drugs of the GI tract disorders Flashcards
what are the most common complaints of the GI disorders
indigestion, gastritis, constipation, and ulcer
what is constipation
hard infrequent stools
what are drug class for vomitting
antiemetics
what are drug class for toxic substance ingestion
emetics
what are the drug class for diarrhea
antidiarrheal
what are the drug class for constipation
laxatives
what are the antinuclear drugs used for
prevent and treat ulcers (gastric and duodenal)
what are the type of drugs for anti ulcers
tranquilizers anticholinergics **antacids **histamine 2 blockers **proton pump inhibitors pepsin inhibiotrs prostaglandin analoque antinuclear drug
what causes vomitting
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
what can antiemetics do with vomiting
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
what are the nonphamracologic measures of vomiting
weak tea flattened carbonated drinks gelatin, gaterade, pedialyte crackers, dry toast IV fluids- may be needed to restore fluids in severe cases
what are the two major antiemetic groups
nonprescription and prescription
what are the nonprescription antiemetics
antihistamines
bismuth subsalicylate (pepto bismo)
phosphorated carbohydrate solution
what is a S/E with bismuth subsalicylate (pepto bismo)
tarry stools/ black tongue because the saliva in the mouth contains sulfur
who do we not give phosphorated carbohydrate solution to
patients with diabetes
what are the prescription antiemetics
antihistamines/anticholinergics
dopamine antagonists
benzodiazpines
sertonin antagonists, glucocorticoids, canabinoids
what patients use sertonin antagonists, glucocorticoids, canabinoids
patients with cancer
what schedule is cannabinoids
2
what do serotonin antagonist end in
setron
non prescription anti-emetics are used for
motion sickness
**take 30 mins before travel
not effective if already vomitting
what are the antihistamine drug examples under nonprescription antiemetics
meclizine, diphenhydramine, dimenhydrinate
what do the antihistamines drug under nonprescription antiemetics treat
nausea, vomting and vertigo caused by motion
what does diphenhydramine inhibits
vestibular stimulation in the middle ear
what are antihistamine SE
drowsiness, dryness of mouth and constipation
what does bismuth subsalicylate (pepto bismol) treat
gastric discomfort or diarrhea acts directly on the gastric mucosa
what are the forms of bismuth subsalicylate (pepto bismol)
chewable tablets and liquids
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
what patients should avoid phosphorated carbohydrate solution
diabetics because its sugar based contain dextrose, fructose and phosphoric acid
antiemetics should be prescribed cautiously in who
pregnancy first trimester
what is the popular antiemetic
trimethobenzamide hydrochloride
what does trimethobenzamide hydrochloride inhibit, administered and a caution
inhibits the medullary chemoreceptor trigger zone
administer by mouth, z track or real suppository
what can women who are pregnant take if vomiting becomes life threatening to mother and fetus
trimethobenzamide
what prescription antiemetic antihistamine drugs
hydroxyzine
promethazine
when is hydroxyzine given
preoperatively with opioids to prevent postoperative N/V and dizziness
when is promethazine prevent
prevents motions sickness, N/V
what drug is under anticholinergic for prescription antiemetic
scopolamine
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
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
what are the SE of dopamine antagonists
extrapyramidal symptoms caused by blocking dopamine rececptors (D2)
butyrohenones is
a dopamine antagoinsts
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
what are examples under butyrophenones
haloperiodol
droperiodol
what may occur in butyrophenones
EPS symptoms if extended periods
hypotensin because it blocks norepinephrine which is why orthostatic hypotension may result
what should we monitor while on butyrophenones
BP
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
what are phenothiazine antiemetic examples
prochlorphenazine and promthazine
what are prescription benzodiazepines antiemetics used for
anxiety and sleep disorders
provides sedation, suppress the anticipation of emesis
what are examples of benzodiazepines
lorazepam
diazepam
what are SE of benzodiazepines
constipation
confusion
vertigo
visual disturbances
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
what are serotonin receptor antagonist
ondansetron
granisetron
what are common SE of serotonin receptor antagonist
headache
diarrhea
fatigue
what are example of glucocorticoids
methylprednisone
dexamethasone
given IV
what are glucocorticoids used for
to suppress NV from chemotherapy
for severe emesis
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
what is the action of emetics
stimulate CTZ and acts directly on gastric mucosa
what is the use for emetics
