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pharm final > drugs of the GI tract disorders > Flashcards

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
Q

what does bismuth subsalicylate (pepto bismol) treat

A

gastric discomfort or diarrhea acts directly on the gastric mucosa

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26
Q

what are the forms of bismuth subsalicylate (pepto bismol)

A

chewable tablets and liquids

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27
Q

what does phosphorated carbohydrate solution do

A

works immediately
reduces hyperactivity of gastric wall smooth muscle
decrease nausea and vomiting by decreasing gastric pH
decreases smooth muscle contraction of the stomach

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28
Q

what patients should avoid phosphorated carbohydrate solution

A

diabetics because its sugar based contain dextrose, fructose and phosphoric acid

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29
Q

antiemetics should be prescribed cautiously in who

A

pregnancy first trimester

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30
Q

what is the popular antiemetic

A

trimethobenzamide hydrochloride

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31
Q

what does trimethobenzamide hydrochloride inhibit, administered and a caution

A

inhibits the medullary chemoreceptor trigger zone

administer by mouth, z track or real suppository

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32
Q

what can women who are pregnant take if vomiting becomes life threatening to mother and fetus

A

trimethobenzamide

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33
Q

what prescription antiemetic antihistamine drugs

A

hydroxyzine

promethazine

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34
Q

when is hydroxyzine given

A

preoperatively with opioids to prevent postoperative N/V and dizziness

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35
Q

when is promethazine prevent

A

prevents motions sickness, N/V

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36
Q

what drug is under anticholinergic for prescription antiemetic

A

scopolamine

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37
Q

what does scopolamine do and SE

A

treats motion sickness
one patch behind ear atlas 4 hours before, patch effective for 3 days

SE: drowsiness, dry mouth blurred vision

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38
Q

what are drug example for prescription antiemetic dopamine antagonists and what do they do

A

suppress emus by blocking dopamine receptors in the CTZ

  • phenothiazines
  • butyrophenones: droperidol
  • metaclopromide
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39
Q

what are the SE of dopamine antagonists

A

extrapyramidal symptoms caused by blocking dopamine rececptors (D2)

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40
Q

butyrohenones is

A

a dopamine antagoinsts

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41
Q

what does butyrophenones do

A

blocks D2 dopamine receptors
used as moderately effective antiemetics
used to treat postoperavie NV and emesis associated with toxins, chemotherapy and radio

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42
Q

what are examples under butyrophenones

A

haloperiodol

droperiodol

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43
Q

what may occur in butyrophenones

A

EPS symptoms if extended periods

hypotensin because it blocks norepinephrine which is why orthostatic hypotension may result

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44
Q

what should we monitor while on butyrophenones

A

BP

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45
Q

when are prescription phenothaine antiemetics used

A

in cancer clients

given the night before treatment, day of the treatment and for 24 hours after the treatment

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46
Q

what are phenothiazine antiemetic examples

A

prochlorphenazine and promthazine

47
Q

what are prescription benzodiazepines antiemetics used for

A

anxiety and sleep disorders

provides sedation, suppress the anticipation of emesis

48
Q

what are examples of benzodiazepines

A

lorazepam

diazepam

49
Q

what are SE of benzodiazepines

A

constipation
confusion
vertigo
visual disturbances

50
Q

what does serotonin receptor antagonist of the prescription antiemetic do

A

suppress NV

by blocking the serotonin receptors in the CTZ and efferent vagal nerve terminals

51
Q

what are serotonin receptor antagonist

A

ondansetron

granisetron

52
Q

what are common SE of serotonin receptor antagonist

A

headache
diarrhea
fatigue

53
Q

what are example of glucocorticoids

A

methylprednisone
dexamethasone

given IV

54
Q

what are glucocorticoids used for

A

to suppress NV from chemotherapy

for severe emesis

55
Q

what is cannabinoids

A

chemicals that help control the mental and physical processes

used for NV/chemotherpahy only when all other treatments have failed

schedule ll

56
Q

what is the action of emetics

A

stimulate CTZ and acts directly on gastric mucosa

57
Q

what is the use for emetics

A

induce vomiting after ingestion of toxic substance

58
Q

what is caution for emetics

A

avoid vomiting if th poisoning is caused by ingestion of caustic substances (ammonia, chlorine bleach, toilet cleaners, petroleum)

59
Q

what if vomiting is contraindicated in emetics

A

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
Q

what are the causes of diarrhea

A 
spicy or spoiled food
fecal impaction
bacteria (E.coli, slmonella)
viruses (parvo, rota virus)
toxins/drug reactions
laxative abuse
61
Q

how is diarrhea life threathening

A

loss of electrolytes

62
Q

what are non pharmacological measure of diarrhea

A

clear fluids
oral sodium
pedialyte or ricolyte
IV electrolytes

63
Q

antidiarrheal should not be used for more than n

A

2 days

64
Q

how do we check for dehydration in babies and adults

A

babies check diapers

adults check eyes

65
Q

what its eh frequent cause of diarrhea

A

E coli

66
Q

what are the drug of choice for diarrhea

A

fluroruinolones

67
Q

what drug is in the drug class fluroruinolones for diarrhea

A

loperamide

68
Q

what does loperamide do

A

slows peristalsis sto decrease frequency of defecation
cause less CNS depression
purchased OTC

