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Pharmacology Final Exam > Drugs to Treat GI disorders > Flashcards

Drugs to Treat GI disorders Flashcards

1
Q

cimetidine (Tagamet): Class

A

Histamine-2 Receptor Antagonist

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2
Q

cimetidine (Tagamet): EPA

A

decrease amount, acidity, and pepsin content of gastric juices by inhibiting histamine 2 receptors

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3
Q

cimetidine (Tagamet): Use

A

treat PUD, GERD, GI bleeding, and Zollinger-Ellison syndrome (more gastric secretions)

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4
Q

cimetidine (Tagamet): ADRs

A

impotence, gynecomastia, decreased libido, confusion, arrhythmias, agranulocytosis, aplastic, anemia

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5
Q

cimetidine (Tagamet): contraindications

A
  • can increase blood levels of warfarin, phenytoin, lidocaine, ketoconazole, and theophylline
  • Avoid NSAIDs, aspirin, alcohol, or other GI irritants
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6
Q

cimetidine (Tagamet): RN Interventions

A

monitor for delirium, educate on medications to avoid, admin IV slowly to prevent bradycardia, avoid antacids within 1 hour of administration

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7
Q

omeprazole (Prilosec): class

A

Proton pump inhibitors (PPIs)

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8
Q

omeprazole (Prilosec): other drugs

A

pantoprazole, lansoprazole, esomeprazole

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9
Q

omeprazole (Prilosec): EPA

A

inhibits hydrogen potassium ATPase in stomach which inhibits gastric acid production

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10
Q

omeprazole (Prilosec): Use

A

PUD, GERD with esophageal erosion & Zollinger-Ellison syndrome. GERD prophylaxis in the hospital setting secondary to intubation or decreased mobility

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11
Q

omeprazole (Prilosec): ADRs

A

risk for bone density, loss with long-term use, abdominal pain, nausea, vomiting, diarrhea, hypomagnesemia

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12
Q

omeprazole (Prilosec): contraindications

A

teratogenic, avoid ketoconazole, it may increase warfarin, phenytoin, and diazepam levels, St. John’s wort decreases omeprazole levels

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13
Q

omeprazole (Prilosec): RN Intervention

A
  • only take for 8 weeks at a time
  • risk for osteoporosis increases with length of therapy (decrease calcium absorption)
  • take adequate amount of calcium, vitamin D, and magnesium
  • monitor for rebound acid hypersecretions when stopping the medication
  • maintain lowest possible dose
  • report any diarrhea immediately (risk for c. diff)
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14
Q

sucralfate (Carafate): class

A

mucosal protectant

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15
Q

sucralfate (Carafate): EPA

A

causes chemical reaction in the stomach thereby creating a gel that coast ulcers and creates barrier between the stomach and gastric secretions

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16
Q

sucralfate (Carafate): administration

A

take orally on an empty stomach, Four times a day (QID); 1 hr before mealtimes and at bedtime (hs). Do not give within 30 min of antacids.

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17
Q

sucralfate (Carafate): Use

A

treats peptic ulcers 4-8 weeks treatment, may bind to ulcer and form a protective barrier

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18
Q

sucralfate (Carafate): ADR

A

low incidence, not absorbed systemically, constipation and dry mouth

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19
Q

sucralfate (Carafate): interaction

A
  • decrease absorption of antibiotics: ciprofloxacin, tetracycline, and fluoroquinolones
  • decrease absorption of digoxin, phenytoin, diazepam, and warfarin
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20
Q

sucralfate (Carafate): RN Intervention

A
  • administer 2 hours before or after other medications that may decrease absorption
  • increase fluids and fiber increase
  • report severe constipation of diarrhea
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21
Q

aluminum hydroxide (Amphojel): class

A

Antacids

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22
Q

aluminum hydroxide (Amphojel): other medications

A

magnesium hydroxide (Milk of Magnesia); calcium-carbonate (Tums)

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23
Q

aluminum hydroxide (Amphojel): EPA

A

alkaline compounds that neutralize gastric acid

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24
Q

aluminum hydroxide (Amphojel): Administration

A

take with a full glass of water

25
Q

aluminum hydroxide (Amphojel): use

A

used to treat PUD and GERD

26
Q

aluminum hydroxide (Amphojel): ADRs

A
  • Calcium based (Tums): constipation
  • Magnesium-based (Milk of magnesia): diarrhea
  • Aluminum-based (Amphojel): hypophosphatemia
27
Q

aluminum hydroxide (Amphojel): contraindications

A

decreased absorption of tetracyclines, digoxin, fluroquinolones, aspirin (do not admin within 1-2 hours of taking these medications

28
Q

aluminum hydroxide (Amphojel): RN Interventions

A
  • monitor bowel functions for constipation or diarrhea
  • monitor phosphorus levels for aluminum based….
29
Q

ondansetron (Zofran): class

A

5-Hydroxytryptamine or serotonin receptor antagonist

30
Q

ondansetron (Zofran): other medication

A

granisetron (- tron)

31
Q

ondansetron (Zofran): EPA

A

Block 5-HT3 serotonin receptors in chemoreceptor trigger zone (CTZ) of brain; minimizes nausea and vomiting.

