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Pharm 1 Exam 3 > Elimination > Flashcards

Elimination Flashcards

1
Q

Proton pump inhibitor drugs, action, side effects, nursing interventions?

A

Drugs: Esomeprazole, omeprazole, pantoprazole
Action: Bind to H+ ions reducing gastric acid
Side effects: Headache, diarrhea, rash, nausea, dizziness
Nursing interventions: More effective than H2 receptor antagonists; heal 90% duodenal ulcers in 4 weeks, 90% gastric ulcers in 6-8 weeks.

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2
Q

H2 receptor antagonists drugs, action, side effects, nursing interventions?

A

Drugs: Cimetidine, famotidine, ranitidine
Action: Suppress volume & acidity or gastric secretions
Side effects: Depression w/ ranitidine
Nursing interventions: Do not take antacids at same time - reduces effectiveness. Cimetidine numerous drug - drug interactions. Supplement Vit B12. Monitor liver & kidney function. Anemia w/ long term use.

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3
Q

Antacids drugs, action, side effects, nursing interventions?

A

Drugs: Aluminum hydroxide, calcium carbonate (Tums), magnesium hydroxide, sodium bicarbonate (alka-seltzer).
Action: Neutralize stomach acid. Do not promote healing of the ulcer. Act in 10 minutes; lasts 2 hrs.
Side effects: Aluminum & calcium - constipation; magnesium - diarrhea, nausea, abdominal cramping.
Nursing interventions: None

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4
Q

Omeprazole (Prilosec) classification?

A

Proton pump inhibitor

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5
Q

Contraindications for Omeprazole?

A

Hypocalcemia
Vomiting
GI bleeding

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6
Q

Uses/action for omeprazole?

A

Gastric acid pump inhibitor; inhibits H+.
Relieves GI distress & promotes ulcer healing.
Uses: gastric ulcers, GERD, Dyspepsia > twice weekly.

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7
Q

Interactions with omeprazole?

A

> Phenytoin, diazepam, warfarin levels, antiretroviral agents, ginkgo, st john’s wort < plasma concentration, food < absorption by 35%.

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8
Q

Side effects for omeprazole?

A

None common.

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9
Q

Nursing interventions for omeprazole?

A

Report urinary problems: pain, blood in urine.
Diarrhea - drug may be discontinued.

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10
Q

How is helicobacter pylori treated?

A

Initial: proton pump inhibitor, clarithomycin (Biaxin) and amoxicillin (or other).
Alternative: PPI, clarithromycin & metronidazole (Flagyl) or PPE, bismth subsalicylate, metronidazole & tetracycline.

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11
Q

Patients who have heartburn may treat it with over-the-counter antacids. What patient education would you provide to a patient taking an antacid?

A

Take 2 hours before or after other drugs - can effect absorption of other drugs.

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12
Q

Angelina reports that for the past 10 years or so she has had intermittent constipation. What could be possible causes for her constipation?

A

Age (peristalsis slows)

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13
Q

Bullk forming drugs, action, side effects, nursing interventions?

A

Drugs: psyllium, methylcellulose
Action: Fiber, absorbs water, > fecal mass
Side effects: Abd fullness or cramping
Nursing interventions: Work slow, plenty of water.

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14
Q

Saline & Osmotic drugs, action, side effects, nursing interventions?

A

Drugs: Lactulose, magnesium, hydroxide, sodium biphosphate
Action: Pull water into colon quickly
Side Effects: Fluid & electrolyte imbalances, diarrhea, abdominal cramping
Nursing interventions: Used for bowel preps. Give w/ full glass of water.

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15
Q

Stimulant drugs, action, side effects, nursing interventions?

A

Drugs: Bisacodyl
Action: Irritate liming of intestines, act quickly
Side effects: Laxative dependence, fluid & electrolyte depletion, diarrhea, cramping.
Nursing interventions: Use sparingly

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16
Q

Stool softeners/surfactant drugs, action, side effects, nursing interventions?

A

Drugs: Ducosate
Action: Cause water & fat absorption into stool
Side effects: Abdominal, cramping, diarrhea
Nursing interventions: Prevent constipation, encourage water intake

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17
Q

Herbal agents drugs, action, side effects, nursing interventions?

A

Drugs: Castor oil, senna
Action: ———
Side effects: Abdominal cramping, diarrhea
Nursing interventions: ———

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18
Q

What classification of drugs can be given to treat diarrhea?

A

Opioids, Misc. drugs

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19
Q

Opioid drugs, action, side effects, nursing interventions?

A

Drugs: Diphenoxylate w/ atropine
Action: Slow peristalsis in colon
Side effects: Drowsiness, dizziness, nausea, dry mouth
Nursing interventions: Use only in acute diarrhea, due to opioid dependency. Contraindicated w/ glaucoma. No antihistamines - CNS depression.

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20
Q

Misc drugs - Bismuth salts action?

A

Binds & absorbs toxins.

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21
Q

Misc drugs - Psyllium action?

A

Add bulk to stool.

22
Q

Misc drugs - Lactobacillus acidophilus action?

A

Add normal flora back into intestine.

23
Q

What underlying condition can cause intermittent diarrhea?

A

Ulcerative collitis.

24
Q

Classification for sulfasalazine?

A

Anti-inflammatory DMARD (disease-modifying antirheumatic drugs)

25
Q

Contraindications for sulfasalazine?

A

Folate deficiency
megaloblastic anemia
renal failure
intestinal & urinary tract obstruction

26
Q

Uses/action for sulfasalazine?

A

Anti-bacterial & anti-inflammatory, inhibits prostaglandins that cause diarrhea.
Uses: off label use for Chron’s disease; rheumatoid arthritis.

