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drugs of the GI tract disorders Flashcards

1
Q

what are the most common complaints of the GI disorders

A

indigestion, gastritis, constipation, and ulcer

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2
Q

what is constipation

A

hard infrequent stools

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3
Q

what are drug class for vomitting

A

antiemetics

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4
Q

what are drug class for toxic substance ingestion

A

emetics

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5
Q

what are the drug class for diarrhea

A

antidiarrheal

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6
Q

what are the drug class for constipation

A

laxatives

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7
Q

what are the antinuclear drugs used for

A

prevent and treat ulcers (gastric and duodenal)

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8
Q

what are the type of drugs for anti ulcers

A 
tranquilizers 
anticholinergics
**antacids
**histamine 2 blockers 
**proton pump inhibitors
pepsin inhibiotrs
prostaglandin analoque antinuclear drug
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9
Q

what causes vomitting

A

motion sickness, viral and bacterial infection, food intolerance, surgery, pregnancy, pain, shock, effects of selected drugs, radiation and disturbances of the middle ear affecting equilibrium

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10
Q

what can antiemetics do with vomiting

A

they can mask the underlying cause of vomitting and they should not be used until the cause has been determined unless the vomiting is so severe that is causes dehydration and electrolyte imbalance

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11
Q

what are the nonphamracologic measures of vomiting

A 
weak tea
flattened carbonated drinks
gelatin, gaterade, pedialyte
crackers, dry toast
IV fluids- may be needed to restore fluids in severe cases
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12
Q

what are the two major antiemetic groups

A

nonprescription and prescription

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13
Q

what are the nonprescription antiemetics

A

antihistamines
bismuth subsalicylate (pepto bismo)
phosphorated carbohydrate solution

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14
Q

what is a S/E with bismuth subsalicylate (pepto bismo)

A

tarry stools/ black tongue because the saliva in the mouth contains sulfur

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15
Q

who do we not give phosphorated carbohydrate solution to

A

patients with diabetes

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16
Q

what are the prescription antiemetics

A

antihistamines/anticholinergics
dopamine antagonists
benzodiazpines
sertonin antagonists, glucocorticoids, canabinoids

