Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > Gastrointestinal Drugs > Flashcards

Gastrointestinal Drugs Flashcards

1
Q

GI systems defense

NV side effects are called emetogenic

Reflex response to ingestion of harmful substances, sights, smells, and memories

Complications: bleeding, aspiration pneumonia, dehydration and significant weight loss, reopening f surgical wounds, severe acid/base imbalances

A

Nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CAM therapies

A
  • Relaxation
  • Hypnosis
  • Guided imagery
  • Acupuncture
  • Acupressure
  • Music therapy
  • Aromatherapy
  • Ginger
  • Laying down flat
  • Sniffing alcohol wipes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Antiemetic that blocks dopamine receptors in the brain

Inhibits signals to vomiting center in medulla

Uses: post-op nausea, vomiting, chemotherapy, radiation sickness

A

Dopamine Antagonists

Ex: Chlorpromazine (Thorazine), prochlorperazine (Compazine), promethazine (Phenergan), haloperidol (Haldol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Side effects & adverse effects of promethazine (Phenergan)

Applies to other dopamine antagonists

A

Side effects: Dry mouth, sedation, constipation, orthostatic hypotension, tachycardia

Adverse effects: Extrapyramidal symptoms with prolonged therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Antiemetic that blocks serotonin receptors in CTZ, blocks vagal nerve terminals in upper GI tract

More effective when used with dexamethasone

Uses: post-op, chemotherapy

A

Serotonin Antagonists

Ex: Ondansetron (Zofran), granisetron (Kytril), dolasetron (Anzemet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Side effects & adverse effects of ondansetron (Zofran)

A

Side effects: Headache, dizziness, hypotension, palpitations, constipation, edema, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Misc. antiemetic blocks dopamine receptors in CTZ

Uses: post-op emesis, chemotherapy, radiation therapy

High doses can cause sedation and fatigue

A

Metoclopramide (Reglan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Side effects of Metoclopramide (Reglan)

A
  • Drowsiness, fatigue, headache, anticholinergic side effects (constipation, urinary retention, blurred vision, tachycardia)
  • EPS (involuntary movements)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nursing interventions for antiemetics

A
  • Provide oral care after vomiting
  • Avoid alcohol when taking antiemetics
  • Avoid driving motor vehicles or engaging in risky behaviors
  • Monitor bowel sounds
  • Check vital signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antiemetics - Lifespan considerations for pediatrics

A
  • Tardive dyskinesia and other EPS associated with metoclopramide
    (Reglan)
  • Ondanestron doesn’t have CNS effects and may be indicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antiemetics - Lifespan considerations for pregnancy & breastfeeding

A
  • Consult with prescriber
  • Try diet and lifestyle changes first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antiemetics - Lifespan considerations for older adults

A
  • More likely to experience side effects (e.g. confusion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stimulates CTZ and acts directly on gastric mucosa

Induces vomiting

A

Emetics

Ex: Ipecac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Type of drug used to ease or stimulate defecation
* Soften the stool
* Increase stool volume
* Hasten fecal passage through the intestine
* Facilitate evacuation from the rectum
* Relieve or prevent constipation

Most not intended for long term use

A

Laxatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Classes of laxatives

A
  • Osmotic (saline) laxatives
  • Stimulant (irritant) laxatives
  • Bulk-forming laxatives
  • Emollients (stool softeners)
  • Combination preparations
  • Lubricants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should laxatives be avoided?

A

-S/sx of acute abdomen (severe abd pain, tenderness, fever, rigid abd, guarding)
-Abdominal obstruction
-Appendicitis, ulcerative colitis, diverticulitis

Do not assume its constipation. Get an Xray.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Laxatives that contain electrolyte salts

Hyperosmolar salts pull water into colon and increase water in feces to increase bulk –> stimulates peristalsis and defecation

Produces semi-formed to watery stool

Uses: Bowel prep for diagnostics or surgery

A

Osmotic (Saline) Laxatives

Ex:
* Sodium salts (sodium phosphate or Phospho-Soda)
* Magnesium salts (magnesium hydroxide [Milk of Magnesia],
magnesium citrate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Side effects of magnesium hydroxide [Milk of Magnesia]

