Drugs for GI Disorders Flashcards
What is the therapeutic outcome of histamine-2 receptor antagonists?
inhibits acid secretion by blocking release of HCl
USED TO TREAT PEPTIC ULCERS, GERD, AND H. PYLORI ULCERS
What would be another treatment along with histamine-2 receptor antagonists for h. pylori ulcers?
antibiotic therapy
h. pylori is a bacteria that is naturally found in the stomach that can erode the stomach lining and cause ulcers
Can histamine-2 receptor blockers be bought OTC?
YES YES YES
What is an adverse effect of histamine-2 receptor antagonists?
CNS - lethargy, depression, confusion
Who should not take histamine-2 antagonists?
older adults
When are the CNS effects of histamine-2 receptor antagonists more common?
In older adults with kidney or liver dysfunction
Should antacids be taken at the same time as histamine-2 receptor antagonists?
NO NO NO (decreases absorption)
What are some patient teaching points to promote the healing of ulcers?
no smoking
no NSAIDS (these can cause ulcers)
adequate rest and reduction of stress (promotes healing)
eat meals regularly (decreases accumulation of gastric acid)
avoid alcohol (can irritate GI tract and promote ulcers)
What is the therapeutic outcome of proton pump inhibitor?
reduces gastric acid secretion
Do proton pump inhibitors have many side effects?
NO NO NO
can cause osteoperosis with long term use
What are some key patient teaching points for administration proton pump inhibitor capsules (prilosec)?
teach them not to crush, chew, or open capsule
take in the morning before eating
How long should ulcers be treated?
4-6 weeks
When giving protonix (IV), what should the nurse monitor for?
erythema and inflammation at IV site, can be irritating to veins.
What is the therapeutic outcome of mucosal protectants?
acidic environment turns sucralfate into thick substance that will coat and protect the ulcer.
Are there many side effects for mucosal protectants?
NO NO NO
if constipation does occur increase fiber and fluids
When should mucosal protectants be taken?
1 hour before each meal and at bedtime
Can mucosal protectants be crushed or chewed? is there an alternative to this?
NO NO NO
they can be dissolved in water
What is the therapeutic outcome of antacids?
neutralize gastric acid to treat peptic ulcers AND symptomatic relief of GERD.
Are there many side effects for antacids?
NO NO NO
What are some administration techniques for antacids?
can take up to 7 times a day
take 1 hour before each meal and 3 hours after meals and at bedtime
chew tablets thoroughly and drink at least 8 ounces of water
When taking other medications while on antacids, should they be taken at the same time?
NO NO NO
take other medications an hour before or an hour after taking an antacid AT LEAST
What is the therapeutic response of antiemetics?
stimulate parasympathetic activity to increase GI secretions and motility to decrease n/v.
What are two different types of antiemetics?
dopamine antagonists ( metoclopramide - mostly to increase gastric motility/ phenergan - to decrease n/v)
serotonin antagonists
How should phenergan be administered?
IV diluted and slowly (dilute with IV fluids and give no faster than 25mg/minute)
What are some adverse effects of dopamine antagonists?
EPS symptoms - review these
hypotension
sedation
anticholinergic symptoms - constipation, tachycardia, vision changes, dry mouth, urinary retention
What are some nursing considerations for dopamine antagonists?
Monitor and report EPS symptoms
monitor BP (hypotension), have patient rise slowly from sitting position
avoid other CNS depressants, driving, alcohol (sedation) FALL RISK
use cautiously in older adults and patients with urinary retention/obstruction, glaucoma (anticholinergic symptoms) INCREASED FALL RISK WITH SEDATION AND HYPOTENSION, CAN ALSO MAKE GLAUCOMA WORSE
VERY SIMILAR TO ANTIPSYCHOTICS!!
What should metoclopramide (dopamine antagonist) be administered?
BEFORE MEALS!!!
it needs to be increasing gastric motility during the meal!
What are some adverse effects of serotonin antagonists?
HA
diarrhea
dizziness
