gastrointestinal medications Flashcards
types of antacids
aluminum compounds, magnesium compounds, calcium compounds, sodium bicarbonate
antacids (general)
MOA:
I:
CI:
INT:
MOA: neutralize HCl = increase pH
I: any GI disease and as a calcium supplement
CI: renal disease/pregnant; hypercalcemia/magnesemia
INT: do not give with other meds
kinetics of antacids (general)
O:
D:
O: immediate
D: with food = 3hrs, without food 20-60min
side effects of antacids (general)
systemic imbalance (high Mg, low Phos)
Na retention
osteomalacia
diarrhea
pt education with antacids
take 2 hrs after other meds
1-3 hrs after meals
no max dose for >2weeks
keep hydrated to flush out
aluminum carbonate
C:
I:
CI:
SE:
C: antacid; aluminum compound
I: use with magnesium to counter laxative effect
CI: CHF, HTN, renal disease
SE: constipation
alka-seltzer
C:
I:
CI:
K:
SE:
C: antacid, sodium bicarbonate
I: inc urinary pH = excretion
CI: CHF, HTN, renal disease
K: onset quick, duration short
SE: metabolic alkalosis
TUMS, Rolaids
C:
I:
K:
SE:
C: antacid; calcium carbonate
I: source of dietary calcium
K: duration long
SE: constipation, belching, flatulence, kidney stone
magnesium hydroxide
C:
I:
CI:
SE:
C: antacid; magnesium compounds
I: laxative
CI: renal failure (kidney can’t rid Mg)
SE: diarrhea
omeprazole (Prilosec)
C:
MOA:
I:
CI:
INT:
SE:
C: proton pump inhibitor (PPI)
MOA: irreversible bind H+/K+/ATPase enzyme = block all HCl prod
I: most effective to dec acid
CI: crushed/opened caps, liver dis/preg/breastfeeding
INT: benzos, phenytoin, iron, dig
SE: HA, PNA, inc fx risk, malabs of calcium
what are other proton pump inhibitors ?
esomeprazole, lansoprazole, pantoprazole
t/f: omeprazole is high PB and has good bioavailability
true
education with omeprazole (Prilosec)
take 1hr before meals
long term = calcium citrate supplement
swallow whole
sucralfate (Carafate)
C:
MOA:
I:
INT:
SE:
C: pepsin inhibitor
MOA: no pepsin = no breakdown of stomach lining = protective barrier for 6hrs
I: PUD, stress ulcers
INT: not with other drugs
SE: constipation, nausea
frequency to take sucralfate (Cerafate)
QID before meals
ondansetron (Zofran)
C:
MOA:
I:
SE:
C: antiemetic; serotonin receptor antagonist
MOA: inhib type 3 serotonin receptors on afferent vagal nerve
I: prevent n/v in chemo + anes
SE: HA, prolonged QT int, torsades de pointes, dizzy
what is the first approved drug for chemo induced n/v and is better taken with dexmethasone (corticosteroid)
ondansetron (Zofran)
metoclopramide (Reglan)
C:
MOA:
I: + off label?
SE:
C: antiemetic
MOA: blocks dopamine receptors in CTZ
I: inc upper GI motility, post op n/v, off label GERD
SE: sedation, diarrhea
misoprostol (Cytotec)
C:
MOA:
I:
CI:
SE:
C: synthetic prostglandin
MOA: protect gastric mucosa = inc mucus and bicarb = inc cell regen
I: prevent NSAID ulcers
CI: pregnancy category X
SE: cramps, diarrhea
what to tell female patients with giving misoprostol (Cytotec)
take other forms of BC, drug is in pregnancy category X
cimetidine (Tagamet)
C:
MOA:
I:
CI:
INT:
SE:
C: histamine 2 receptor antag. (H2 blocker)
MOA: displace histamine from H2 receptor = no proton pump stim = no HCl
I: prevent ulcer, GERD, esophagitis, upper GI bleed
CI: elder, COPD, immunocomp = risk PNA
INT: alc, warfarin, CCB, caffeine (inc)
azoles, smoke, dig (dec)
SE: thrombocytopenia, dizziness, HA, PNA, leukemia
why is PNA a side effect of cimetidine (Tagamet)
cimetidine = H2 blocker = no HCl prod = nothing to kill bacteria from food = bacteria climbs up to resp tract = PNA
education for cimetidine (Tagament)
takes 4-6wks for ulcer to heal; continue to take
don’t use OTC bc diff potency
IV slow infusion (prev hypotension and cardiac dysrhyth)
other H2 blockers
famotidine, nazotidine
