DRUGS FOR GASTROINTESTINAL TRACT Flashcards by Grecian Mae

Q

MOA: neutralizes gastric acid secretions and
raises the gastric pH of the stomach

A

ANTACIDS

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Q

DI: + digoxin / antibiotics = decrease absorption

A

ANTACIDS

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Q

reflux indigestion - esophageal irritation and
inflammation resulting from reflux of the stomach
contents into the esophagus : PUD, ulcer
prevention

A

ANTACIDS

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Q

SE: rebound hyperacidity (excessive amount of
acid in the stomach)

A

ANTACIDS

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Q

SE:
- GI disturbances (constipation / diarrhea)

A

ANTACIDS

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Q

SE: Electrolyte imbalances

A

ANTACIDS

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Q

SE: Hypermagnesemia (hypotension, N/V, ECG
changes)

A

ANTACIDS

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Q

SE: Hypophosphatemia (anorexia, malaise,
muscle weakness)

A

ANTACIDS

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Q

SE: Hypernatremia = water retention

A

ANTACIDS

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Q

SE: Systemic alkalosis

A

ANTACIDS

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Q

NI: Assess effectiveness of medication

A

ANTACIDS

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Q

NI: Avoid other medicines that lower gastric pH
or increases hyperacidity such as caffeine,
aspirin

A

ANTACIDS

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Q

NI: Take 1- 3 hours after eating don’t take other
medicines within 1-2 hours of taking
antacid; not at mealtime =slow gastric
emptying time = increased GI activity gastric
secretions

A

ANTACIDS

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Q

NI: Drink 2-4 oz of water after antacid

A

ANTACIDS

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Q

NI: Shake liquid preparations well and followed
with water

A

ANTACIDS

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Q

NI: Instruct to inquire about interactions with
any new medication & OTC

A

ANTACIDS

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Q

NI: Inform clients that they may experience
better relief from liquids than tablets

A

ANTACIDS

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Q

NI: Do not give milk products and vitamin D
with calcium carbonate =milk alkali
syndrome (alkalosis, hypercalcemia,
crystalluria, renal failure)

A

ANTACIDS

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Q

It is used to treat peptic ulcer disease
and gastric hyperacidity

A

DRUGS FOR
GASTROINTESTINAL TRACT

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Q

break or ulcerations in
the protective mucosal lining of the lower
esophagus, stomach, or duodenum

A

Peptic Ulcer Disease

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Q

MOA: block the H2 receptors of the parietal cells of the stomach, thus reducing gastric acid
secretion and concentration

A

HISTAMINE - 2 RECEPTOR ANTAGONISTS

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Q

treatment ulcer, prevention of stress
ulcer, hyperacidity, patients on prolonged NPO/
preoperative, GI bleed

A

HISTAMINE - 2 RECEPTOR ANTAGONISTS

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Q

DI: + digoxin / anticoagulants = increase their
action + antacid = decrease effectiveness

A

HISTAMINE - 2 RECEPTOR ANTAGONISTS

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Q

SE: HA, confusion, nausea, diarrhea,
abdominal pain, anemia, severe
bradycardia (IV administration), constipation

A

HISTAMINE - 2 RECEPTOR ANTAGONISTS

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cimetidine (Tagamet)

HISTAMINE - 2 RECEPTOR ANTAGONISTS

Famotidine (Pepcid)

HISTAMINE - 2 RECEPTOR ANTAGONISTS

ranitidine (Zantac)

HISTAMINE - 2 RECEPTOR ANTAGONISTS

Nizatidine (Axid)

HISTAMINE - 2 RECEPTOR ANTAGONISTS

NI: Administer before meals

HISTAMINE - 2 RECEPTOR ANTAGONISTS

NI: Reduced doses of drug are needed by older adults

HISTAMINE - 2 RECEPTOR ANTAGONISTS

NI: Administer IV drug in 20 –100mLsolution

HISTAMINE - 2 RECEPTOR ANTAGONISTS

NI: Do not administer at the same time with antacids, give an hour before or 2 hours after

HISTAMINE - 2 RECEPTOR ANTAGONISTS

NI: Avoid smoking because it hampers the effectiveness of the drug

HISTAMINE - 2 RECEPTOR ANTAGONISTS

NI: Drug induced impotence and gynecomastia – reversible

HISTAMINE - 2 RECEPTOR ANTAGONISTS

NI: Relaxation technique

HISTAMINE- 2 RECEPTOR ANTAGONISTS

NI: Eat foods rich in Vit B12 to prevent deficiency as a result of drug therapy

HISTAMINE - 2 RECEPTOR ANTAGONISTS

AKA: anti-spasmodics

ANTICHOLINERGIC AGENTS

MOA: decreases acetylcholine by blocking the cholinergic receptors.