32
Q

ondansetron (Zofran): Use

A

treat nausea/vomiting secondary to chemo/radiation and in postoperative recovery

33
Q

ondansetron (Zofran): ADRs

A

torsades de point, stevens johnson syndrome, headache, dizziness

34
Q

ondansetron (Zofran): contraindication

A
  • prolonged QT syndrome (cardiac)
  • teratogenic
  • avoid SSRIs/SNRIs, tricyclic antidepressants, MAOI, lithium, buspirone and triptans due to risk of serotonin syndrome
35
Q

ondansetron (Zofran): RN Intervention

A
  • monitor QT interval on telemetry/ EKG
  • push slowly over 1-2 minutes if IV
  • can be given every 8 hours as needed
  • Educate client to report severe/persistent headaches
  • increased risk for falls
36
Q

dimenhydrinate: class

A

antihistamine/ anticholinergic

37
Q

dimenhydrinate: other medications

A

diphenhydramine (Benadryl)

38
Q

dimenhydrinate: EPA

A

prevents vertigo, nausea, and vomiting to blocked release of histamine (h1) receptors in inner ear and those connected to CTZ

39
Q

dimenhydrinate: Use

A

treat nausea/vomiting secondary to chemo/radiation therapy and in postoperative recovery

40
Q

dimenhydrinate: ADRs

A

anticholinergic effects (dry mouth, constipation, urinary retention, decreased bladder tone), sedation, drowsiness, dizziness

41
Q

dimenhydrinate: contraindications

A
  • BPH or those with risk of urinary retention
  • closed angle glaucoma, hyperthyroidism, cardiovascular disease, pregnancy and lactation
  • increased risk for sedating effects with other CNS depressants
42
Q

dimenhydrinate: RN intervention

A
  • increased risk for falls
  • educate on importance of frequent sips of water or hard candies
  • consume high fiber foods
  • use laxative support if needed
  • monitor BP and pulse when giving it via IV (risk for hypotension/bradycardia)
  • monitor for urinary retention
43
Q

metoclopramide (Reglan): Class

A

Dopamine Antagonist/ Prokinetic

44
Q

metoclopramide (Reglan): EPA

A

dopamine receptor blocker, increased threshold of CTZ in the brain

45
Q

metoclopramide (Reglan): Use

A

treat nausea and vomiting associated with chemotherapy, opioids, and radiation therapy. Can be used to increase GI motility in GERD

46
Q

metoclopramide (Reglan): ADR

A

Sedation, extrapyramidal reactions (incontrollable repetitive movements of tardive dyskinesia), restlessness, neuroleptic malignant syndrome

47
Q

metoclopramide (Reglan): contraindications

A
  • GI obstruction, hemorrhage, or perforation
  • Parkinson disease
  • Many drug interactions
48
Q

metoclopramide (Reglan): RN intervention

A
  • increased risk for falls
  • take the lowest dose possible
  • monitor for signs and symptoms of EPS or tardive dyskinesia
  • monitor for neuroleptic malignant syndrome
49
Q

What are the signs and symptoms of EPS

A

lip smacking, writhing motions, involuntary movements, involuntary spasms of the face and neck, anxiety

50
Q

What does neuroleptic malignant syndrome look like?

A

muscle rigidity, hyperthermia, tachycardia, diaphoresis, altered consciousness

51
Q

psyllium (Metamucil): class

A

Bulk forming laxative

52
Q

psyllium (Metamucil): EPA

A

adds bulk and stimulates peristalsis

53
Q

psyllium (Metamucil): therapeutic effect

A

relief from constipation within 8-72 hours

54
Q

docusate sodium (Colace): class

A

stool softener

55
Q

docusate sodium (Colace): EPA

A

changes surface tension of stool, increased water absorption into stool

56
Q

docusate sodium (Colace): ADR, implications, contraindications

A
  • may cause GI effects
  • it can affect the absorption of drugs
  • it is contraindicated with esophageal or GI obstruction, dysphagia
57
Q

bisacodyl (Dulcolax): class

A

cathartics

58
Q

bisacodyl (Dulcolax): Use

A

treat constipation, neurogenic bowel or for bowel prep

59
Q

bisacodyl (Dulcolax): therapeutic effect

A

taken PO usually produced bowel movement in 6-12 hours. Rectally administered produces a bowel movement within 15 minutes to 1 hour

Pharmacology Final Exam (4 decks)

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