A

Fluid & electrolyte imbalances, cramps, NVD, flatulence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Laxatives that irritate sensory nerve endings in intestines, stimulate peristalsis

Irritates mucosa

Uses: opioid induced constipation, slow intestinal transit

Can make constipation worse if used long-term

A

Stimulant laxatives

Ex: Bisacodyl (Dulcolax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Side effects & adverse effects of bisacodyl (Dulcolax)

A

Side effects: Dizziness, cramps, nausea, diarrhea, potassium and calcium imbalances, reddish/brown urine

Adverse effects: Overuse can decrease tone and sensation in the large intestine (usually reversible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Laxatives that absorb water into the intestine, increase bulk, and peristalsis

Typically works in 1-3 days

Uses: short term tx, IBS, ileostomy/colostomy

A

Bulk forming laxatives

Ex: Psyllium (Metamucil), polycarbophil (FiberCon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Side effects & adverse effects of psyllium (Metamucil)

A

Side effects: cramps, n/v/d, flatulence

Adverse effects: insufficient fluid intake causes intestinal obstruction

23
Q

Bulk-Forming Laxatives: Patient Teaching

A
  • Mix in glass of water or juice
  • Stir and drink immediately
  • Follow with another full glass of water
24
Q

Laxatives that promotes water accumulation in the intestine and stool

Uses: Stool softener, prevent constipation, decrease straining, post-op pts

Typically starts working in 1-3 days

A

Emollients (Lubricants and Stool Softeners)

Ex: Docusate sodium (Colace)

25
Q

Side effects of Docusate sodium (Colace)

A

NVD, cramping

26
Q

Nursing interventions for laxatives

A
  • Monitor fluid intake and output
  • Note evidence of fluid and electrolyte imbalance resulting from watery stools
  • Encourage patient to increase water intake
  • Advise patient to avoid overuse of laxatives
  • Warn patient that the drug is not for long-term use
  • Educate patient to consume foods high in fiber
  • Do not take drug within 1 hour of any other drug
27
Q

Type of drug used to decrease GI motility, decrease reabsorption/secretion of fluid in bowel, decrease activity of bacteria

  • Side effects: Constipation, abdominal discomfort, dizziness, dry mouth
  • Adverse effects (rare): Intestinal obstruction, toxic megacolon
A

Antidiarrheal Drugs

28
Q

Antidiarrheals: Nursing Interventions

A
  • Monitor frequency of bowel movements
  • Assess bowel sounds
  • Check for evidence of dehydration
  • Administer cautiously to pregnant patients, patients with glaucoma, liver disorders, or ulcerative colitis
29
Q

Antidiarrheals: Patient Teaching

A
  • Encourage patients to drink clear liquids
  • Avoid fried foods or milk products
  • If no relief in 2 days; if fever, abdominal pain, or distention occurs; blood or mucus appears in stool, notify prescriber
  • Avoid alcohol, other CNS depressants
30
Q

Antidiarrheals Life Span Considerations - pedi

A
  • Avoid bismuth subsalicylate (contains aspirin)
  • Infants and children at risk for dehydration
31
Q

Antidiarrheals Life Span Considerations - older adults

A
  • At risk for dehydration
32
Q
  • Affects upper GI system
  • Acidic stomach contents back up (refluxes) into esophagus
  • Can cause esophageal ulcers
A

Gastroesophageal Reflux Disease (GERD)

33
Q
  • Affects upper GI system
  • Gastric and duodenal ulcers
  • Breaks in mucosal lining
A

Peptic Ulcer Disease (PUD)

34
Q

GERD & PUD Meds

A
  • Histamine H2 blockers
  • PPIs
  • Cytoprotective drugs/Pepsin inhibitors
  • Prostaglandin analogues
  • Antacids
  • Antibiotics
  • Promotility drugs
35
Q

Acid prevention

A

Antacids
PPIs
H2 Blockers

36
Q

Mucosal Protectant

A

Cytoprotective drugs

37
Q

General patient teaching for GERD & PUD meds

A
  • Report reflux, heartburn, indigestion
  • Report bowel movements (frequency, consistency)
  • Don’t double dose
  • Report GI problems (dysphagia, pain, blood in emesis/stool)
  • Avoid alcohol, aspirin, NSAIDs, irritating foods
38
Q