ANTICHOLINERGIC AGENTS

MOA: It reduces gastric acid secretion, decreases smooth muscle motility and delays gastric emptying time

ANTICHOLINERGIC AGENTS

adjunct therapy for PUD. Spasms and cramping associated with irritable bowel syndrome

ANTICHOLINERGIC AGENTS

SE: tachycardia, urinary retention, dry mouth, HA, constipation

ANTICHOLINERGIC AGENTS

NURSING RESPONSIBILITIES: ➔ Monitor bowel elimination ➔ Take before meals ➔ Give antacids 2 hours after anticholinergic

ANTICHOLINERGIC AGENTS

MOA: suppresses the final step of gastric acid production by inhibiting hydrogen - potassium ATPase enzyme. Inhibit up to 90% than H2 blockers

PROTON PUMP INHIBITOR

short term treatment of erosive esophagitis.

PROTON PUMP INHIBITOR

long term treatment of duodenal ulcer.

OMEPRAZOLE

Treatment of H. pylori, active benign gastric ulcers

PROTON PUMP INHIBITOR

INTERACTIONS: may increase concentration o oral anticoagulants, diazepam, phenytoin if with omeprazole

PROTON PUMP INHIBITOR

SE: headache, abdominal discomfort, dizziness, flatulence, diarrhea

PROTON PUMP INHIBITOR

SE: headache, abdominal discomfort, dizziness, flatulence, diarrhea

PROTON PUMP INHIBITOR

omeprazole (Losec)

PROTON PUMP INHIBITOR

pantoprazole (Pantoloc)

PROTON PUMP INHIBITOR

esomeprazole (Nexium)

PROTON PUMP INHIBITOR

lanzoprazole (Prevacid)

PROTON PUMP INHIBITOR

NI: ➔ Take before meals ➔ Regular medical check – up

PROTON PUMP INHIBITOR

AKA: Pepsin inhibitor / Mucosal Protective Drug

CYROPROTECTIVE

MOA: forms a barrier / coating at the ulcer site

CYROPROTECTIVE

sucralfate (Iselpin)

CYROPROTECTIVE

rebamipide (Mucosta)

CYROPROTECTIVE

SE: constipation ( not systemically absorbed)

CYROPROTECTIVE

DI: may impede absorption of warfarin, phenytoin, theophylline

CYROPROTECTIVE

NURSING INTERVENTIONS: ➔ Take before meals; as prescribed (4-8 weeks) ➔ Take one hour apart from antacid ➔ Digoxin: administer sucralfate at least 2 hours apart

CYROPROTECTIVE

MOA: decrease vagal activity. Inhibits gastric acid secretion & protects the mucosa. Promotes secretion of sodium bicarbonate and cytoprotection mucus

PROSTAGLANDIN ANALOGUE

USE: PUD

PROSTAGLANDIN ANALOGUE

SE: diarrhea, abdominal pain

PROSTAGLANDIN ANALOGUE

misoprostol (Cytotec)

PROSTAGLANDIN ANALOGUE

NURSING RESPONSIBILITIES: ➔ Take with food ➔ No alcohol, NSAIDs, aspirin, smoking

PROSTAGLANDIN ANALOGUE

What drug can cause uterine contraction?

PROSTAGLANDIN ANALOGUE

MOA: aids in breaking up gas bubbles trapped in the intestines; increases gastric emptying

ANTI-FLATULENTS

USES: post operative patients, children with colic

ANTI-FLATULENTS

SE: constipation, LBM(domperidone), dry mouth, abdominal cramps

ANTI-FLATULENTS

simethicone (Kremil-S, Simeco)

ANTI-FLATULENTS

domperidone (Motilium)

ANTI-FLATULENTS

NI: Increase oral fluid intake

ANTI-FLATULENTS

NI: Manage constipation: high fiber (bran, grain, fruits), ambulation

ANTI-FLATULENTS

NI: Auscultate bowel sounds

ANTI-FLATULENTS

NI: Avoid gas forming foods (apples, broccoli, cabbage, coconuts, egg plant, milk, radish, onions)

ANTI-FLATULENTS

NI: Manage diarrhea

ANTI-FLATULENTS

MOA: used to control vomiting

ANTI-EMETICS

Decrease the response to chemoreceptor trigger zone (CTZ) by inhibiting the dopaminergic receptors

Phenothiazines (ANTI-EMETICS)

chlorpromazine (Thorazine)

PHENOTHIAZINES

prochlorperazine maleate (Compazine)

PHENOTHIAZINES

Promethazine

PHEOTHIAZINES

block the action of acetylcholine in the brain to decrease nausea and vomiting

ANTHISTAMINES (ANTI-EMETICS)

diphenhydramine (Dramamine)

ANTHISTAMINES (ANTI-EMETICS)

cyclizine HCL (Marezine)

ANTHISTAMINES (ANTI-EMETICS)

meclizine HCL ( Bonamine)

ANTHISTAMINES (ANTI-EMETICS)

hydroxyzine pamoate (Vistaril)

ANTIHISTAMINES (ANTI-EMETICS)

diphenhydramine HCL (Benadryl)

ANTIHISTAMINES (ANTI-EMETICS)

Promethazine (Phenergan)

ANTIHISTAMINES (ANTI-EMETICS)

prevent motion sickness by decreasing the GI motility and secretions

ANTI-CHOLINERGICS (ANTI-EMETICS)

Scopolamine (Triptone)

ANTI-CHOLINERGICS (ANTI-EMETICS)

(active ingredients of marijuana)

CANNABINOIDS (ANTI-EMETICS)

Dronabinol

CANNABINOIDS (ANTI EMETICS)

Nabilone

CANNABINOIDS (ANTI-EMETICS)

increases gastric emptying

OTHERS ( ANTI-EMETICS)

metoclopramide HCL (Plasil)

OTHERS ( ANTI-EMETICS)

trimethobenzamide HCL (Tigan)

OTHERS ( ANTI-EMETICS)

USES: severe nausea, vomiting, before & after chemotherapy, motion sickness

ANTI-EMETICS

SE/AE: - anticholinergic effects - drowsiness (anti histamines) - orthostatic hypotension - extrapyramidal findings (phenothiazines): parkinson’s disease symptoms – tremors, muscle rigidity, bradykinesia - Hypersensitivity, photosensitivity

ANTI-EMETICS

NI: Have ipecac at home in case of accidental poisoning, note expiration date

ANTI-EMETICS

NI: Never administer to comatose or semi – comatose patients or accidentally ingest caustic substances (ammonia, chlorine bleach, toilet cleaners or battery acid)

ANTI-EMETICS

NI: Can be very messy and maybe difficult for a child to ingest

ANTI-EMETICS

NI: Administer 10 mL of ipecac followed by a glass of water in children<1y.o.;15 mL for children > 1 y.o.; 15-30mLfollowed by several glasses of water for adults

ANTI-EMETICS

NI: May repeat ipecac dose in 30 min if the first dose does not produce emesis

ANTI-EMETICS

NI: Never give with or after activated charcoal. If needed, give before the activated charcoal, activated charcoal is given via lavage if emetics ineffective

ANTI-EMETICS

NI: Monitor VS especially RR because apomorphine can cause respiratory depression and hypotension

ANTI-EMETICS

It is to eliminate fecal matter

LAXATIVE/CATHARTICS

promote soft stools

LAXATIVES

promote soft watery stool with some cramping

CATHARTICS

pull water into the colon and increases water in the feces to increase bulk which stimulates peristalsis.

OSMOTIC LAXATIVES

Hyperosmolar salts Saline products ( composed of sodium or magnesium)

OSMOTICS LAXATIVES

cephulac (Lactulose)

OSMOTIC LAXATIVES

Glycerin

OSMOTIC LAXATIVES

Sodium biphosphate

OSMOTIC LAXATIVES

increase peristalsis by irritating the nerve endings in the intestinal mucosa.

CONTACT LAXATIVES/ STIMULANTS/ IRRITANTS

Senna (Senokot)

CONTACT LAXATIVES/ STIMULANTS/ IRRITANTS

Bisacodyl (Dulcolax)

CONTACT LAXATIVES/ STIMULANTS/ IRRITANTS

Castor oil

CONTACT LAXATIVES/ STIMULANTS/ IRRITANTS

natural fibrous substances that promote large, soft stools by absorbing water into the intestine, increasing fecal bulk and peristalsis;non absorbable agents.

