Gastrointestinal Drugs Flashcards by Bryant Balantad

Non pharmacologic measures for Antiemetics

a. Weak tea (ginger, chamomile,mint..)
b. Gatorade
c. Crackers
d. Toast

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Acts directly to stomach to suppress gastric vomiting

Pharmacologic measures for Antiemetics

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Examples: Nonprescription antiemetics

a. Antihistamines
b. Dimenhydrinate (Dramamine)
c. Diphenhydramine (benadryl)
d. Bismuth subsalicylate (pepto-bismol)

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Side Effects: Non prescription antiemetics

a. Drowsiness
b. dry mouth
c. constipation

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Prescriptive Antiemetics

a. Hydroxyzine (vistaril)
b. Promethazine (phenergan)

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Example: Anticholinergic Prescriptive Antiemetics

a. Scopolamine

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Example: Dopamine Antagonists

a. Phenothiazines
b. Promethazine (phergan)
c. Butyrophenones
d. Metoclopramide (Regian)

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Side Effects: Promethazine

a. Drowsiness
b. dry mouth
c. blurred vision
d. tachycardia
e. constipation
f. urinary retention
g. photosensitivity
h. EPS (tardive dyskinesia, acute dystonia, akathisia)

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Inhibit CTZ, blocks H1 receptor sites

Promethazine

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blocks dopamine receptors (D2) receptors in CTZ

Butyrophenones

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Blocks d2 receptors in CTZ

Metoclopramide (Regian)

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Examples: Butyrophenones

a. Halopsine)eridol (haldol)
b. droperidol

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Side Effects: Butyrophenones

a. EPS
b. hypotension

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Side Effects: Metocloporamide

a. Sedation
b. diarrhea
c. EPS

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Cancer chemotherapy
Used in combination with a glucocorticoid and serotonin 5-ht3 receptor antagonist

benzodiazepines

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Example: Benzodiazepines

Lorazepam

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What class is Ondansetron under

Serotonin Receptor Antagonist

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Blocks serotonin receptors in CTZ and afferent vagal nerve terminals in UGI

Ondansetron

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Side Effects: Ondansetron

a. Headache
b. diarrhea
c. dizziness
d. fatigue

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Used for cancer chemotherapy

a. Serotonin Receptor Antagonist
b. Glucocorticoids

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Examples: Glucocorticoids

a. Dexamethasone (Decadron)
b. Methylprednisolone (Solu-Medrol)

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Act as antiemetics by binding to cannabinoid receptors in the brain, reducing nausea and vomiting by inhibiting the vomiting reflex

Cannabinoids

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Example: Cannabinoids

Dronabinol (marinol)

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Side Effects: Cannabinoids

a. Drowsiness
b. dizziness
c. euphoria
d. confusion

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Are substances that induce vomiting by stimulating the vomiting center in the brain or irritating the stomach lining.

Emetics

Stimulates CTZ & acts directly on gastric mucosa to vomit

Ipecac (OTC)

Administration: Ipecac

Use ipecac syrup, not ipecac fluid extract

Administration: Ipecac

Vomiting occurs in 15 to 30 mins

Decrease hypermotility

Antidiarrheals

Caution: Antidiarrheals

Should not be used for more than 2 days or if ever is present

Types: Antidiarrheals

a. Opiates and opiate - related agents b. Somatostatin analog c. Adsorbents

Opiates decrease GI motility

Opiates and Opiate - related agents

Examples: Opiates and Opiate - related agents

a. Paregoric (camphorated opium tincture) b. Diphenoxylate with atropine (Lomotil) c. Loperamide (Imodium)

Opiates may causee

Atropine

soft to watery stool with cramping

Cathartic laxatives

watery stool with cramping

Purgatives

Types: Laxatives

a. Osmotic b. Stimulants c. Bulk-forming d. Emollient (stool softeners)

Increase peristalsis

Stimulant ( Irritant )

Hyperosmolar salts pull water into colon, increase water in feces to increase bulk, which stimulates peristalsis

Osmotic (Saline) Laxatives

Examples: Osmotic (Saline) Laxatives

a. Polyethylene glycol (GoLYTELY) b. Lactulose (Chronulac)

Examples: Stimulant ( Irritant )

a. Phenolphthalein (Ex-Law, Correctol) b. Bisacodyl (Dulcolax)

Side Effects: Stimulant ( Irritant )

a. reddish to brownish urine

Results: Stimulant ( Irritant )

a. orally 6-12 hours b. supp 15-60 mins

Absorb water into intestines, increase bulk and peristalsis

Bulk Forming Laxatives

Side Effects: Bulk Forming Laxatives

a. Abdominal cramps b. Excess laxatives

Result: Bulk Forming Laxatives

8 - 12 hours

Examples: tranquilizers

a. Chlordiazepoxide and clidinium (Librax) is combination of anxiolytic / anticholinergic glycopyrrolate (robinul)

a. Lowers surface tension b. Promotes water accumulation in intestine c. emulsifies and lubricates feces for easier passage

Emollients ( Stool Softeners )

Side Effects: Emollients

a. Abdominal cramping b. nausea c. vomiting d. diarrhea

Pharmacologic measures for Anti ulcer drugs

a. Tranquilizers b. Anticholinergic drugs c. Antacids d. Histamine 2 blockers e. Proton pump inhibitors f. Pepsin Inhibitor g. Prostaglandin E1 analog

Example: Emollients

Docusate ( colace )

Use: Emollients

a. Prevents constipation b. Reduces straining post surgery or myocardial infarction

Reduces vagal stimulation, decreases anxiety

Tranquilizers

Non pharmacologic measures for Anti ulcer drugs

a. Avoid tobacco b. Avoid alcohol c. Avoid hot, spicy, and greasy foods d. Take any NSAIDS, including aspirin and oral glucocorticoids, with food or in decreased dosage e. Sit upright f. Do not eat before bedtime g. Wear loose-fitting clothing

Inhibits release of HCl by blocking acetylcholine and histamine

Anticholinergic drugs

Examples: Anticholinergic Drugs

a. Propantheline (Pro-Banthine)

Neutralize gastric acid, reduce pepsin activity

Antacids

Examples: Antacids

a. Aluminum (AL) hydroxide (Amphojel) b. Magnesium (mg) / aluminum hydroxide (Maalox) c. Sodium bicarbonate (Alka-seltzer

Reduce gastric acid by inhibiting hydrogen/potassium ATPase

Proton Pump Inhibitors

Examples: Histamine 2 blockers

a. Tidine family b. Cimetidine (tagamet) c. ranitidine (zantac) d. Famotidine (pepcid) e. nizatidine (axid)

Reduce stomach acid production by blocking histamine receptors in the stomach lining, which helps prevent and heal ulcers

Histamine 2 blockers

Examples: Proton Pump Inhibitors

a. Prazole family b. Esomeprazole (nexium) c. Pantoprazole (protonix) d. Omeprazole (prilosec) e. Lansoprazole (prevacid)

Example: Prostaglandin E1 analog

a. Misoprostol (cytotec)

Examples: Pepsin Inhibitor

a. Sucralfate (carafate)

Combines with protein to form thick paste covering ulcer, protects from acid and pepsin

Pepsin Inhibitor

Inhibits gastric acid secretion and protects mucosa

Prostaglandin E1 analog

Nursing Interventions: Anti Ulcer Drugs

Administer drugs before meals or at bedtime to decrease food induced acid secretion