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17
Q

what patients use sertonin antagonists, glucocorticoids, canabinoids

A

patients with cancer

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18
Q

what schedule is cannabinoids

A

2

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19
Q

what do serotonin antagonist end in

A

setron

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20
Q

non prescription anti-emetics are used for

A

motion sickness
**take 30 mins before travel
not effective if already vomitting

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21
Q

what are the antihistamine drug examples under nonprescription antiemetics

A

meclizine, diphenhydramine, dimenhydrinate

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22
Q

what do the antihistamines drug under nonprescription antiemetics treat

A

nausea, vomting and vertigo caused by motion

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23
Q

what does diphenhydramine inhibits

A

vestibular stimulation in the middle ear

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24
Q

what are antihistamine SE

A

drowsiness, dryness of mouth and constipation

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25
what does bismuth subsalicylate (pepto bismol) treat
gastric discomfort or diarrhea acts directly on the gastric mucosa
26
what are the forms of bismuth subsalicylate (pepto bismol)
chewable tablets and liquids
27
what does phosphorated carbohydrate solution do
*works immediately* reduces hyperactivity of gastric wall smooth muscle decrease nausea and vomiting by decreasing gastric pH decreases smooth muscle contraction of the stomach
28
what patients should avoid phosphorated carbohydrate solution
diabetics because its sugar based contain dextrose, fructose and phosphoric acid
29
antiemetics should be prescribed cautiously in who
pregnancy first trimester
30
what is the popular antiemetic
trimethobenzamide hydrochloride
31
what does trimethobenzamide hydrochloride inhibit, administered and a caution
inhibits the medullary chemoreceptor trigger zone | administer by mouth, z track or real suppository
32
what can women who are pregnant take if vomiting becomes life threatening to mother and fetus
trimethobenzamide
33
what prescription antiemetic antihistamine drugs
hydroxyzine | promethazine
34
when is hydroxyzine given
preoperatively with opioids to prevent postoperative N/V and dizziness
35
when is promethazine prevent
prevents motions sickness, N/V
36
what drug is under anticholinergic for prescription antiemetic
scopolamine
37
what does scopolamine do and SE
treats motion sickness one patch behind ear atlas 4 hours before, patch effective for 3 days SE: drowsiness, dry mouth blurred vision
38
what are drug example for prescription antiemetic dopamine antagonists and what do they do
suppress emus by blocking dopamine receptors in the CTZ - phenothiazines - butyrophenones: droperidol - metaclopromide
39
what are the SE of dopamine antagonists
extrapyramidal symptoms caused by blocking dopamine rececptors (D2)
40
butyrohenones is
a dopamine antagoinsts
41
what does butyrophenones do
blocks D2 dopamine receptors used as moderately effective antiemetics used to treat postoperavie NV and emesis associated with toxins, chemotherapy and radio
42
what are examples under butyrophenones
haloperiodol | droperiodol
43
what may occur in butyrophenones
EPS symptoms if extended periods | hypotensin because it blocks norepinephrine which is why orthostatic hypotension may result
44
what should we monitor while on butyrophenones
BP
45
when are prescription phenothaine antiemetics used
in cancer clients | given the night before treatment, day of the treatment and for 24 hours after the treatment
46
what are phenothiazine antiemetic examples
prochlorphenazine and promthazine
47
what are prescription benzodiazepines antiemetics used for
anxiety and sleep disorders | provides sedation, suppress the anticipation of emesis
48
what are examples of benzodiazepines
lorazepam | diazepam
49
what are SE of benzodiazepines
constipation confusion vertigo visual disturbances
50
what does serotonin receptor antagonist of the prescription antiemetic do
suppress NV | by blocking the serotonin receptors in the CTZ and efferent vagal nerve terminals
51
what are serotonin receptor antagonist
ondansetron | granisetron
52
what are common SE of serotonin receptor antagonist
headache diarrhea fatigue
53
what are example of glucocorticoids
methylprednisone dexamethasone given IV
54
what are glucocorticoids used for
to suppress NV from chemotherapy | for severe emesis
55
what is cannabinoids
chemicals that help control the mental and physical processes used for NV/chemotherpahy only when all other treatments have failed schedule ll
56
what is the action of emetics
stimulate CTZ and acts directly on gastric mucosa
57
what is the use for emetics
induce vomiting after ingestion of toxic substance
58
what is caution for emetics
avoid vomiting if th poisoning is caused by ingestion of caustic substances (ammonia, chlorine bleach, toilet cleaners, petroleum)
59
what if vomiting is contraindicated in emetics
activated charcoal or gastric lavage can be used administer within 30 mins of substance ingestion may cause tongue discoloration, black stool abdominal pain and diarrhea
60
what are the causes of diarrhea
``` spicy or spoiled food fecal impaction bacteria (E.coli, slmonella) viruses (parvo, rota virus) toxins/drug reactions laxative abuse ```
61