BULK FORMING

psyllium (Metamucil)

BULK FORMING

lubricants to prevent constipation, decrease straining during defecation = lower surface tension and promotes water accumulation in the intestine and stool docusate

EMOLLIENTS/ STOOL SOFTENERS

Sodium (Colace)

EMOLLIENTS/ STOOL SOFTENERS

lessen irritation to hemorrhoids, cause lipid pneumonia if accidentally aspirated.

LUBRICANTS

Mineral oil

LUBRICANTS

SE: dehydration, electrolyte imbalance (hypokalemia), abdominal cramps

LAXATIVES/CATHARTICS

NI: Monitor for misuse of these drugs, can be a habit forming, short term use (tone of bowel)

LAXATIVES

Monitor serum electrolytes

LAXATIVES

Assess bowel elimination pattern: discontinue if diarrhea persists, rectal bleeding, cramping

LAXATIVES

Do not give if obstruction is suspected (abdominal pain with fever, nausea and vomiting)

LAXATIVES

Teach exercise and high fiber diet to promote elimination

LAXATIVES

Clients who should avoid straining may benefit from a lubricant laxative

LAXATIVES

Mineral oil enemas work well without causing severe strain in clients who had a recent heart attack and fecal impaction

LAXATIVES

Mineral oil enemas also work well if saline is contraindicated

LAXATIVES

Bulk forming laxatives which come in flavored and sugar free forms would be mixed in 8- 10 oz of water or juice and drink immediately followed by a full glass of water

LAXATIVES

Take on an empty stomach

LAXATIVES

removes toxins by binding with them and forms a coating over the mucosa

ABSORBENTS (ANTI-DIARRHEALS)

bismuth subsalicylate (Pepto-Bismol)

ABSORBENTS (ANTI-DIARRHEALS)

Activated charcoal

ABSORBENTS (ANTI-DIARRHEALS)

Kaolin

ABSORBENTS (ANTI-DIARRHEALS)

Pectin

ABSORBENTS (ANTI-DIARRHEALS)

decrease intestinal motility

OPIATES (ANTI-DIARRHEALS)

paregoric (camphorated opium tincture) codeine

OPIATES (ANTI-DIARRHEALS)

diphenoxylate HCL + atropine sulfate (Lomotil)

OPIATES (ANTI-DIARRHEALS)

Loperamide (Imodium)

OPIATES (ANTI-DIARRHEALS)

Alcohol+ kaolin+ pectin+ paregoric = parapectolin

ANTICHOLINERGIC (ANTI-DIARRHEALS)

Scopolamine hydrobromide (Donnagel)

ANTICHOLINERGIC (ANTI-DIARRHEALS)

USES: short term diarrhea, irritable bowel syndrome, overdose SE: constipation; dizziness; OPIATES=abuse potential, urinary retention, dry mouth, flushing

ANTI-DIARRHEALS

NI: Know how to administer properly.

ANTI-DIARRHEALS

NI: Encourage clear liquids avoid fried foods milk products

ANTI-DIARRHEALS

NI: Instruct: relieve symptoms not cure the disease

ANTI-DIARRHEALS

NI: Notify physician if diarrhea persists longer than 48 hours or if abdominal pain occurs

ANTI-DIARRHEALS

NI: Assess elimination, dehydration

ANTI-DIARRHEALS

NI: Activated charcoal is a powder that must be mixed with water during administration

ANTI-DIARRHEALS

NI: Monitor VS ( opiates cause CNS depression)

ANTI-DIARRHEALS

MOA: stimulates motility of the upper GI tract increase the rate of gastric emptying without stimulating gastric, biliary or pancreatic secretions

GASTROINTESTINAL STIMULANTS

USES: gastroesophageal reflux, treat urinary retention & abdominal distention

GASTROINTESTINAL STIMULANTS

CI: mechanical obstruction, perforation, GI hemorrhage

GASTROINTESTINAL STIMULANTS

SE/ AE: restlessness, drowsiness, dizziness, insomnia, HA, N/V, salivation, decrease CR, BP, increase lung secretion & LBM

GASTROINTESTINAL STIMULANTS

bethanechol chloride ( Urecholine)

GASTROINTESTINAL STIMULANTS

metoclopramide (Plasil)

GASTROINTESTINAL STIMULANTS

domperidone (motilium)

GASTROINTESTINAL STIMULANTS

NURSING INTERVENTIONS: ➔ Administer 30 minutes before meal and at bedtime ➔ Monitor pulse, BP when large doses are taken because of the risk of hypotension ➔ Monitor I & O

GASTROINTESTINAL STIMULANTS