69
Q

what are some preventtive measure for getting diarrhea

A 
drinking bottled water
boiled water
eat washed fruits
cooked veggies
meat should be well cook
70
Q

what is the purpose of antidiarrheals

A

treat diarrhea and hyper motility

71
Q

what are the types of antidiarrheals

A
  • opiates and opiate related agents
  • somatostatin analong, octreotide for severe diarrhea (only used for metastasis cancer)
  • absorbents: kaopectate
  • antidiarrheal combinations
72
Q

what do opiates and opiate related agents inhibit

A

GI motility, decrease hyperperistalsis, slow passage of intestinal contents

73
Q

what are examples of opiates and opiate related agents

A

coedine

lomotil

74
Q

what is lomotil

A

diphenoxylate with atropine
less dependence
decreases abdominal cramping, intestinal motility and hypersecretion

(travelers diarrhea)

75
Q

what is a drug example of somatostatin entailing

A

octreatide

76
Q

what does octreastide inhibit

A

gastric acid, pepsinogen, and gastrin
decreases smooth muscle contractility

prescribed for severe diarrhea from metastiatic cancer

77
Q

what does absorbent do

A

goat the GI walls and absorb toxins or bacteria/causing diarrhea and excrete these agents with the stools

78
Q

what are examples of absorbent

A

pepto bismol

cholestyramine

79
Q

what is cholestyramine

A

diarrhea due to excess bile acid in the colon

not FDA approved

80
Q

what population is the major complaint for constipation

A

geriatric

81
Q

what is the contributing factors for constipation

A

insufficient water intake and poor dietary habits

82
Q

what are the causes of constipation

A

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
Q

what do laxative do

A

promote soft stool

84
Q

what do cathartics do

A

results in soft to water stool with some cramping

85
Q

what are the types of laxatives

A 
osmotic (saline)
stimulatant (contact)
bulk forming (drug of choice for pregnant women)
emollient (stool softners) 
chloride channel activators
86
Q

what are non pharmacological measures of constipation

A

diet containing fiver, water, exercise and routine bowel movements

87
Q

when should you avoid laxatives

A

intestinal obstruction
symptoms of appendicitis
ulcerative colitis or diverticulitits

88
Q

what do osmotic laxative include

A

salts, saline products, glycerin and lactulose

89
Q

what is the action of osmotic laxative

A

hyperosmolar salts pull water into colon and increase water in feces to increasebult which stimulates peristalsis and defecation

90
Q

when are osmotic laxative use

A

bowel preparation for diagnostics or surgery

91
Q

what are contradictions of osmotic laxative

A

clients with CHF with renal insufficient should avoid magnesium salts

92
Q

what is the MAO of stimulant

A

increase peristalsis by irritating sensory nerve endings in the intestinal mucosa

93
Q

what are examples of stimulants

A

bisacodyl
senna
castor oil

94
Q

what is the most frequently used and abuse laxative

A

bisacodyl

95
Q

what is caster oil

A

harsh laxative that acts on the small bowel and produces a watery stool

96
Q

what are SE of stimulant

A

nausea, abdnomial cramps, weakness, fluid and electroylete imblalance

97
Q

what are bulk forming laxative

A

natural fibrous substances

98
Q

what does bulk forming do

A

promotes large soft stools by absorbing water int he intestine increasing bulk of luminal contents

99
Q

how do you mix powdered bulk forming laxatives

A

mix with water or juice, stir and drink immediately followed by a 1/2 or full glass of water

100
Q

what is the onset of action of bulk forming

A

8-24 hours and may take up to 3 days

101
Q

what is bulk forming choice of

A

drug for pregnant women

102
Q

what are examples of bulk forming

A

psyllium hydrophilic

methlycellulose

103
Q

clients with diverticulosis, irritable bowel syndrome and colostomy may use which laxative

A

bulk forming

104
Q

what are emollients

A

stoolsoftners and lubricants used to prevent constripation

105
Q

emollients are usually prescribed after

A

MI or surgery

106
Q

what are an example of emollients

A

docusate sodium

mineral oil

107
Q

what does docusate sodium do

A

prevents constipation 1-5 days

108
Q

what does mineral oil do

A

lubricant, absorbs essential fats vitamin A,E,K D

109
Q

what are se of emollients

A

nausea, diarrhea, abdominal cramping

110
Q

what are emollients contradicted in

A

children, geriatric, deliberating adults

-aspirate the mineral oil result in lipid pneumonia

111
Q

what does chloride channel activators do

A

treats idopathic chronic constipation in adults

112
Q

what is an example of chloride channel activators

A

lubiprostone

113
Q

what dos lubiprostone do

A

acivates chloride channels in the lining of the small intestine, softens stool and increase motility

114
Q

what happens with chloride channel activators

A

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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