how is diarrhea life threathening
loss of electrolytes
62
what are non pharmacological measure of diarrhea
clear fluids oral sodium pedialyte or ricolyte IV electrolytes
63
antidiarrheal should not be used for more than n
2 days
64
how do we check for dehydration in babies and adults
babies check diapers | adults check eyes
65
what its eh frequent cause of diarrhea
E coli
66
what are the drug of choice for diarrhea
fluroruinolones
67
what drug is in the drug class fluroruinolones for diarrhea
loperamide
68
what does loperamide do
slows peristalsis sto decrease frequency of defecation cause less CNS depression purchased OTC
69
what are some preventtive measure for getting diarrhea
``` drinking bottled water boiled water eat washed fruits cooked veggies meat should be well cook ```
70
what is the purpose of antidiarrheals
treat diarrhea and hyper motility
71
what are the types of antidiarrheals
- opiates and opiate related agents - somatostatin analong, octreotide for severe diarrhea (only used for metastasis cancer) - absorbents: kaopectate - antidiarrheal combinations
72
what do opiates and opiate related agents inhibit
GI motility, decrease hyperperistalsis, slow passage of intestinal contents
73
what are examples of opiates and opiate related agents
coedine | lomotil
74
what is lomotil
diphenoxylate with atropine *less dependence* decreases abdominal cramping, intestinal motility and hypersecretion (travelers diarrhea)
75
what is a drug example of somatostatin entailing
octreatide
76
what does octreastide inhibit
gastric acid, pepsinogen, and gastrin decreases smooth muscle contractility prescribed for severe diarrhea from metastiatic cancer
77
what does absorbent do
goat the GI walls and absorb toxins or bacteria/causing diarrhea and excrete these agents with the stools
78
what are examples of absorbent
pepto bismol | cholestyramine
79
what is cholestyramine
diarrhea due to excess bile acid in the colon | not FDA approved
80
what population is the major complaint for constipation
geriatric
81
what is the contributing factors for constipation
insufficient water intake and poor dietary habits
82
what are the causes of constipation
fecal impation, bowel obstruction, chronic laxative use, neurological disorders, ignoring the urge to poop, lack of exercise, selected drugs- anticholinergnice, narcotics and certain antacids
83
what do laxative do
promote soft stool
84
what do cathartics do
results in soft to water stool with some cramping
85
what are the types of laxatives
``` osmotic (saline) stimulatant (contact) bulk forming (drug of choice for pregnant women) emollient (stool softners) chloride channel activators ```
86
what are non pharmacological measures of constipation
diet containing fiver, water, exercise and routine bowel movements
87
when should you avoid laxatives
intestinal obstruction symptoms of appendicitis ulcerative colitis or diverticulitits
88
what do osmotic laxative include
salts, saline products, glycerin and lactulose
89
what is the action of osmotic laxative
hyperosmolar salts pull water into colon and increase water in feces to increasebult which stimulates peristalsis and defecation
90
when are osmotic laxative use
bowel preparation for diagnostics or surgery
91
what are contradictions of osmotic laxative
clients with CHF with renal insufficient should avoid magnesium salts
92
what is the MAO of stimulant
increase peristalsis by irritating sensory nerve endings in the intestinal mucosa
93
what are examples of stimulants
bisacodyl senna castor oil
94
what is the most frequently used and abuse laxative
bisacodyl
95
what is caster oil
harsh laxative that acts on the small bowel and produces a watery stool
96
what are SE of stimulant
nausea, abdnomial cramps, weakness, fluid and electroylete imblalance
97
what are bulk forming laxative
natural fibrous substances
98
what does bulk forming do
promotes large soft stools by absorbing water int he intestine increasing bulk of luminal contents
99
how do you mix powdered bulk forming laxatives
mix with water or juice, stir and drink immediately followed by a 1/2 or full glass of water
100
what is the onset of action of bulk forming
8-24 hours and may take up to 3 days
101
what is bulk forming choice of
drug for pregnant women
102
what are examples of bulk forming
psyllium hydrophilic | methlycellulose
103
clients with diverticulosis, irritable bowel syndrome and colostomy may use which laxative
bulk forming
104
what are emollients
stoolsoftners and lubricants used to prevent constripation
105
emollients are usually prescribed after
MI or surgery
106
what are an example of emollients
docusate sodium | mineral oil
107
what does docusate sodium do
prevents constipation 1-5 days
108
what does mineral oil do
lubricant, absorbs essential fats vitamin A,E,K D
109
what are se of emollients
nausea, diarrhea, abdominal cramping
110
what are emollients contradicted in
children, geriatric, deliberating adults | -aspirate the mineral oil result in lipid pneumonia
111
what does chloride channel activators do
treats idopathic chronic constipation in adults
112
what is an example of chloride channel activators
lubiprostone
113
what dos lubiprostone do
acivates chloride channels in the lining of the small intestine, softens stool and increase motility
114
what happens with chloride channel activators
within 1 hours experience SOB chest pain or tightness usually goes away within 3 hours, if not call dr

pharm final (4 decks)

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