Exam 3 Drugs Upper GI Flashcards
What do Antacids do
To neutralize or reduce acidity of stomach and duodenal contents (helps raise the pH of the stomach).
Antacid uses
Heartburn
Acid indigestion
Peptic ulcer
Gastroesophageal reflux disease (GERD)
Examples of Antacids
aluminum hydroxide magnesium hydroxide magaldrate magnesium oxide calcium carbonate
Magnesium and Sodium containing antacids can result in a
Laxative effect = diarrhea
Aluminum and Calcium containing antacids can result in
constipation
Calcium containing antacids higher incidents of
renal failure and kidney stone formation
Contraindication
In severe abdominal pain of unknown cause
Contraindication in Sodium containing antacids = contraindicated in patients with cardiovascular diseases
cardiovascular diseases
Calcium containing antacids=contraindicated in patients with
renal calculi and hypercalcemia
Interaction with Antacids
- Other oral drugs should not be administered with antacids.
- Give the antacid one hour before or two hours after other medications.
Antacids increase gastric PH and
decrease in absorption of weak acidic drugs
Histamine H2 Antagonists do what?
Inhibit the action of histamine at the H2 receptor cells of the stomach
By Inhibiting the action of histamine at the H2 receptor cells of the stomach what is happening in the stomach
Reduces secretion of gastric acid
Allows ulcerated areas to heal
Examples of Histamine H2 Antagonists
cimetidine
ranitidine
famotidine
Histamine H2 Antagonists Uses
Treatment of peptic or duodenal ulcer
Excessive secretion of HCL and GERD
Histamine H2 Antagonists Reactions
Mild transient diarrhea
May cause confusion and disorientation in older adults (mainly Cimetidine (Tagamet)).
Proton Pump Inhibitors treat what?
acid-related disorders
_________ is more powerful than the H2 antagonists.
Proton Pump Inhibitors
Currently indicated for first line therapy for erosive esophagitis, symptomatic GERD that is unresponsive to other treatment, and short term treatment for active duodenal ulcers and active benign gastric ulcers, and NSAID-induced ulcers.
Proton Pump Inhibitors
Proton Pump Inhibitors Contraindicated only if
known hypersensitivity
Proton Pump Inhibitors Generally well tolerated, may predispose the patient to GI tract infections due to
overuse of the medications.
Give Proton Pump Inhibitors _______ minutes before other _______ to avoid __________.
Give 30 minutes before other drugs to avoid interactions.
H. Pylori is a
Organism associated with chronic gastritis and large number of cases of peptic and duodenal ulcer
H. Pylori is Treat with triple drug regimen tell me what it is.
2 antibiotics
1 antisecretory drug (Prevacid, Prilosec, Aciphex, Nexium
Miscellaneous Acid Reducers Cholinergic Blocking Drugs
- Reduces gastric motility and decreases the amount of acid secreted by the stomach
- Have been replaced by the H2 antagonist because they have fewer side effects
Examples of Cholinergic Blocking Drugs
Propantheline
Glycopyrrolate
Miscellaneous Drugs Pepsin Inhibitors what do they do
Binds with protein molecules to form a substance that buffers acid and protects the stomach lining
Pepsin Inhibitors are used in long or short term treatments and what do they treat.
Used in short term treatments of duodenal ulcers
Most common adverse reaction of Pepsin Inhibitors
Constipation
Example of Pepsin Inhibitor
Sucralfate
Miscellaneous Drugs Prostaglandin Drug
what does it do
Inhibits the production of gastric acid and has mucosal protective properties
Prostaglandin is used to
reduce the risk of NSAID-induced gastric ulcers
Most common reaction of prostaglandin
headache, nausea, diarrhea, and abdominal pain
Example of a prostaglandin
Misoprostol
Gastrointestinal Stimulants treat
delayed gastric emptying and emesis
What do gastrointestinal stimulants do
Increase the motility of the upper GI tract
Does not increase the production of stomach secretions
Gastrointestional stimulants are mainly used for:
GERD and Gastric stasis
Main adverse reactions of Gastrointestional Stimulants
Restlessness, drowsiness, dizziness, itching, and difficulty breathing.
Examples of Gastrointestional stimulants
Metoclopramide
Dexpanthenol
Antiemetic is used to
treat or prevent nausea or vomiting
Antivertigo is used to
to treat or prevent vertigo
Vertigo S/S
feeling of spinning
motion sickness
Middle, inner ear problem
Vomiting is
stimulation of Chemoreceptor Trigger Zone (CTZ)
Impulse sent to vomiting center in Medulla
Action of Drugs for Anti-vertigo
- Inhibit CTZ = decreases vomiting/nausea
2. Depressing sensitivity of vestibular nerve in the inner ear = decreases vertigo
Uses for Antiemetics
Prevent or treat nausea and vomiting
Situations for use to Antiemetics
- Antiemetic before surgery to prevent vomiting in post operative period when recovering from anesthesia
- In conjunction with Cancer drugs to prevent vomiting
- In conjunction with radiation therapy
- Used with narcotics to prevent nausea that may be associated with admin of narcotic
Use of Antiemetic Drugs
To treat vertigo, motion sickness
Antiemetic Drugs Treat nausea/vomiting associated with:
Sickness
Medical disorders
Medication side effects
Preoperatively
Adverse Reactions of Antiemetic drugs
- Most common = drowsiness and sedation.
- Does directly affect the CNS and causes a depressant effect.
- Hypotension
- Respiratory depression
Precautions of Antiemetic drugs
- Causes of severe nausea and vomiting should not be treated with antiemetic meds alone – cause should be investigated
- Antiemetic medications can cause other medical disorders to go undiagnosed
Interactions of Anti-emetic drugs
Additive action with alcohol and CNS depressants Sedatives Hypnotics Antianxiety opiates
Examples of Meds Antiemetic
Phenergan
Tigan
Zofran
Examples of Meds Antivertigo
Antivert
Dramamine
Nursing Process Anti-emetic
- Document amount of vomiting
- Intake and Output
- Patient may be NPO and on IV fluids until nausea subsides and able to tolerate PO
- Vital signs
- With prolonged vomiting = daily weights
- Monitor effectiveness of medications
Goal of antiemetics
Manage Symptoms
Goals and Interventions Interventions
Observe s/s of dehydration (poor skin turgor, dry mucous membrane, decrease U/O Encourage sips of water Provide emesis basis Change clothing, refresh patient Measure I&O S/S of electrolyte imbalance
Goals and Interventions to Goals and Interventions
Assist with ambulation
Instruct patient to ask for assistance
Side rail up for elderly or confused
Patient Education
Drowsiness with use
Avoid driving
Avoid use with alcohol
Motion Sickness = take ___ hour before travel
1
Before anatineoplastic therapy
As ordered
How long before chemo treatment
30 min-1 hr before
Nursing Evaluation
Nausea and Vomiting controlled
No fluid volume deficit
Patient is injury free
Patient verbalizes compliance with prescribed treatment regimen.
What do Emetics
Drug that induces vomiting
How do emetics induce vomiting
Stimulates vomiting center in medulla
Emetics Uses
to empty stomach rapidly when there is accidental or intentional ingestion of poison or drug overdose
Contraindicated emetics
Unconscious, semiconscious
After ingesting corrosive substance such as strong acid
Example of emetics
Syrup of ipecac
For emetics you need to watch
Airway, risk of aspiration
To prevent aspiration how should you lay the patient
Position patient on side
Do not give when ingestion of
corrosive substance or petroleum substance (paint thinner, kerosene) has been ingested