)

A

Involuntary movements such as
lip smacking, frowning/scowling
blinking, sticking out tongue
shaking of arms and legs

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16
Q

Pro-Kinetic Agents Generic name

A

Metoclopramide

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17
Q

Metoclopramide mechanism of action

A

Block dopamine and serotonin in CTZ

Augment action of acetylcholine to increase GI motility

Accelerates intestinal transit and promotes gastric emptying

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18
Q

Metoclopramide Side effects

A

Extrapyramidal symptoms
Diarrhea/constipation
Sedation
Insomnia

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19
Q

Metoclopramide Contraindications

A

GI bleeding/perforation
Bowel obstruction

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20
Q

Metoclopramide Interactions

A

Opioids
Anticholinergics

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21
Q

Metoclopramide and tube feedings

A

Promote gastric motility with tube feedings

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22
Q

Anticholinergic antiemetic generic name

A

Scopolamine

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23
Q

Scopolamine mechanism of action

A

Interferes with transmission of impulses from vestibular apparatus to the vomit center

Blocks
vagus nerve

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24
Q

Scopolamine Route of administration

A

Transdermal patch (3-day patch)
Give 30 mins prior to motion

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25
Q

Scopolamine Therapeutics:

A

Best for motion sickness

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26
Q

Scopolamine Side effects:

A

Sedation
Anticholinergic effects
Constipation
Dissociation/dysphoria
avoid using in clients w/ mental health disorders
Hypotension
use cautiously with cardiovascular disorders

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27
Q

Scopolamine Contraindications

A

Mental health disorders
Cardiovascular disorders

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28
Q

Antihistamine generic name

A

Meclizine (Dramamine) — over the counter

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29
Q

Meclizine mechanism of action

A

Inhibit vestibular stimulation IN THE INNER EAR

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30
Q

Meclizine Therapeutics

A

Relieve nausea symptoms of
motion sickness
vertigo
dizziness
*Minimal effect on chemotherapy nausea

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31
Q

Meclizine Side effects

A

Sedation
Fatigue
Dry mouth
Dissociation/dysphoria
avoid w/ mental health disorders
Hypotension
use caution cardiovascular disorders

32
Q

Nausea Nursing interventions: Teaching

A

-use with caution (especially OTC)
-consult MD if pregnant
-avoid alcohol
-avoid hazardous tasks

33
Q

Nausea nursing interventions: Nurse actions

A

Respect
client’s requests for alternative methods for treating nausea and vomiting

Monitor
bowel sounds
hydration input/output (I/O)

34
Q

Nausea Non-pharmacologic Measures

A

Fresh air
Slow deep breathing
Carbonated soda
Tea
Crackers
Ginger
Peppermint
Lavender
Acupressure
High flow O2
Hydration/Fluids
Frequent oral care

35
Q

What is a Peptic Ulcer?

A

A circumscribed lesion i the mucosal membrane
developing in
lower esophagus
stomach
duodenum
Jejunum

36
Q

Common causes of peptic ulcers

A

GERD
acid reflux
Common cause of gastric ulcer is the breakdown of the gastric mucosal barrier

37
Q

Secretory Functions of the Stomach lining:

A

Parietal cells secrete HCl acid
Chief cells secrete pepsinogen
Mucoid cells secrete mucous

38
Q

Aggressors of Peptic ulcers:

A

H. Pylori
NSAIDS/steroids
take with food
Acid
Pepsin
Smoking

39
Q

Defensive factors of Peptic Ulcers

A

Mucus
Bicarbonate
Blood flow
Prostaglandins

40
Q

Production of gastric acid is stimulated by three endogenous compounds:

A

Acetylcholine acting at muscarinic receptors
Histamine acting at histamine 2 receptors
Gastrin acting at gastrin receptors

41
Q

Anti ulcer drug therapy

A

Antibiotic
Antisecretory agents
Mucosal protectants
Antacids

42
Q

Histamine (H2) receptor antagonist generic names:

A

Famotidine
Cimetidine

43
Q

Famotidine action

A

Suppress secretion of gastric acid by blocking histamine 2 receptors

44
Q

Famotidine side effects

A

Pneumonia/aspiration
Headache
Diarrhea
Nausea
Decreased libido
Impotence

45
Q

Famotidine Interactions

A

Antacids reduce absorption
(Take 1-2 hours apart)

46
Q

Famotidine administration

A

Take with or immediately following meals
3X/day
before each meal
before bedtime

47
Q

Famotidine Onset

A

30-60 mins

48
Q

Famotidine peak

A

1-3 hours

49
Q

Famotidine Duration

A

6-12 hours

50
Q

Famotidine pregnancy category

A

B

51
Q

H2 blockers end in

A

_____TIDINE

52
Q

Proton Pump Inhibitors Generic Name(s):

A

Pantoprazole
Omeprazole
Lansoprazole

53
Q

Proton Pump Inhibitors end in

A

___PRAZOLE

54
Q

Pantoprazole/omeprazole/lansoprazole action

A

Irreversible inhibition of the H+K+- ATPase (proton pump)

55
Q

Pantoprazole/Omeprazole/Lansoprazole Side effects:

A

Headache
Diarrhea
Nausea
Pneumonia

56
Q

Pantoprazole/Omeprazole/Lansoprazole long term side effects

A

Gastric cancer
Hip fractures/osteoperosis
reduced absorption of Ca++ ions

57
Q

Pantoprazole/Omeprazole/Lansoprazole administration:

A

Once a day dosing

58
Q

Pantoprazole/Omeprazole/Lansoprazole Drug interactions

A

Highly protein bound
use caution with other protein bound drugs

59
Q

Pantoprazole/Omeprazole/Lansoprazole pregnancy category

A

C

60
Q

Goal of antacid therapy

A

Neutralize the acid
Inhibit pepsin activity
Increase resistance of the stomach lining
Increase tone of lower esophageal sphincter

61
Q

Ulcers & GERD Non-pharmacologic Measures:

A

Avoid tobacco
Weight loss
Take NSAIDS and glucocorticoid with food or decreased dosage
Sit upright
Do not eat before bedtime
Do not recline after eating
Wear loose fitted clothing

62
Q

Ulcers & GERD Eating Pattern:

A

5-6 small meals can reduce fluctuations in gastric pH

Avoid hot/spicy/greasy food

Avoid alcohol

63
Q

Pepsin Inhibitor generic name

A

Sucralfate

64
Q

Sucralfate Action

A

Coats & creates protective barrier over ulcer
prevents pepsin from digesting stomach wall

65
Q

Sucralfate administration

A

1 hour before meals
on an empty stomach
acid environment necessary
1-2 hours between other drugs

66
Q

Sucralfate Side Effects

A

Constipation

67
Q

Sucralfate Interactions

A

Decreases absorption of other medications
give 2 hours before or after

68
Q

Antacid- Aluminum compounds

A

Aluminum hydroxide

69
Q

Antacid- Magnesium Compounds:

A

Magnesium hydroxide

70
Q

Antacid- Calcium Compounds

A

Calcium carbonate

71
Q

Antacid- Combinations (Al-Mg-OH)

A

Magaldrate
Maalox

72
Q

Antacid Action

A

Neutralize stomach acid

73
Q

Antacid dosing

A

1-3 hours after meals & bedtime

74
Q

Antacid- Side effects

A

Constipation
aluminum and calcium
White streaks in stool
aluminum
Diarrhea
magnesium
Hypernatremia/fluid retention and alkalosis
sodium bicarbonate

75
Q

Antacid- Interactions

A

Alter absorption to many medications!!

76
Q

Antacid- Teaching

A

Do not take indiscriminately or switch antacids without prescriber’s consent

Antacids can hide symptoms of more serious nature

Don’t take other medications at same time as antacids

Shake suspension form well before taking it

Some antacids may color stools white or cause white streaks

Nursing Pharmacology (11 decks)

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