induce vomiting after ingestion of toxic substance
what is caution for emetics
avoid vomiting if th poisoning is caused by ingestion of caustic substances (ammonia, chlorine bleach, toilet cleaners, petroleum)
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
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
how is diarrhea life threathening
loss of electrolytes
what are non pharmacological measure of diarrhea
clear fluids
oral sodium
pedialyte or ricolyte
IV electrolytes
antidiarrheal should not be used for more than n
2 days
how do we check for dehydration in babies and adults
babies check diapers
adults check eyes
what its eh frequent cause of diarrhea
E coli
what are the drug of choice for diarrhea
fluroruinolones
what drug is in the drug class fluroruinolones for diarrhea
loperamide
what does loperamide do
slows peristalsis sto decrease frequency of defecation
cause less CNS depression
purchased OTC
what are some preventtive measure for getting diarrhea
drinking bottled water boiled water eat washed fruits cooked veggies meat should be well cook
what is the purpose of antidiarrheals
treat diarrhea and hyper motility
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
what do opiates and opiate related agents inhibit
GI motility, decrease hyperperistalsis, slow passage of intestinal contents
what are examples of opiates and opiate related agents
coedine
lomotil
what is lomotil
diphenoxylate with atropine
less dependence
decreases abdominal cramping, intestinal motility and hypersecretion
(travelers diarrhea)
what is a drug example of somatostatin entailing
octreatide
what does octreastide inhibit
gastric acid, pepsinogen, and gastrin
decreases smooth muscle contractility
prescribed for severe diarrhea from metastiatic cancer
what does absorbent do
goat the GI walls and absorb toxins or bacteria/causing diarrhea and excrete these agents with the stools
what are examples of absorbent
pepto bismol
cholestyramine
what is cholestyramine
diarrhea due to excess bile acid in the colon
not FDA approved
what population is the major complaint for constipation
geriatric
what is the contributing factors for constipation
insufficient water intake and poor dietary habits
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
what do laxative do
promote soft stool
what do cathartics do
results in soft to water stool with some cramping
what are the types of laxatives
osmotic (saline) stimulatant (contact) bulk forming (drug of choice for pregnant women) emollient (stool softners) chloride channel activators
what are non pharmacological measures of constipation
diet containing fiver, water, exercise and routine bowel movements
when should you avoid laxatives
intestinal obstruction
symptoms of appendicitis
ulcerative colitis or diverticulitits
what do osmotic laxative include
salts, saline products, glycerin and lactulose
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
when are osmotic laxative use
bowel preparation for diagnostics or surgery
what are contradictions of osmotic laxative
clients with CHF with renal insufficient should avoid magnesium salts
what is the MAO of stimulant
increase peristalsis by irritating sensory nerve endings in the intestinal mucosa
what are examples of stimulants
bisacodyl
senna
castor oil
what is the most frequently used and abuse laxative
bisacodyl
what is caster oil
harsh laxative that acts on the small bowel and produces a watery stool
what are SE of stimulant
nausea, abdnomial cramps, weakness, fluid and electroylete imblalance
what are bulk forming laxative
natural fibrous substances
what does bulk forming do
promotes large soft stools by absorbing water int he intestine increasing bulk of luminal contents
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
what is the onset of action of bulk forming
8-24 hours and may take up to 3 days
what is bulk forming choice of
drug for pregnant women
what are examples of bulk forming
psyllium hydrophilic
methlycellulose
clients with diverticulosis, irritable bowel syndrome and colostomy may use which laxative
bulk forming
what are emollients
stoolsoftners and lubricants used to prevent constripation
emollients are usually prescribed after
MI or surgery
what are an example of emollients
docusate sodium
mineral oil
what does docusate sodium do
prevents constipation 1-5 days
what does mineral oil do
lubricant, absorbs essential fats vitamin A,E,K D
what are se of emollients
nausea, diarrhea, abdominal cramping
what are emollients contradicted in
children, geriatric, deliberating adults
-aspirate the mineral oil result in lipid pneumonia
what does chloride channel activators do
treats idopathic chronic constipation in adults
what is an example of chloride channel activators
lubiprostone
what dos lubiprostone do
acivates chloride channels in the lining of the small intestine, softens stool and increase motility
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
