Drugs for GI Disorders

Question 1

What is the therapeutic outcome of histamine-2 receptor antagonists?

Answer 1

inhibits acid secretion by blocking release of HCl

USED TO TREAT PEPTIC ULCERS, GERD, AND H. PYLORI ULCERS

Question 2

What would be another treatment along with histamine-2 receptor antagonists for h. pylori ulcers?

Answer 2

antibiotic therapy

h. pylori is a bacteria that is naturally found in the stomach that can erode the stomach lining and cause ulcers

Question 3

Can histamine-2 receptor blockers be bought OTC?

Answer 3

YES YES YES

Question 4

What is an adverse effect of histamine-2 receptor antagonists?

Answer 4

CNS - lethargy, depression, confusion

Question 5

Who should not take histamine-2 antagonists?

Answer 5

older adults

Question 6

When are the CNS effects of histamine-2 receptor antagonists more common?

Answer 6

In older adults with kidney or liver dysfunction

Question 7

Should antacids be taken at the same time as histamine-2 receptor antagonists?

Answer 7

NO NO NO (decreases absorption)

Question 8

What are some patient teaching points to promote the healing of ulcers?

Answer 8

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)

Question 9

What is the therapeutic outcome of proton pump inhibitor?

Answer 9

reduces gastric acid secretion

Question 10

Do proton pump inhibitors have many side effects?

Answer 10

NO NO NO

can cause osteoperosis with long term use

Question 11

What are some key patient teaching points for administration proton pump inhibitor capsules (prilosec)?

Answer 11

teach them not to crush, chew, or open capsule

take in the morning before eating

Question 12

How long should ulcers be treated?

Answer 12

4-6 weeks

Question 13

When giving protonix (IV), what should the nurse monitor for?

Answer 13

erythema and inflammation at IV site, can be irritating to veins.

Question 14

What is the therapeutic outcome of mucosal protectants?

Answer 14

acidic environment turns sucralfate into thick substance that will coat and protect the ulcer.

Question 15

Are there many side effects for mucosal protectants?

Answer 15

NO NO NO

if constipation does occur increase fiber and fluids

Question 16

When should mucosal protectants be taken?

Answer 16

1 hour before each meal and at bedtime

Question 17

Can mucosal protectants be crushed or chewed? is there an alternative to this?

Answer 17

NO NO NO

they can be dissolved in water

Question 18

What is the therapeutic outcome of antacids?

Answer 18

neutralize gastric acid to treat peptic ulcers AND symptomatic relief of GERD.

Question 19

Are there many side effects for antacids?

Answer 19

NO NO NO

Question 20

What are some administration techniques for antacids?

Answer 20

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

Question 21

When taking other medications while on antacids, should they be taken at the same time?

Answer 21

NO NO NO

take other medications an hour before or an hour after taking an antacid AT LEAST

Question 22

What is the therapeutic response of antiemetics?

Answer 22

stimulate parasympathetic activity to increase GI secretions and motility to decrease n/v.

Question 23

What are two different types of antiemetics?

Answer 23

dopamine antagonists ( metoclopramide - mostly to increase gastric motility/ phenergan - to decrease n/v)

serotonin antagonists

Question 24

How should phenergan be administered?

Answer 24

IV diluted and slowly (dilute with IV fluids and give no faster than 25mg/minute)

Question 25

What are some adverse effects of dopamine antagonists?

Answer 25

EPS symptoms - review these

hypotension

sedation

anticholinergic symptoms - constipation, tachycardia, vision changes, dry mouth, urinary retention

Question 26

What are some nursing considerations for dopamine antagonists?

Answer 26

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!!

Question 27

What should metoclopramide (dopamine antagonist) be administered?

Answer 27

BEFORE MEALS!!!

it needs to be increasing gastric motility during the meal!

Question 28

What are some adverse effects of serotonin antagonists?

Answer 28

HA

diarrhea

dizziness