27
Q

Interactions with sulfaslazine?

A

Antibiotics alter absorption.

28
Q

Side effects of sulfasalazine?

A

Nausea
Vomiting
bloody diarrhea
anorexia
headache
skin reactions

29
Q

Nursing interventions for sulfasalazine?

A

Monitor folate levels.
Discolor urine & Skin orange-yellow
Relapses - 40%
Monitor kidney function
Check for sulfa drug allergy.

30
Q

What are three steps in treating inflammatory bowel disease (IBD)?

A

1) 5-aminosalicylate acid medications (most rapid symptom relief)
2) If those fail, oral corticosteroids are used
3) Immunosuppressant drugs (methotrexate) 3 month onset of action.

31
Q

What are antiemetics used for?

A

Nausea and vomitting

32
Q

Anticholinergics & antihistamines drugs, action, side effects, nursing interventions?

A

Drugs: Hydroxyzine, meclizine
Action: ——-
Side effects: Drowsiness, dry mouth, blurred vision
Nursing interventions: Motion sickness - 20-60 minutes before travel

33
Q

Benzodiazepines drugs, action, side effects, nursing interventions?

A

Drugs: Lorazepam
Action: Relaxation & anti-emetic effect
Side effects: Dizziness, drowsiness, fatigue, slurred speech
Nursing interventions: ——-

34
Q

Cannabinoids drugs, action, side effects, nursing interventions?

A

Drugs: Dronabinol
Action: Relaxation & anti-emetic effect
Side effects: Dizziness, drowsiness, euphoria, confusion
Nursing interventions: ——–

35
Q

Corticosteroids drugs, action, side effects, nursing interventions?

A

Drugs: dexamethasone
Action: Anti-emetic
Side effects: Mood swings, wt gain, acne, insomnia, Na + fluid retention
Nursing interventions: Short-term acute nausea w/ chemo & post-surgical

36
Q

Neurokinin receptor antagonists drugs, action, side effects, nursing interventions?

A

Drugs: Aprepitant
Action: anti-emetic
Side effects: Fatigue, constipation, diarrhea, anorexia, nausea, hiccups
Nursing interventions: Chemo or surgery

37
Q

Phenothiazines drugs, action, side effects, nursing interventions?

A

Drugs: prochlorperazine, promethazine
Action: normally used to treat psychoses
Side effects: dry eyes, blurred vision, dry mouth, constipation, drowsiness
Nursing interventions: Chemo

38
Q

Serotonin receptor antagonist drugs, action, side effects, nursing interventions?

A

Drugs: Ondansetron
Action: —–
Side effects: Headache, drowsiness, fatigue, constipation, diarrhea
Nursing interventions: Chemo, radiation, surgery, given prophylactically

39
Q

Classification for Promethazine (phenergan)?

A

Antihistamine, antiemetic, antivertigo

40
Q

Contraindications for promethazine?

A

Angina, atrial fibrillation, hypertension, MAOIs, depression, hepatic disease.

41
Q

Uses/action for promethazine?

A

Depression of TZ in medulla.
Uses: motion sickness, N&V, nystagmus

42
Q

Before giving promethazine?

A

Take BP

43
Q

Interactions with promethazine?

A

Alcohol, CNS depressants, anticholinergics

44
Q

Side effects of promethazine?

A

Sedation, drowsiness, blurred vision, dry mouth.
Transient hypertension or hypotension

45
Q

Nursing interventions for promethazine?

A

Motion sickness - take 30-60 minutes before travel, repeat @ 8-12 hr intervals.
Do not drive until effects known.
Avoid alcohol, other CNS depressants.

46
Q

What are associated risk factors for peptic ulcers?

A

Close family history
Blood group O
Smoking tobacco
Caffeine
Drugs (corticosteroids, NSAIDS, platelet inhibitors)
Excessive psychological stress
Infection with helicobater pylori

47
Q

What are duodenal ulcers, and who do they occur in? Symptoms?

A

– More common than gastric ulcers
– Occur most commonly in 30-50 age group
– Usual symptom: Gnawing or burning upper abdominal pain
—— Occurs 1-3 hrs after a meal
—— Pain worse when stomach is empty
– Other symptoms: nocturnal pain, nausea, vomiting
– bleeding may occur
—— bright red blood in vomit
—— black, tarry stools

48
Q

What are gastric ulcers? Who do they occur in? Symptoms?

A

– Less common type of ulcer
– More common in over-60 age group
– Symptoms
—— Pain may be relieved after food or may continue after a meal
—— Anorexia, weight loss, vomiting
– remissions infrequent or absent
– more commonly associated with cancer

49
Q

What is GERD? Who do they occur in? Symptoms?

A

Gastroesophageal reflux disease
– Caused by loosening of sphincter between esophagus and stomach
– Associated with obesity
– Acidic stomach contents move up into esophagus
—— intense burning (heartburn)
—— lead to esophageal ulcers, esophagitis, or strictures
– Lifestyle changes can improve GERD symptoms

50
Q

Antacid drugs, mechanism of action, primary use?

A

Drugs: aluminum hydroxide, magnesium hydroxide, calcium carbonate
Mechanism of action: Neutralizes stomach acid by raising pH of stomach acid contents

51
Q

Antacid drugs, mechanism of action, primary use?

A

Drugs: aluminum hydroxide, magnesium hydroxide, calcium carbonate
Mechanism of action: Neutralizes stomach acid by raising pH of stomach acid contents
Primary use: In combination with other antiulcer agents for relief of heartburn due to PUD or GERD
—— Administer aluminum antacids at least 2 hours before or after other drugs because absorption could be affected
—— Aluminum, calcium - constipation; magnesium - diarrhea

Pharm 1 Exam 3 (5 decks)

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