Drugs that decrease secretion of gastric acid, heal and prevent ulcers

Blocks H2 receptors in stomach –> decreases acid production

End in “tidine”

Most OTC

A

Histamine H2 blockers

Ex: Cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid)

No more ranitidine (Zantac)

39
Q

Side effects of famotidine (Pepcid)

A

headaches, agitation, dizziness, n/v, constipation/diarrhea, erectile dysfunction, skin rash, pruritis, can decrease B12 absorption

40
Q

Nursing Interventions for Histamine H2 blockers

Ex: famotidine (Pepcid)

A
  • Administer 30 minutes before meals or at bedtime to decrease food-induced acid secretion
    (“-tidine” = 30 minutes before you go to dine)
  • Avoid smoking
  • Avoid NSAIDs
  • Tell patient that drug-induced impotence is reversible
  • Avoid foods and liquids that cause gastric irritation
  • Avoid overeating
  • Decrease stress
  • Avoid OTC use for more than 2 weeks, consult doctor
  • Watch for confusion in older adults!
41
Q

What to eat when you have an ulcer

A

fruits veggies, legumes, lean meats, fish & seafood, eggs, whole soy foods, fermented dairy, healthy fats, grains, green tea, herbs & spices

42
Q

What to avoid when you have an ulcer

A

alcohol, coffee, caffeine, milk or cream, fatty meats, fried foods, heavily spiced foods, salty foods, citrus foods & juices, tomatoes, chocolate

43
Q

Drugs that suppress secretion of gastric acid by inhibiting hydrogen/potassium ATPase in gastric parietal cells

Most powerful drugs for treating GERD and PUD

End in “azole”

A

Proton Pump Inhibitors (PPIs)

Ex: Omeprazole (Prilosec), Lansoprazole (Prevacid), Pantoprazole (Protonix), Esomeprazole (Nexium)

44
Q

Side effects and adverse effects of PPIs

A

Side effects: diarrhea, constipation, gas, headache

Adverse effects: allergic reactions, bone fractures from porous bones, GI bleeding

45
Q

Used as stress ulcer prophylaxis on Med-Surg units

A

PPIs

46
Q

Nursing Interventions for PPIs

A
  • Give approximately 30 minutes before meals, preferably in morning
  • Assess for black, tarry stools
  • Educate pts to report black/tarry stools, diarrhea, abd pain, persistent HA
47
Q

PPIs Considerations for older adults

A
  • May decrease calcium absorption (greater risk of fractures)
  • Regular bone density tests due to porous bones
  • May decrease vitamin B12 absorption
48
Q

PPIs Considerations for pregnancy & breastfeeding

A
  • Omeprazole- Category C
  • Other PPIs- Category B
  • Not recommended while breastfeeding
49
Q

Neutralize acidity of stomach contents, relieve heartburn and indigestion, decrease GERD symptoms, heal ulcers
* Short-acting

A

Antacids

Ex: Sodium bicarbonate (Alka-Seltzer), Calcium carbonate (Tums),
Magnesium hydroxide/aluminum hydroxide (Maalox), Aluminum
hydroxide (Amphogel) –> SCAM

50
Q

Side effects and adverse effects of antacids

A

Side effects (very rare): constipation (Al and Ca), diarrhea (Mg) = mellows GI tract), stomach cramps

Adverse effects: usually none

51
Q

Reminders for antacids

A

Impairs absorption of other drugs
* Anti-acids = anti-mixing
* 1 hour before or after other meds

Encourage patient to drink at least 2 oz of water to ensure drug reaches stomach

52
Q
  • Ulceration caused by mucosal lining erosion
  • Hypersecretion of HCl and Pepsin
  • pH of 2-5
  • Most common causes: H. pylori infection and NSAIDs
  • Symptoms: n/v, feeling bloated or full, food can make pain better or worse
A

PUD

53
Q

Meds for PUD

A

Antibiotics + PPI
* Amoxicillin + clarithromycin + PPI (standard triple therapy)
14 day course preferred

Other potential meds:
* Metronidazole (Flagyl): effective against sensitive strains,
side effects: n/v, can give if allergy to penicillin
* Bismuth subsalicylate (Pepto-Bismol): disrupts cell wall of H.
pylori

Pharm (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions